Horizon Star - April 2019

20 Years of Sleep Studies Atlantic Sleep Centre helps patients aged 16 to 96 Page 11

#ResearchAtHorizon Telepremie bridges gap from hospital to home Page 14

Take the Waste Walk challenge! Are you looking to work smarter, not harder? Page 15

Issue No. 16, Vol. 4 April 2019

A publication for the staff of Horizon Health Network

For the love of the game Group of therapists at Horizon’s SJRH create para ice hockey program to give everyone a chance to play Canada’s sport Page 5

A cautionary tale about a marijuana lollipop Page 6 Top 10: Your good luck charms Page 17


5 6 7 8 9 10

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Young volunteer brings comfort to patients at Miramichi Regional Hospital

Social Pediatrics program wins award Have you visited the Community News Channel lately?

A cautionary tale about a marijuana lollipop

Horizon employees save man’s life

Revolutionary change in diabetes care for Horizon patients

Fredericton Heart Function Clinic celebrates 1st anniversary

Group of therapists at Horizon’s SJRH create para ice hockey program

Atlantic Sleep Centre: 20 years of excellence



E-learning opportunity for Horizon employees Take the Waste Walk challenge! 15

Cochrane Library access New co-chair of Horizon’s PFAC 16





Partners for success: Horizon’s SJRH and NBCC Saint John Community Star Award recipients

#ResearchAtHorizon: Changing the care delivery experience for parents and babies

Top 10: What is your lucky charm?

Active Offer Every Day: What’s next?

Medication Reconciliation on Discharge at Upper River Valley Hospital

It’s easy to say Bravo! at horizonbravo.ca

On our cover: Occupational therapist April Lambert, physiotherapist Kristy Murray, and occupational therapistsDanielleChase, Lynn Fletcher andTinaMeegwere photographed in the Therapeutic Services department at Horizon’s Saint JohnRegional Hospital in earlyMarch.

In Every Issue Message from CEO Editor’s Note Colleagues’ Corner Look Who’s Shining Top 10

This magazine is published by Horizon Health Network’s Communications Department, and is distributed free of charge to Horizon staff, physicians and volunteers. A French version can be found online at fr.horizonnb.ca. Editor: GinaBeth Roberts Design and layout: Hudson Creative Agency Printed by: Advocate Printing Please send comments and/or story ideas to HorizonStar@HorizonNB.ca .

For the love of the game: Group of therapists at Horizon’s SJRH create para ice hockey program to give everyone a chance to play Canada’s sport

It was a Canadian Tire commercial that aired during the PyeongChang Winter Olympics that got Lynn Fletcher thinking: Why doesn’t Saint John have a para ice hockey league? In the commercial, a dad brings his son, who uses a wheelchair, to a pond to play hockey, outfitting him with a sled used in para hockey. A year later, that inspiration has become a reality, as Lynn, along with four colleagues in Therapeutic Services at Horizon’s Saint John Regional Hospital have set-up a para ice hockey program in – and for – their community. Fundy Para Ice Hockey is an association for anyone in the Greater Saint John area with or without disabilities who wants to try para ice hockey, formerly known as sledge hockey. The group was started by Lynn, and fellow OTs Danielle Chase, April Lambert and Tina Meeg, and physiotherapist Kristy Murray. They wanted to offer a low-cost winter activity to their community — one that showed people that if you have a disability or illness they are still ways you can stay active. The message of the commercial is the same as the one the group wants to convey through the league: Yes, anyone can play hockey. Para ice hockey is just a different way of playing it. Off-ice conditioning The group of women has kids that play hockey, and some even play hockey themselves or are

Dear Staff, Physicians and Volunteers, Since first joining Horizon over two years ago now, I have seen an improvement in the way Horizon is perceived in the community and in the media. Please be assured I am not taking credit for this development. It is the work you do every day that is being recognized, and for this, I am your biggest cheerleader. Horizon has always had a wealth of good news stories to share. And in the past I believe we lacked some of the communication channels, and perhaps, the confidence

A welcome note from the editor Welcome to the 16th edition of the Horizon Star! I hope the snow has completely melted away from our streets, sidewalks and parking lots by the time you’re reading this — that will be a sure sign spring is here! This new season brings with it a reinvigorating sense of purpose in our work (and a promise of summer just around the bend), as now is the time to plant seeds for future growth. This could be in your personal life, as you prepare your soil for your garden bed, which will foster the growth of nutritious and delicious vegetables, fruits and herbs. Or, this could apply to your professional life, as you invest in your role as an employee with courses, webinars or even a fruitful discussion with someone you haven’t met before. Maybe you even want to turn that spring cleaning into an official Waste Walk by signing-up for spring training with the Performance Optimization team and then be entered into their contest for some great prizes! Many who read this issue will be new grads, joining the Horizon team with new perspectives and skill sets. They will be oriented and welcomed by a team of veteran and experienced leaders in learning and organizational awareness. We are at our best when we have a team that’s a mix of both groups. In this issue, there are several stories on new research, new programs, and new faces. On page 16 you’ll meet the new chair of our Patient and Family Advisory chair, while on pages 8 and 14 you’ll read about new pieces of health care transforming the patient experience for the better. There are also pieces on storied teams, like the Atlantic Sleep Centre and Library Services, which have long brought advice and support to patients, clients and you and your colleagues. For the first time, our cover story features the volunteer work of Horizon employees. Turn to page 5 and you’ll read the story of a group of occupational therapists and physiotherapist who are using their work and life experience to bring Canada’s sport to everyone with a new para hockey program for Saint John. As always, it’s an honour to share your stories, and I hope you’ll continue to reach me at HorizonStar@HorizonNB.ca

to share them with our staff and public directly. Over the last 16 months Horizon’s Communications department has introduced more channels to share our stories and celebrate our employees. We now are active on social media; we profile stories of patient care in the Horizon Stories feature on our website; we have In Your Community, a publication about Horizon work that is improving community health; and we’ve recently created our newest channel — Horizon’s Community News Channel, where all this work, including videos, link together in one place. These channels, as well as this publication, the Horizon Star, allow us to learn from, and about each other. In an organization as large as we are, it’s sometimes a challenge to feel connected to staff that work in different departments and facilities. These storytelling channels allow us to grow as one organization. If you have story ideas you think would be of

