Special Feature: Accreditation Countdown

Surveyors will be on-site in just five short weeks: May 31 to June 4, 2009. Activities planned over the next few weeks include an Accreditation Fair, mock surveys, and presentations by Agency staff, to help prepare staff for the site visit (we’ll bring you more on what to expect for the site visit in the May issue). While we recognize this is a busy time for staff, we encourage all staff to take part in as many of these activities as possible.

This issue includes a Q&A – common questions that you have been asking through the Accreditation Survey in March, and of your Accreditation team leaders – and we focus on two more new key areas: Communication and Medication Management.

We also have two extra features on Fire Response (part of Worklife/Workforce key area) and Steps for Disclosing a Critical Incident to a Patient or Family (part of the Culture of Safety key area). 

Make sure to complete our Accreditation Quiz: the Sequel at: www.surveymonkey.com/s.aspx?sm=M_2b0_2biOJYDgjpGsGLwhMRig_3d_3d   

Accreditation Q&A

Accreditation Quiz: the Sequel

Once you've had a chance to review the newsletter, make sure to complete our newest Accreditation Quiz: Are you smarter than an Accreditation Surveyor: the Sequel. You'll have a chance to win one of two $50 gift certificates to the Cactus Club. Your responses will help us identify your learning needs for upcoming activities.

Click here for the quiz:
http://www.surveymonkey.com/s.aspx?sm=M_2b0_2biOJYDgjpGsGLwhMRig_3d_3d What, exactly, does the Accreditation survey look like?
For those of you familiar with the old style of Accreditation, a lot has changed in recent years. Accreditation Canada takes a very hands-on approach to the process now. During their visit to the BC Cancer Agency, Surveyors will have both formal and informal meetings with staff, leadership, patients, volunteers and community partners. The Accreditation Surveyors encourage a great deal of participation from BC Cancer Agency staff and partners, and you will be urged to discuss their perceptions and expectations. The Surveyors will visit many areas of the Agency, including research, to speak with staff and visitors, review documents, and observe our activities and processes in action.

A video describing the tracer method that Surveyors use will be shown at Accreditation Fairs in May (check the box below or the Coming Events section of the Link for dates).

What types of questions will Surveyors ask?
While we don’t know the exact questions that the Surveyors will ask you, they are trying to establish to what extent the BC Cancer Agency provides safe, high-quality patient-focused care. Many of the types of questions that the Surveyors may ask are included in the Accreditation Quality and Safety Goal fact sheets on the h\drive (h:\everyone\BCCA Accreditation 2009) and the BC Cancer Agency website.

What is Accreditation?

By participating in the Accreditation program, we are able to demonstrate our population-based cancer control program and our commitment to continuous quality improvement, patient safety, improved efficiency and accountability.

The BC Cancer Agency has taken Accreditation Canada’s required organizational practices and standards and bundled them together in six key areas. These are:
• Population Oncology
• Infection Prevention and Control
• Communication
• Medication Management
• Culture of Safety
• Worklife/Workforce
When they speak with you, they will not only be asking questions that are relevant to your area of service, they will want to get a sense of your knowledge of quality and safety in the organization overall, for example, how we ensure patient identity before providing treatment or care, and would you know what to do in a fire.

To prepare you for this, BC Cancer Agency leadership have been holding Accreditation ‘practice’ sessions at each of the centres in March and April, with more scheduled in May. You may have spoken with them as they have visited the regions, asking the types of questions that the Surveyors might also have.

What exactly is an ROP?
This is a “required organizational practice.” Accreditation Canada uses this to measure how well an organization is meeting the expected standards of patient quality and safety.

ROPs are essential practices that organizations must have in place to enhance patient/client safety and minimize risk. Accreditation Canada considers not having these ROPs in place puts a health care organization at significant risk. It is important that we all understand and demonstrate our compliance with the ROPs, as otherwise, the Surveyors consider this a high priority and serious situation.

What do I need to know?
Since January, your manager will have provided you with details and explanations about six Quality and Safety Goals, and how they apply to your area of expertise. This is important information, because Surveyors will be looking for evidence that as an organization and as individuals, we follow practices and processes that minimize risk and focus on both patient and staff safety and quality of life.

Accreditation Fair coming to a centre near you!

In May, the BC Cancer Agency’s Accreditation Committee members and Sue Fuller-Blamey, director of Quality, Safety and Accreditation, will be out in the regions with displays, interactive games and quizzes (yes prizes will be awarded!), and be available to answer your questions about Accreditation.

