Horizon Star - January 2019

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How the Active Offer provided comfort to two new Canadian residents

Sherry MacPhee, Nephrology nurse manager at Horizon’s Saint John Regional Hospital, and members of her teamwho took part in a successful Performance Excellence project to reduce work-up times for both kidney recipients and living donors, are photographed at the Nephrology clinic in mid-December. Pictured, from left: Evelyn Magee, RN and Renal Recipient Transplant Coordinator; Kayla McKay Transplant administrative assistant; Claribel Sosa Espinal de Rijos, Senior Project Manager, Performance Optimization; Dr. Paul Sohi, Nephrologist; Dr. Nessa Gogan, Nephrologist; Sue Melvin, RN and Renal Donor Transplant Coordinator; Sherry MacPhee, Nurse Manager; and Dr. Martin MacKinnon, Nephrologist. Missing from the photo is Dr. Christine Pippy, Nephrologist.

Béatrice Vermaut, 44 years old, became a New Brunswick resident in July 2017.

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Kidney transplant recipients to benefit from Performance Optimization project at Horizon care experience and quality of life.

While our family was in the process of immigrating to New Brunswick, I was

In Oncology, the physician made an effort to speak in my mother tongue. He always makes sure he is accompanied by a French-speaking nurse to ensure we both understand each other. Today, I do not even have to ask for my health care providers to speak French anymore; staff recognize me and automatically use my language of preference. Beyond the linguistic aspect, I would like sincerely thank the employees of Horizon Health Network for their professional and empathic approach. I know I am in good hands.

diagnosed with lymphatic cancer. We thought our dream was ruined. Fortunately, my cancer went into remission, and our trip to Canada could continue. Obviously, frequent medical check-ups are necessary, and I’m an Oncology patient at Horizon’s Saint John Regional Hospital. Before my first appointment, I was afraid that communication would be a barrier because my English is far from perfect!

The number of kidney transplants for Horizon’s Nephrology patients has increased over the last year, thanks to a project in Saint John focused on reducing work-up times for both kidney recipients and living donors. Claribel Sosa, Senior Project Manager, Performance Optimization has worked with the Nephrology team at the Saint John Regional Hospital (SJRH) to reduce the wait time for patients and donor candidates to complete their work-up process prior to receiving or donating a kidney. A work-up involves a number of tests and consults to ensure safety for transplantation. Transplants are then performed in Halifax. “This is important because kidney recipients can be placed on the active list sooner to ultimately reduce the time to get a transplant,” she said. “When patients have to wait a long time to receive a transplant, they are treated with dialysis and in some instances become ineligible for transplant due to worsening of their condition.” Likewise for donors, the sooner their charts are completed and evaluated, the sooner they can be approved to be donors. The number of transplants has increased from an average of 9.5 in the last four years to 15 transplants in 2018. There’s also been a reduction in cycle time and an increase in the number of recipient patients and living donor candidates work-ups completed (see factbox for more information). Recipient patients have had their transplants completed sooner, too, creating an improved

Success by the Numbers

Performance Optimization helped Saint John Regional Hospital’s Nephrology nurse manager Sherry MacPhee and team analyze their processes and discover the root causes of the wait times by applying Lean Six Sigma tools. They also provided guidance through the implementation and control phases of the project. As a result, the Nephrology team compressed and shortened the wait between patient tests, which meant fewer visits to the hospital for patients. As well, new cardiologists were added to the recipient and donor evaluation process, nephrologists created more time slots to assess patients and patients were also referred to centres with shorter wait times. Having a monthly goal and a target date for each patient, celebrating small gains to keep the team motivated, and engaging leadership, including project sponsor Geri Geldart, Horizon’s VP of Clinical Services and process owner Lisa Byrne, program administrator, helped make this project successful. Claribel’s advice to colleagues across Horizon who are embarking on a similar project is to implement change management processes early, as staff may feel overwhelmed with change, but don’t lose faith. “With time and persistence obtaining results is possible,” she said. The project has already saved more than $143,000 from avoided dialysis treatments.

Recipient Patients Reduced cycle time from 404 to 288 days from January 2018 to March 2018. Punctuality (work-ups completed within the eight months or less)

2016: 32 per cent 2017: 30 per cent 2018 (as of September): 63 per cent

My doubts quickly dissipated.

The Admission and Registration department offered me service in French immediately.

Number of patients who completed work-ups (per year):

2016: 25 2017: 22 2018 (as of September): 34

Agathe Robert, 27 years old, became a Canadian citizen in 2016.

It is sometimes difficult for me to express my questions in English, but staff always do their best to speak to me in French. This is highly appreciated and reassures me, because I can be sure sure I understand them correctly. I recently registered to take prenatal classes in French. I’m so happy Horizon provides this opportunity for French-speaking parents. For me, it’s a moment of intimacy, and having access to it in my mother tongue makes all the difference.

I’m pregnant with my first child.

Living Donors Reduced cycle time from 234 to 185 days for the months of June 2018 to September 2018. Punctuality (charts completed within the six months or less)

Of course, it’s a time of joy and euphoria. It is also a time of discovery and questions.

I want to express my gratitude to all Horizon staff that I interact with.

2016: 39 per cent 2017: 50 per cent 2018 (as of October): 61 per cent

Whether it’s doctors, medical administrative assistants or nurses, their approach is always professional and friendly.

Number of living donors with charts completed (per year):

2016: 10 2017: 12 2018 (as of October): 21

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