Members of the Fundy Para Ice Hockey league at their first on-ice session.

as stopping during the learning stage involves running into a wall or each other). And while most of the equipment is the same, para ice hockey is played with a sledge and two modified hockey sticks, each with picks on one end to stick into the ice. The group invited the captain and assistant captain of the Fredericton Capitals para ice hockey team to lead their first on-ice session, and that’s where Tina got the full experience of just how difficult this sport can be. She quickly realized the crucial combination of upper body and arm strength, endurance, balance and a level of fearlessness that puts trusts in two narrow blades and a small seat. She was inspired by the less-fearful teenagers who’d quickly pop-up back up after falling down and supported by a set of blades that were widened during the learning process to make the sledge easier to balance. Even those who are new to the sport have experienced victories they may have never thought possible. Lynn remembers the smile of the face of a young girl who scored her first goal – and had two assists – during one of her first scrimmages. “Everyone looks the same,” said Danielle. “You can’t pick out who would have a disability or not.” “That’s the beauty of it,” said Lynn. Work connections Playing para ice hockey is a lot like occupational and physical therapy in that it involves solving a problem of functionality to allow a person to be able do something. That’s what these OTs and PT do in their everyday work. “We all went to school to help people be as independent as possible and I think this is just another part of this,” April said.

involved with other sports. Most of them are “at the rink all the time.” They quickly discovered that unlike Fredericton, Moncton and Sussex, Saint John didn’t have a para hockey program. However, there were sledges and other pieces of para ice hockey equipment at rinks across the city, and those pieces of equipment weren’t being used. The group began meeting during their lunch hours, and outside of work hours, and started developing the program – everything from a name, logo and swag, to sponsorship and advertising, to learning the rules and ice times. The program couldn’t have been possible without their many partners. They received a Go NB! Wellness grant from the Government of New Brunswick, and worked closely with Ability NB, Para New Brunswick, Hockey New Brunswick, Canadian Tire Jumpstart, and the City of Saint John. On-ice success With the support of these partners they were able to book ice times, purchase jerseys and swag, and offer a six-session learn-to-play program at no cost during February and March. The group advertised the program at hockey rinks, schools, on social media and with stakeholders, and welcomed 30 players from ages nine to 50, including father-son duos, friends, moms and brothers. Participants didn’t need to have any experience with hockey, and were all levels of ability, including players with disabilities and able-bodied players. The first session was in the gym, which allowed players to get the feel of the sleds on wheels – instead of blades. They also had to learn the rules, many of which are similar to ice hockey: it’s five-on-five, plus a goalie, and icing and off-side calls still apply. The penalties, called by upright referees, are different, though, and you can’t T-bone another player with your sledge (which is quite difficult,



Karen McGrath President and CEO

interest, please share them with our Communications team. If you’re working on some research or a new program that would be interesting to the public, Horizon would love to profile it. Every day Horizon provides safe and quality care to our patients, clients and their families. The large majority of those patients/clients are thankful for the care they receive at any of our 100 facilities. Many patients/clients have wondered in the past how to say a special thank you to someone that made their health care experience less hectic, or even enjoyable. Based on the success of the Bravo! program as a way to express gratitude and recognize a job well done among staff, now patients/clients and families can access the Bravo! program. Even before the official launch to the public, we received some Bravos! from the public from time to time. Introducing this opportunity was a very important step for our organization as we understand that recognition of good work instills pride and engagement with our staff and physicians. I look forward to recognition increasing across Horizon. By the time you are reading this, my spring CEO tour will be underway. During this forum, I will be looking to you to share your ideas for Horizon’s new strategic plan. The plan is set to be released in 2020, and we want input from as many stakeholders as possible. I am looking forward to some great discussions! In addition, don’t be surprised if I ask you to follow me on social media! After seeing the engagement happening on Horizon’s social channels, I could not resist. Please follow me on Twitter (@KarenCEOHorizon), Instagram (@KarenMcGrathCEO) and LinkedIn.

with new ideas. Happy reading,

Front row, from left: occupational therapists Lynn Fletcher and Tina Meeg. Back row, from left: occupational therapist Danielle Chase, physiotherapist Kristy Murray and occupational therapist April Lambert.

Karen McGrath President and CEO Horizon Health Network

…continued next page Look Who’s Shining! Know someone who’s accomplished something outstanding outside the workplace? Nominate a colleague, peer or volunteer for this feature by emailing HorizonStar@HorizonNB.ca .

GinaBeth Roberts Editor, Horizon Star

Colleagues Corner

Horizon employees save man’s life at local YMCA

Continued from page 4

A cautionary tale about a marijuana lollipop

A para ice hockey sledge and sticks.