May 11 Vancouver Island Centre
May 14 Centre for the Southern Interior May 20 Vancouver Centre
May 21 Fraser Valley Centre
May 22 Abbotsford Centre
May 25 Research Centre

Rooms tba; watch for details via e-mail.If you need more detailed information, it is available on the h-drive at H:\Everyone\BCCA Accreditation 2009 or on the BC Cancer Agency website.

You will also have a chance to speak with the Agency’s Accreditation experts at upcoming education sessions and the Accreditation Fairs in May.

How can my department be prepared?
Take the time to read back issues of the Link, the fact sheets and Q&A documents, and ask your manager or regional leader questions you might have. Give some thought to how the ROPs apply to your area, and discuss it with your colleagues. Find out when the mock surveys and Accreditation Fairs are coming to your centre and take advantage of the chance to learn with the experts.

How will Accreditation affect the research areas?
Research is an integral function at the BC Cancer Agency, and Surveyors will be interested to see how the Quality and Safety Goals are met in our labs. As with clinical and administration departments, Surveyors may want to visit research areas, look at documents, observe processes, and talk to staff and students. Surveyors will want to understand the link between research and practice and how the best evidence is used to provide better care and outcomes for BC cancer patients.

I don’t think my department is involved in Accreditation – will surveyors still ask me questions?
Everyone at the BC Cancer Agency is involved in Accreditation. Surveyors want to speak with a broad range of staff, students, patients, volunteers and community partners to get a good sense of how well we perform. They want to gather the widest range of experiences and answers so that they can truly evaluate how the Agency is meeting the national standards.

When will the Surveyors be at my site?
Each of the regional centres and research centre will host at least one Surveyor (in Vancouver there will be two) from June 1 to June 3.

General debrief info?
Everyone is invited to hear from the Surveyors on Thursday, June 4 from 11 a.m. to noon at the debriefing session to be held n Vancouver at the BC Cancer Agency's Research Centre, Gordon and Leslie Diamond Lecture Theatre and videolinked to:

FVC Main Floor Conference Room
VIC Meeting Room #3, Rm 3202
CSI Shuswap Room
AC Clinical Conference Room


Spotlight on Communication
Good communication = good care

Good communication is a critical component of providing excellent care. If communication breaks down between care provider and patient, or between care providers – patient care suffers.

Below we highlight four required organizational practices (ROPS) within the Communication key area that Surveyor’s will likely ask frontline staff about: informed consent, patient transfers, using two identifiers, and coordinating care of high-risk patients. Watch your e-mail for more information and links to the forms and policies mentioned below.

Informed consent
Receiving informed consent from a patient is the cornerstone of good health care delivery.

“Healthcare and cancer care in particular carries such high stakes for patients. While the benefits of an intervention can be great, there is also an immense potential to cause harm, so it is of paramount importance that patients understand their options and make informed decisions,” says Dr. Ross Halperin, a radiation oncologist with the Centre for the Southern Interior and team lead for reviewing informed consent policies.

Ross led a review of patient charts to see if informed consent was consistently documented, and how we stacked up with other PHSA agencies and cancer agencies nationally. In an random audit of patient charts from all centres, it was found that staff do a good job of informing patients about their diagnosis and treatment options (risks and potential benefits), providing patients with ample time to ask questions, and also ensuring patients provide written consent for treatment.

New forms for patient transfers
“Anytime a patient transfers – within departments or to external organizations – there’s a possibility that hand-off could interfere with care, so we need to have a good system in place to provide as seamless care as possible,” says Mary Flaherty, director of clinical operations, systemic therapy, for the Abbotsford and Fraser Valley Centres and a leader for the Accreditation Communication area.

Some of the key transition points for care include:

• when a patient is being transferred to the Agency 
• when a patient is transferred from the Agency’s care back to the originating centre 
• and when a patient is discharged from BCCA for follow up with other health care professionals or to other hospitals or palliative care units 

Quick checklists are being produced to help staff with the transfer of information.

The printed checklist forms are a tool for staff to use to ensure everything is covered off.  “Staff is currently following many of these steps, we’re simply formalizing the process,” says Mary.

Using two identifiers for patients
BC Cancer Agency healthcare providers are required to ask patients for two pieces of identification before proceeding with any service or treatment. Audits were conducted in BCCA in February and March 2009, which found staff were already using at least two identifiers. Acceptable identifiers include the patient’s name, date of birth, client identification cards (appointment card, Care Card) and photo as commonly used in Radiation Therapy. 

