Horizon Star - March 2021

Research findings from Horizon’s Saint John Therapeutics project published in national journal

Special bond: Sisters, sisters-in-law and sisters in transplant

Linda Duncan, a nursing unit clerk at Horizon’s Saint John Regional Hospital (SJRH), jumped on the opportunity to go from being a Horizon employee to a Horizon patient. In 2020, Linda’s sister Sandy became ill with a recurring Clostridium Difficile Colitis (C. Diff) infection. When asked, Linda, who has been part of the Horizon team for 32 years, did not hesitate to help her sister. “When Dr. Jacquelyn LeBlanc, an infectious disease specialist asked me (to do a fecal transplant), I replied with, “Do you mean a poop transplant?’” Linda laughed as she said how unique it sounds. Linda and Sandy have a special sisterhood. They are sisters by blood, but they are also sister-in-laws, having married the Duncan brothers 47 and 49 years ago. Throughout the years the Duncan family has experienced a lot, but in March of 2020, they embarked on one of their most challenging experiences. For many, March 2020 brings back thoughts of the beginning of the COVID-19 pandemic in New Brunswick, but for the Duncan sisters the month also marks Sandy’s breast cancer diagnosis. In April, Sandy underwent lumpectomy surgery. “Since it was day surgery, she didn’t need to stay in the hospital, which we were thankful for, due to COVID-19 restrictions,” said Linda. “But in the months following surgery, Sandy wasn’t feeling well, and she needed to be admitted to the hospital in July for C. Diff.” C. diff can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon. The Duncan sisters anticipated a short

call themselves to book an appointment at a time convenient for them, with high priority patients receiving priority appointments,” said Becky. “The small change made a big impact in administrative efficiency.” A few months into the implementation of OAB, a University of New Brunswick professor and applied psychologist, Dr. David Speed, who was looking to conduct advanced studies in the area of OAB, began working with Becky and Shelly Fyffe, former Horizon Process Improvement Facilitator, to analyze the findings of the OAB project, beginning with OT data. The goal of the study was to see if OAB improved administrative outcomes in OT. The study looked at the number of referrals, wait times for first appointments, whether there would be more rapid discharges, and whether there was a change in missed appointments. Becky and her team monitored raw data for number of calls, no shows and wait times to track the progress when using OAB.

Occupational Therapy (OT) data collected from Horizon’s Saint John Therapeutics’ Open Access Booking Model Project has been published in a national journal. Open-access booking (OAB) refers to the administrative system by which patient appointments are scheduled. In 2017, a need was identified to make scheduling patients in Therapeutic Services, including OT, Physiotherapy, Audiology and Speech Language Pathology in the Saint John area more efficient. Becky McCollum, Director of Therapeutic Services Saint John Area and her team wanted to reduce outpatient waitlists and increasingly long wait times experienced by patients for these services. Through a LEAN Six Sigma approach, the Saint John Therapeutics team transitioned to an open access booking model. “Patients were able to self-refer and could

The results of the study in OT found there was an increase in referrals from clients. Wait times did not necessarily decrease, however more clients were seen. It was found that patients were discharged faster, as they would progress more rapidly through the OT system with the same quality of treatments. This allowed therapists to take new clients sooner. There was no change recorded in missed appointments for OT, although this was seen in the data for the other disciplines involved. This work was published in Volume 87, Issue 5, of the Canadian Journal of Occupational Therapy 2020 in an article titled “Investigating Open-access Booking in New Brunswick Occupational Therapy” by Dr. David Speed and Shelley Fyffe. With the overall success in improving administrative outcomes, OAB will become a regional solution, set to roll out to Therapeutics in the Moncton, Fredericton and Miramichi areas in the spring of 2021.



Sisters Linda Duncan (right) and Sandy Duncan (left) have many incomparable experiences in life, including marrying a set of brothers. In 2020 they added a fecal transplant to their list, which helped Sandy recover from ClostridiumDifficile Colitis (C. Diff).

hospital stay, however Sandy’s condition continued to worsen with many problems arising, including kidney failure. “While being in the hospital, Sandy missed her window of opportunity for radiation,” Linda said. “She has been through a lot, but was able to get better, and I am so happy that I was able to help.” When Linda started sharing the news that she would be doing a fecal transplant for her sister, many colleagues and friends expressed how they have never heard of the procedure. “Fecal transplant is recognized as a very effective modality for cure in patients who fail

standard therapy for Clostridium Difficile,” Dr. LeBlanc said. The procedure, performed by gastroenterologist Dr. Cory Gillis, was a success, and Sandy was discharged in October. Today, she is back to running errands and going about her routine. “We are so thankful to all the staff. Sandy spent time on many different units and everyone was great,” Linda said. “We wanted to share our story, so people can hear about fecal transplants and how for us it was a great option to help Sandy.”

Sisters Linda Duncan (left) and Sandy Duncan (right) have many incomparable experiences in life, including marrying a set of brothers. In 2020 they added a fecal transplant to their list, which helped Sandy recover from ClostridiumDifficile Colitis (C. Diff).

Becky McCollum, Director of Therapeutic Services, Saint John area (right) sits with Tracy Underwood, OT Manager Saint John Area, who played a key role in the success of the OAB project. The Saint John Therapeutics Open Access Booking Model Project won Horizon’s Quality Quest Award in 2019.

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