On the morning of Jan. 13, 2019, Sarah Cleveland was at the YMCA in Saint John with her husband and young daughter. She was on the second level, walking the track, and had been there around 15 minutes when she stopped to talk to a family friend. She didn’t know at that time she was right next to a man whose life she would help save. Sarah is an instructor with the Saint John School of Radiological Technology. Prior to this role she was an X-ray and CT scan technologist at Horizon’s Saint John Regional Hospital, as well as other facilities. After stopping to talk to the friend, she kept walking around the track, and was on the other side of the room when she saw the man on the ground. There were a few people huddled around him, including a Horizon employee* from another site. Being a health care professional, her urge to help was instinctual. She went over to the man, and saw he was lying underneath a weight tree. She immediately assessed the situation, checking his vital signs only to discover “he wasn’t breathing, and he had no pulse,” she said. While someone called 911, YMCA staff

She believes everyone should know CPR, which is much more difficult on a body, compared to a mannequin, and how to operate an AED, which she says is made for people who aren’t health care professionals. Saint John Police Chief Bruce Connell was thoroughly impressed by the actions of Sarah and her fellow Horizon employee. “Although (the Horizon employees) are both trained healthcare professionals, there is no doubt that their quick assessment, reaction and taking charge of the situation saved a life. As you know in these situations time is of the essence,” he wrote in in an email to Horizon’s Regional Chief of Staff, Dr. John Dornan. The police force is forming a Commendation Board to review the Horizon employees as citizens and their contributions in this emergency situation. At press time, the review was still undergoing. As far as Sarah knows the man who she helped has made a full recovery. He dropped off a hand-written card and flowers to the YMCA, which the team shared with her during a debriefing of the incident. *The Horizon Star reached out to the other Horizon employee who helped save this man’s life, but requests to be interview for this story were not returned.

Dr. Alexandra Saunders never imagined a marijuana lollipop would put her on the national stage so early in her medical career — but it has. As Chief Resident of Dalhousie University’s Internal Medicine Program at Horizon’s Saint John Regional Hospital, she expressed an interest in cardiology. Knowing this, Dr. Robert Stevenson, a cardiologist at the NB Heart Centre, asked her to review a case of a 70-year-old Saint John man who presented at the Emergency Department after consuming a marijuana lollipop. The man, who had been managing his heart condition successfully for over two years, was showing signs of a heart attack, as well hallucinations, as the lollipop contained a high percentage of THC. THC is the cannabinoid responsible for the way your brain and body respond to cannabis (the psychoactive effects). Dr. Saunders called local cannabis dispensaries to learn more about the levels of THC in this particular lollipop. She eventually learned through online resources there was over 90mg of THC in it. The average intake per cannabis use is 7mg THC. The 70-year-old patient was not a regular user; in fact, he was experimenting for the first time in an effort to sleep better and relieve some arthritic pain. In the end, the patient was treated and once the effects of the THC wore off, his chest pain

retrieved an Automated External Defibrillator (AED) and others moved the weight tree, Sarah started compressions and the other Horizon employee soon after started the defibrillator. They did several rounds of CPR and two shocks with the AED before paramedics arrived and took over his care. The man came to during the third round of shocks from the AED, began breathing on his own and was transported to hospital for further care. “He was a lucky man,” Sarah said. “Had it happened somewhere where they didn’t have a defibrillator, or if he was by himself, the outcome could have been much different.” After the event, she thought maybe 10 minutes had passed, but it felt longer than 10 minutes. She learned after, it lasted only four minutes. At the School of Radiological Technology Sarah instructs student radiographers in a classroom setting, but has been involved in codes at the hospital, supporting the team by retrieving equipment or documenting events, especially during her time in Diagnostic Imaging, but she’s never done chest compressions before. “You don’t have a crash cart, you don’t have the medications, you don’t have the doctors and respiratory therapists ... you just don’t have those resources in public,” she said.

All have busy days in outpatients or acute care, working with patients of all ages – from pediatrics to geriatrics. They do everything from pressure management to hand therapy, making sure patients are strong enough to return home. They also work with physicians and other health care professionals, making plans for discharge and referrals to special care or nursing homes. As Lynn’s party definition for Occupational Therapy lays it out: We help you get on with it. Occupational therapists and physiotherapists often work closely together to enable people to be safe and independent at home. “You have some kind of health issue and you have to go home and live life,” she said. “You have to have a job; you have to take care of your kids. You also have to have some fun and stay healthy. We’re all about getting you back to that.” They help people make big or small differences in their everyday life after health issues affect independence. This could be creating a new way to make a meal, manage the stairs or an adaptation to your home. “There’s a lot of Velcro and duct tape involved sometimes,” said Lynn. They also want to make sure their patients can remain active. “It’s pretty central to what we all believe in,” said Lynn. “We want our patients to get home and be independent, safe and active. Being active is how you maintain your health and it’s what in New Brunswick we really need to focus on.” The future of Fundy Para Ice Hockey By press time, the buzzer will have sounded of the league’s its final ice time, but they have hopes for its growth next year. They hope to have organizers, coaches and players who want to continue the program, and implement a weekly ice time and develop a team. Hockey coaches are certified through Hockey New Brunswick, and Para Ice Hockey is under the umbrella of Hockey New Brunswick and Hockey Canada. They group would love to combine with teams from other New Brunswick communities to play in tournaments, and would love to have an athlete that reaches the national stage. If you’re interested in playing, coaching or off-ice support with the Fundy Para Ice Hockey league, email fundyparaicehockey@gmail.com, contact them on Facebook (Fundy Para Ice Hockey) or join your local league.

resolved. He was able to return home, but for several months had more difficulty with shortness of breath and low energy level. Since the legalization of cannabis there has been much discussion about its effects on one’s health, and there are still many unknowns. Drs. Saunders and Stevenson knew they needed to share their findings with the medical community about what could happen to people with a history of cardiovascular disease who use edibles. Furthermore, cannabis-laced edibles are set to become legal in fall 2019, therefore more medical research is welcomed, and Drs. Saunders and Stevenson have become experts in the emerging area of interest. They co-authored a research paper, “Marijuana Lollipop-Induced Myocardial Infarction” that was recently published in the Canadian Journal of Cardiology, a well-known and reputable medical journal. “Marijuana can be a useful tool for many patients, especially for pain and nausea relief,” said Dr. Saunders. “At the same time, like all other medications, it does carry risk and side effects and it’s important that people realize what can happen.” Their article has resulted in media interest from around the world. “It’s been very rewarding to be part of something that has received so much attention from the medical community so early in my career,” said Dr. Saunders. The findings are valuable for medical professionals to share with their patients on the risks associated with using edible marijuana. For others, this patient’s story is a cautionary tale for anyone experimenting with edibles. Dr. Robert Stevenson, a cardiologist at the NB Heart Centre.



Dr. Alexandra Saunders, Chief Resident of Dalhousie University’s Internal Medicine Program at Horizon’s Saint John Regional Hospital.

Sarah Cleveland, an instructor with the Saint John School of Radiological Technology, is pictured in a classroom in early March.

Want to tell your colleagues about the services you provide for patients and staff throughout Horizon? Email HorizonStar@HorizonNB.ca .

Young volunteer brings comfort and companionship to patients at Horizon’s Miramichi Regional Hospital

A revolutionary change in diabetes care for Horizon patients

Dr. John Dornan, an endocrinologist and Horizon’s Regional Chief of Staff, is always looking for ways to reduce complications for his diabetes patients. Recently, while working with Type 1 diabetic patient Alicia Hunt, he recognized the potential a new type of insulin pump technology could have on her life. The pump, which Dr. Dornan calls an “artificial pancreas,” would mimic functions of healthy pancreas. After four weeks of use, the pump has exceeded Alicia’s expectations. “My husband says he hasn’t seen me this well in ages,” she said. “I’m happier and just doing better all around.” The MiniMed 670G Insulin Pump System was developed by Medtronic and approved by Health Canada in fall 2018. It is the first insulin pump to support closed-loop functionality for basal insulin. Alicia met with Dr. Dornan and Marilyn Heighton, a registered nurse who is also a certified diabetes educator, at Horizon’s Saint John Regional Hospital in late January of this year, where they helped her begin using her

The Medtronic MiniMed 670G Insulin Pump System is referred to by Dr. John Dornan as an “artificial pancreas” because it mimics functions of healthy pancreas.

Robert Loggie has wisdom and maturity that belie his 22 years, perhaps from knowing that for as long as he could remember he wanted to help people in his community.

And for the past decade, he has.

“I have been volunteering with various organizations since I was 12 years old and it has always been something I’ve been passionate about,” said Robert, a volunteer with Horizon’s Miramichi Regional Hospital (MRH). Robert has known his calling for most of his life: he wants to practice medicine. Volunteering would not only help him get into medical school but also help him learn important skills. His most important reason for volunteering, however, is because he is able “to make a small but significant impact in patients’ lives,” he said. Every Monday and Tuesday evening the enthusiastic Mount Allison grad spends a couple of hours, sometimes more, hoping to do just that. Whether it’s bringing a snack or socializing and playing cards with patients, some of whom are in palliative care, Robert is empathetic and fully present with the patient, something he believes means so much to them. “Some patients just need someone to talk to and someone to listen to them,” he said. “I think everyone needs someone to talk to and it’s not always possible for the nurses or other staff to spend a lot of time with an individual patient.” “Sometimes the patient’s family and friends aren’t physically able to stay with them 24/7, and sadly, some patients don’t have anyone to visit them. This is where volunteers can help.” Robert recounts a friendship that developed between him and an elderly patient who had been hospitalized at MRH for several months. One of the patient’s daughters expressed to him how much of an impact he had made to her mother’s life. This comes as no surprise to Lori Sabo, Volunteer Coordinator at MRH. “He really got to know the patient and her interests,” she said. “When he discovered she loved gardening, he would come in early, thumbing through magazines to find one on gardening for her.” “It really made me happy to know I’d made such an impact on a patient’s life,” said Robert.

new technology – one of the first patients in Atlantic Canada to do so. “We dreamed the artificial pancreas would be here in our lifetime and now it’s here,” said Dr. Dornan. “It’s one of the revolutionary changes in diabetes care in my career. It will be one of the biggest things I see.”

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Horizon patient Alicia Hunt wears her newMedtronic MiniMed 670G Insulin Pump System.

This was an emotional day filled with happy tears for Alicia and her health care team; this small device was going to make big changes in her life. “I know in my heart of hearts this pump is going to give me a longer life expectantly and a fuller life,” said Alicia. The new insulin pump technology gives insulin automatically and safely. Now, a patient’s blood sugars will not drop too low while they sleep or rise dangerously high during the day. “With significantly better blood sugar control than I’ve had in decades, I wake up feeling well and full of energy,” she said. “The other day I spend 90 per cent of my day in target range. That alone was a huge accomplishment!” She’s happy to have more control over her diabetes, allowing her to do more of the things she loves, like be a mom and dance with her three-year old daughter. “We are planning camping trips with our daughter for the summer and I can’t wait,” she said. “I’ll take every moment this pump has given to me.” Alicia has already experienced the benefits.

Robert Loggie, 22, volunteers at Horizon’s Miramichi Regional Hospital, and hopes to make a “small but significant impact in patients’ lives.”

“He’s just fantastic,” said Lori. “He’s just a very thoughtful person. (Recently) some colleagues were commenting about how mature Robert is. He seems so comfortable with himself, self- assured and focused.” Those are required qualities to work with all patients, especially those in Palliative Care. “Many of these people are within their last days and maybe even hours of life,” Robert said. “If I can provide them with some support and company during their remainder of time here on earth, that can have a positive impact.” The breadth and depth of the experience Robert has acquired in this role over the past couple of years lines up well with his future goals. “I want to go to medical school and to get in, it is very important to demonstrate one’s involvement in the community. It also helps demonstrate to medical schools that you have an idea about what you’re getting yourself into and that you are committed to medicine,” he said. Lori and the staff and patients who interact with Robert are preparing themselves for the

day when Robert inevitably announces he will be leaving for medical school. “We would certainly wish him the best,” said Lori. “But we hope he sets up his practice in Miramichi and stays here.” These are big “ifs,” but it seems to be a possible path for Robert’s career aspirations, much of it stemming from his passion to help others through volunteering. No matter your ambitions, Robert believes volunteering is something everyone should consider. “Volunteering can help people learn important skills and gain beneficial experiences, no matter their goals in life,” he said. “For me, volunteering with Horizon has increased my self-esteem and my happiness and has enhanced my communication skills and my leadership skills. Not only is it very rewarding, it’s just a kind thing for someone to do.” If you would like to experience the rewards of volunteering with Horizon, get in touch with Horizon’s Volunteer Resources Department at your local hospital or volunteer.resources@horizonnb.ca.

Dr. John Dornan, endocrinologist and Horizon’s Regional Chief of Staff, and Marilyn Heighton, a registered nurse who is also a certified diabetes educator, were both overjoyed to see their patient, Alicia Hunt, receive a new pump system.

Lori says that staff are noticing as well.

Fredericton Heart Function Clinic celebrates first anniversary The Heart Function Clinic at Horizon’s

Atlantic Sleep Centre: 20 years of excellence

The Atlantic Sleep Centre at Horizon’s Saint John Regional Hospital is proud to be celebrating its 20th anniversary. The Atlantic Sleep Centre opened its doors to patients on Feb. 5, 1999 under the direction of Dr. Rachel Morehouse and manager Terry Walker, Registered Polysomnographic Technologist (RPSGT). Since then, the centre has seen over 10,000 patients and has performed more than 8,000 in-lab sleep studies. Patients come from New Brunswick, Prince Edward Island, Nova Scotia and Newfoundland and have ranged in age from 16-months-old to 96-years-old. The Atlantic Sleep Centre became the first sleep centre in Canada to become accredited through the American Academy of Sleep Medicine on Aug. 16, 2005. This accreditation was effective for five years and the centre was recertified again in 2010 and 2015. Staff plan on always keeping the accreditation through renewals. The Atlantic Sleep Centre organized and hosted the first Maritime Technical Sleep Conference in May 2005. This conference attracted sleep technologists, respiratory therapists and nurses from across the Maritimes, offering a forum for discussions and education on the latest information in the field of sleep. It was a lot of work but the results exceeded expectations. The sleep centre hosted the conference again in 2007, and every two years thereafter, alternating hosting duties with the Queen Elizabeth II Sleep Centre in Halifax until the final conference was held in 2011. In October 2017, the Atlantic Sleep Centre started an outpatient Level 3 Sleep Study program, and since then there have been 3,165 referrals. Staff have collaborated with the hospital’s Heart Failure Clinic for many years to identify patients that should be referred to the sleep centre, and in 2018 the sleep centre began collaborating with the Diabetes Education Centre to identify diabetes patients that should be referred to the Atlantic Sleep Centre.

The sleep centre’s technologists have been involved in several community-based talks over the last 20 years, including theProgram for Intensive Life Skills (PILS) PILS program through Horizon’s St. Joseph’s Community Mental Health Program, The ABZzzz’s of Sleep at the Saint John Public Library through Horizon’s St. Joseph’s Community Health Centre and a Sleep Information Session for Horizon’s Ridgewood Addiction Services. The team has also made presentations on sleep and given talks and presentations (too numerous to mention) over the past 20 years. Research has been important to the Atlantic Sleep Centre over the last 20 years, too. Dr. Morehouse had been conducting research since the centre’s beginnings, and Dr. Sullivan has joined her in this endeavour when he joined in January 2005. In total, 18 research studies have been completed. The topics of these research studies have included insomnia, obesity and PTSD, narcolepsy and restless legs syndrome and comparing Level 3 sleep studies (at-home studies) to Level 1 sleep studies (gold standard in-lab studies). The Atlantic Sleep Centre team currently consists of: three physicians, Dr. Glen Sullivan, director; Dr. Rachel Morehouse; and Dr. Graham Bishop (Dr. Prakash Joshi retired from the Sleep Centre in 2007); one clinical coordinator and Chief Registered Polysomnography Technologist, Holly Stuart (a temporary position, as Andrea Savoy is on leave of absence); four Registered Polysomnography Technologists, Barb Richard, Tracey Aylward, Janna Morin and Laura Woodhouse; a secretary, Wendy Hayes and, a receptionist, Kim Bailey. Thank you to the Atlantic Sleep Centre team for 20 successful years! The Atlantic Sleep Centre invites all staff and the public to its Open House on Friday, May 10 from 9 a.m. to noon for tours and light refreshments.

Woodbridge Centre recently celebrated one year of providing heart failure patients in the Fredericton area with timely and specialized care and support. Staff at the clinic, which welcomed its first patients in January 2018, assess and manage the symptoms and medications of heart failure patients and support positive behaviour and lifestyle changes, such as diet and physical activity. Rachel Garland, the clinic’s full-time registered nurse, is the heart of the clinic. Heart failure patients have a very high incidence of readmission and 50 per cent could die within the first five years of diagnosis. However, if managed, they can live longer, with a better quality of life. That’s why having a Heart Function Clinic, where Rachel can see these patients more timely and with specialized care, is so important. “We work on making sure they understand their conditions and what they can do to prevent hospitalizations,” said Rachel. Their close relationship allows her to recognize when something is going wrong. She helps

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Rachel Garland, Colleen Donnelly and Julie Harding are photographed in Rachel’s office at the Heart Function Clinic at Horizon’s Woodbridge Centre. Not pictured is Dr. Jeffrey Moore.

She also works closely with the neighbouring cardiac rehabilitation clinic, as they share resources like admin support, a dietitian and other disciplines. They’ve already seen an increase in positive outcomes for patients who have been referred to the Heart Function Clinic, a decrease in hospitalization for clinic patients, less time in hospital for those who are admitted, and overall cost savings on the health care system. From a director’s perspective, Colleen Donnelly, administrative director Administrative Director for Women & Children’s Health and Ambulatory Care Clinics in the Fredericton area, said starting a new clinic that has such a close relationship with its patients, is extremely exciting and overwhelming. “It’s phenomenal to see the positive impact that Rachel has made with the Heart Function Clinic,” said Colleen. The team experienced common challenges associated with setting up a new program, but were supported by the two other Heart Function Clinics within Horizon, located at Horizon’s The Moncton Hospital and Saint John Regional Hospital. There are now six heart function clinics in New Brunswick (the other three under Vitalité), and they hope to eventually develop a network and program standards for all the six clinics.

them make small changes in their daily life, such as cutting down on high-salt meals and providing education on the signs and symptoms of fluid overloading. Being that support and being able to provide early intervention instills confidence in her patients, many who wish they’d had this type of clinic years earlier. “I know quite a few people that have benefitted from this clinic,” said nurse manager Julie Harding. “They do need to be seen by somebody who knows what they’re doing and can save that trip to the Emergency Room because maybe it is just a slight medication adjustment and follow-up with bloodwork that Rachel can do so well.” Follow-up patients take a Minnesota Living with Heart Failure questionnaire, which provides their health care professionals with information on the more subjective aspects of their lives, such as depression and anxiety, on intake and six months later. The team can tailor each patient’s treatment through follow-up appointments, phone calls and nurse- and physician-led clinics. Rachel works collaboratively with cardiologists and internists for the best possible medication and treatment plans, who make the referrals for any patient who would be at the clinic. Together, they follow a very specific type of triple therapy, outlined by the Canadian Vascular Society Guidelines.

The Atlantic Sleep Centre team, pictured here, is celebrating 20 years of excellence in patient care and research. Missing from the photo is LauraWoodhouse.

Social Pediatrics program wins national award and successfully implemented in dozens of other sites across the United States and Canada. “It is well documented that children facing

Partners for success: Horizon’s SJRH and NBCC Saint John

A Horizon hospital has been awarded the first Industry Partner Award from its neighbouring college, celebrating a long and beneficial relationship between the education and health care institutions. For more than four decades, New Brunswick Community College (NBCC) has been a driving force in New Brunswick’s economic and social prosperity. NBCC’s programs, services and initiatives support the aspirations of individual learners, further the opportunities of the labour market and, in collaboration with partners, enable solutions for the challenges of communities and industry. One of those partners is Horizon’s Saint John Regional Hospital (SJRH), the largest tertiary care hospital in New Brunswick. For years, the SJRH has partnered with the Saint John Campus of NBCC in a mutually beneficial relationship. “The relationship with NBCC has existed for as long as both facilities has existed,” said Brenda Kinney, executive director of the Saint John region of Horizon. “It’s a relationship that developed out of necessity; we depend on having a workforce that is prepared by NBCC.” For decades, NBCC graduates in the health care, administrative and trades fields have found work at the hospital. Before they graduate, they also benefit from use of training equipment donated by the hospital, use of The Community Star Awards are given to an individual, group, company, organization or a community involved in the promotion of addiction prevention, intervention or postvention activities. The recipients of the 2018 Community Star Awards were Rachel Mills (Miramichi area), Ensemble Moncton (Moncton area), Avenue B (Saint John area), and Fredericton Housing First Services (Fredericton and Upper River Valley area). “Horizon is pleased to support our Community Star recipients, because that’s truly what they are,” said Jean Daigle, Horizon’s VP of Community. “Whether through lived experience, or providing support to those who need it, our 2018 Community Stars are living our Horizon mission of helping people be healthy by allowing many to overcome barriers and empower their future.” The Community Star Awards are sponsored by the Department of Health. Every year, each area within Horizon and Vitalité Health Networks selects an award recipient from the community during National Addictions Awareness Week, which promotes a healthy lifestyle and helps reduce the risk of addiction among the general population.

organizations in the community aiming to better the care of families and children. Dr. Marianne McKenna, originally from Summerside, P.E.I., joined in 2009 as a General Pediatrician. Active in medical education and advocacy, she is the Regional Director of Medical Education for Dalhousie University. She is a lead in the Child Advocacy Centre project which is bringing holistic and one-stop services for children suspected to have suffered from sexual maltreatment. Marianne is on the board of the teen pregnancy network and is the lead for the Social Pediatrics clinical elective at Dalhousie Medicine New Brunswick. Dr. Annie Murphy-Savoie is originally from Saint John and returned after her training at Memorial University and Toronto Sick Kids as a Developmental Pediatrician specializing in behavioural and developmental disorders. She has a practice in Horizon’s St. Joseph’s Hospital and continues to be actively involved in advocacy in the community and research to ensure the best care of kids in New Brunswick. Annie was very involved in the development of the early learning centre in the south end of Saint John, which serves children in one of our focus neighbourhoods. This team of pediatricians and researchers are invested in improving the long-term health and social outcomes of our children. Their commitment and strong community ties are the cornerstone of Community Social Pediatrics in New Brunswick.

social disparities, trauma and toxic stress will experience a disproportionate number of negative physical and mental health outcomes across their lifespan,” said Dr. Gander. “From

The New Brunswick Social Pediatrics team. From left: Sarah Campbell, Dr. Sarah Gander, Dr. Marianne McKenna, Dr. Annie Murphy-Savoie and Kathryn Flood.

A Horizon initiative helping children and families in their social lives, community and society has won a grant from a national organization, which it will use to further help families struggling with addiction. New Brunswick Social Pediatrics (NBSP) is a relatively new initiative developed with the primary purpose of improving the quality of life, health and long-term outcomes of children and their families in our province. The team, based at Horizon’s Saint John Regional Hospital, is led by Drs. Sarah Gander, Marianne McKenna and Annie Murphy-Savoie. They are supported by Sarah Campbell, research manager, and Kathryn Flood, research coordinator. In February, NBSP was awarded a $25,000 grant from The National Chapter of Canada IODE to implement the Strengthening Families Program. The program focuses on high-risk families struggling with addiction in the Saint John area. The program uses parent-child therapy techniques, and focuses on intervention, teaching effective parenting strategies and helping children learn skills, through interactive play, that may decrease their risk for behavioral disorders and future addictions. “The emphasis on the whole family is key to the success of this program,” said Dr. Gander. “This is seen as a potentially life-altering program to vulnerable families as it provides parent-coaching, a meal and models a supportive, healthy environment for families.” Ten families will participate in this 14-week pilot program in the fall, with follow-up sessions six and 12 months later. NBSP’s flagship project is the Parent-Child Assistance Program (PCAP), a three-year program that targets women who use drugs or alcohol during pregnancy and aims to help break the cycle of generational poverty in our priority neighbourhoods. PCAP is specifically tailored to address the needs of pregnant and recently postpartum women who experience alcohol- and substance-use disorder. This program was piloted in Washington State in the early 1990s with positive results and has since been evaluated, expanded,

this understanding emerged the field of Community Social Pediatrics, which seeks to impact health at the community level and addresses the needs of children and families in a way that reflects the social context of their lives, community and society.” About the team Dr. Sarah Gander is a native to New Brunswick who has settled in Saint John and is raising her family of two boys, Eddie and David with her husband Steve. Sarah started her practice as a pediatrician in 2008 after training in Newfoundland and Kingston, Ont. She is the Pediatric Clinical Department Head in Saint John and has a busy clinical practice. Sarah is faculty at both Dalhousie University and Memorial University of Newfoundland and completed her Master of Education in 2016. Sarah is very involved with numerous

From left: Chris London, NBCC Board of Governors; Brenda Kinney, executive director, Saint John area, Horizon; and Marilyn Luscombe, NBCC President and CEO.

hospital resources, practicum placements and support for applied research projects. “Applied research at NBCC has really grown the last 10 to 15 years, and that’s led to a really good partnership between NBCC, the University (of New Brunswick at Saint John) and us as a living lab,” said Brenda. “Our co- location here in Tucker Park has really opened up lots of opportunities between partners.” In celebration of the partnership between the College and the hospital, NBCC Saint John has

awarded its first Industry Partner Award to the SJRH. The award recognizes the hospital’s consistent and dedicated support of NBCC learners and alumni. “We’re thrilled to receive this award,” said Brenda. “It’s an absolutely wonderful recognition of a very important partnership, one that both parties benefit from. We are very happy to be in partnership with NBCC.”


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*This article has been slightly adapted from the original version, which appeared on NBCC’s website.

Community Star Award recipients help others overcome barriers, empower their future

The 2018 Community Star Award recipients are truly bright lights in their communities.



From left: Mike Ryan, Housing First coordinator; Bruce MacPherson, director for Horizon’s Addiction and Mental Health Services in the Fredericton and Upper River Valley areas; and Shelby MacIntyre, Housing First coordinator.

Charlotte Pickford (left), programmanager for Horizon’s Addiction and Mental Health Services in the Miramichi area, and Rachel Mills (right).

Have you visited Horizon’s Community News Channel lately? If not, you’re missing out on some amazing Horizon stories told through words, photos and videos. Discover the community news channel at news.horizonnb.ca. Have a story to tell? We’re always looking for new voices and content. If you have a story to share on the community news channel, please email ginabeth.roberts@horizonnb.ca or call 506-850-5731.


Jill LeBlanc-Farquharson (middle), director of Horizon’s Addiction and Mental Health Services for the Moncton area, and DebbyWarren (left), executive director at Ensemble, along with colleagues. Horizon congratulates these valued community partners.

Saint John

Susan Neal and Renee Fournier, managers of Addiction &Mental Health Services, present the Saint John award to Julie Dingwell, executive director of Avenue B along with staff and clients.

#ResearchAtHorizon: Changing the care delivery experience for parents and babies through technology

Improving the Health Care Experience of Transgender Individuals: E-learning opportunity for Horizon employees From Public Health Sexual Health and Horizon Learning Services teams

Interested parents of NNICU infants were randomly assigned to either a Telehealth group or a standard of care group. In the standard of care group, parents would simply attend a follow-up appointment with their primary care provider 24 hours after leaving the NNICU (as well as any other appointments scheduled with specialists). In the Telehealth group, parents had two additional virtual visits (a day before and a day after the standard of care primary care provider follow-up appointment) that involved a home monitoring kit designed by Krisan and her team. Using the kit, parents would weigh the baby on a scale that shared the data with the NNICU team via a tablet. A small sensor secured around the baby’s ankle would also send data on oxygen saturation back to the clinical team at the hospital. A movable web cam completed the kit, and allowed the parents to provide the health care team with precise real-time interactive video of the baby. While parents’ responses to surveys levels did not indicate less anxiety or more confidence, interviews told a different story: parents found the home monitoring appointments reassuring and positive.

In our ongoing efforts to provide exceptional care to every person, every day, the Horizon Public Health Sexual Health team, in collaboration with the transgender (trans) community and pertinent community stakeholders, embarked on an initiative to better understand the unique health care experience of our trans community. This work, done in partnership with Horizon Learning Services, led to the development of the e-learning module Improving the Health Care Experience of Transgender Individuals. Many trans individuals reported experiencing discrimination, harassment and refusal of care in health care settings. It was also cited that the trans community reported avoiding routine and/or emergency care as a result of these negative and sometimes harmful experiences. Health care staff also expressed a desire to learn about providing culturally-sensitive and respectful care to trans patients and clients. Several members of the trans community and family members participated in the project. They provided input in-person and over the phone. They bravely spoke about their life journeys and experiences with the health care system. One participant shared her experiences as being positive and supportive in nature. Her wish was to debunk common myths and misperceptions that exist for trans people.


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Leanne Davis, research coordinator at Horizon’s Saint John Regional Hospital, chats with colleagues Natasha Hanson, research writer, and Krisan Palmer, Horizon’s regional manager for Telehealth, via Telepremie technology.

A program designed and led by Horizon teams is helping our most vulnerable patients and their parents connect with their health care providers through technology. Horizon’s Telehealth Program began its journey to improve patient care through technology in 1998 with post-surgical home monitoring for heart surgery patients – a program that continues today as the longest- running telehealth initiative in North America. Because of the numerous solutions created by Telehealth, barriers to receiving follow- up health care, such as the availability of a specialist in the community, living far from the hospital or clinic, and poor weather conditions, can be reduced and often eliminated.

While Telehealth has designed solutions for departments, such as the NB Heart Centre, oncology, a provincial emergency stroke network, and palliative care home visits, more recently the program’s staff focused on helping our smallest patients – the babies of the Saint John Regional Hospital’s neonatal intensive care unit (NNICU) and their parents. Krisan Palmer, regional manager for Telehealth, and her team, were approached by Dr. Cecil Ojah, neonatologist at Horizon’s Saint John Regional Hospital. Dr. Ojah was interested in using technology to make the transition from the intensive care unit to home less stressful and more empowering for new, anxious parents. “Ultimately, TelePremie was about designing a solution to ‘bridge the gap’ and facilitate a smooth transition from the hospital to the home, ultimately empowering parents with the knowledge and confidence they needed to take care of their babies after staying in the NNICU,” said Krisan. The team then requested the support of Horizon’s Research Services’ SOAR Team (Support Opportunities and Assistance for Research), a unique program that paired the applicants with experienced research professionals to design and manage their proposed research study of their telehealth solution for the NNICU. The successful project, TelePremie: Telehomecare for step-down care post-NICU discharge, ran from August 2017 to March 2018, and was funded through Canada Health Infoway.

the trans community face. We want to acknowledge the honesty and contribution of the individuals who told us their stories and shared their truth. Thank you so very much! The e-learning is available to all Horizon staff on Skyline, under Tools and Resources. We hope this module is a first step in breaking down barriers to care and reinforcing that safe, culturally-appropriate and inclusive care is a human right for all!

The Improving the Health Care Experience of Transgender Individuals e-learning module went live in September 2018 to all community health staff. Due to the overwhelming interest and completion rates, in November 2018 senior leadership asked the e-learning be shared with all Horizon staff. This has been a very humbling and rewarding project for our team. We have gained valuable knowledge and awareness of health inequities

The data also showed that it was possible for the health care teams to accurately assess the babies’ clinical stability, opening potential applications to other areas, such as other mother-baby programs. The possibilities are endless, with exciting new advances on the horizon. designed by Krisan and her team. Using the kit, parents would weigh the baby on a scale that shared the data with the NNICU team via a tablet. In the Telepremie program, parents had two additional virtual visits that involved a home monitoring kit



Are you looking to work smarter, not harder? Then it’s time to get waste walking!

Waste walks are a fantastic way to empower your employees, teams and departments to make improvements in their workplaces. They can be big or small – anything from clearing out a storage closet to replacing equipment that results in financial savings to improving wait times for patients or clients. To celebrate seven years of developing a culture of continuous improvement at Horizon, Performance Optimization is challenging staff to reduce waste.

All validated waste walks from April 1 to Sept. 30 will be entered to win one of three prizes, including the top prize of a Fitbit (to track your next waste walk, maybe?) and Horizon swag. Horizon has nearly than 600 waste walkers on its team — and we want you to join! To be eligible for the challenge, you must have completed the waste walk training. You can register for upcoming training session on Performance Optimization’s Skyline page.

The Research Team included: • Cecil Ojah, MD • Jennifer Woodland, PhD • Natasha Hanson, PhD • Leanne Davis, MA • Krisan Palmer, RN • Darlene DeCourcey, BN, RN

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waste walks have been reported! 777

Horizon employees have been trained! 596

This research would not have been possible without the help/support of: • Tanya McFarlane • NNICU nurses and administrative assistants • Dr. Luis Monterrosa, neonatologist • Participants

From left: Krisan Palmer, Horizon’s regional manager for Telehealth, Leanne Davis, research coordinator, and Natasha Hanson, research writer, are photographed at Horizon’s Saint John Regional Hospital with technology and equipment used in the Telepremie program.

Horizon employees have received their White Belt certificates!

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