“Do not” use abbreviations
One person’s shorthand can mean something completely different to someone else. Medication errors can occur as a result of misinterpretation of a written order with ambiguous abbreviations. Staff should be familiar with the Institute for Safe Medication Practices Canada (ISMP Canada) Do Not Use Dangerous Abbreviations, Symbols and Dose Designations List.

“There were many abbreviations that were acceptable when I began in nursing 30 years ago that no longer are,” says Mary. “For instance QD means take daily while QOD means take every other day and OID means take four times daily. QD and QOD have often been misinterpreted, so we know the best practice is spell out these instructions in full. There’s also confusion about 'less than' and 'greater than' symbols, so now we’re instructed not to use them.”

Coordinating care of high-risk patients
Many patients receive combined modalities of care – for instance chemotherapy and radiation therapy concurrently – and these carry a higher risk due to the complexity of treatment and the potential for combined toxicity and the need to coordinate care by several teams of care providers.

To minimize risk and improve coordination between programs, a new policy has been developed, which emphasizes:

• care is to be thought of as a single intervention not two parallel processes.
• a unified booking system for both chemo and radiation therapy.
• placement of an alert on the Cancer Agency Information System (CAIS) for each patient receiving dual modality intervention.

Spotlight on Medication Management
imPROVE event looks at Medication reconciliation

A team of BC Cancer Agency physicians, front-line staff and administrators have been hard at work developing a medication reconciliation program for the Vancouver Centre’s in-patient unit. The new program was fully tested and implemented during a Rapid Process Improvement Workshop (RPIW) in March.

Medication reconciliation (the main component of medication management) is a process of obtaining a complete and accurate list of a patient’s current home medications – including name, dosage, and frequency – and comparing the list to a physician’s admission, transfer and/or discharge orders. Any discrepancies or potentially harmful interactions are brought to the attention of the prescriber, and appropriate changes are made to the medications.

“When patients come to us, they trust that they’ll receive the correct medication in the right dose, right route and the right time, and it’s important that we do everything possible to ensure this happens,” explains Sue Fuller Blamey, director of quality & safety, BC Cancer Agency, and workshop lead of the ImPROVE team. “Research has shown that medication reconciliation at admission and discharge improves patient safety, and with our new program in place, we hope to prevent adverse drug events.”

The Rapid Process improvement workshop team created three simple medication reconciliation forms to be used at admission, hospitalization, and discharge. Placed at the front of a patient’s chart at all times, these forms provide an up-to-date and accurate list of medications for the entire clinical team to use.

“Previously, there was no formal process in place to obtain a patient’s medication history. We relied on patients and their families to speak to various members on the medical team, which led to documentation in multiple places. There was clearly room for error – whether it’s duplication in medication, omissions, dosing errors, or harmful drug interactions," says Dr. Cheryl Ho, medical oncologist and member of the imPROVE team. "In addition, we did not have a clear process on discharge that ensured the medication changes made in the hospital were reflected in what patients did once they returned home.”

With the introduction of a medication reconciliation program, the clinical team now collects data about a patient’s medical history from different sources during admission, and compiles the information on the new forms.

“Many patients are taking a host of medications. The new process allows us to capture a patient’s medical history thoroughly, including non-prescription medications such as herbal remedies and naturopathic therapies. It’s now easier to identify any conflicts with the medications and make necessary changes immediately,” adds Cheryl.

The medication reconciliation discharge form has a dual purpose. It provides patients with an accurate record of the medications they were prescribed, which can be shared with their care providers outside the BC Cancer Agency. The discharge form is also used for out-patient prescriptions.

The medication reconciliation program was first piloted from November 2008 to February 2009 with gynecologic in-patients at the Vancouver Centre. The program expanded to the entire in-patient unit during the Rapid Process Improvement Workshop week.

“We’re confident the program will be successful because the solutions came from front-line staff and physicians; and to date, everyone has been very receptive to the changes.”

“We’re now working on adapting this program for out-patient settings,” adds Sue.

What constitutes good medication management practice?
 (for full list see Medication Management key area on h:drive):

• the organization obtains essential client information and medication history for each client upon admission or first contact, including any allergies.
• patients know who to contact if they have concerns about their medication, both while receiving care and at the end of care or transfer of care.
• the prescribing medical professional is contacted when medication orders are incomplete, illegible, or unclear, and orders are only accepted by phone in emergencies.
• staff are educated about new medications prior to their use; and they have access to accurate medication-related information and to training.
• a policy and process to manage medication shortages.
• separating or isolating “look-alike” and “sound a-like” medications. Further using labels or warnings on medication packages and storage bins with problematic names, packaging or labels.
• medication labels are distinctive, use clear abbreviations, and contain only essential information to avoid confusion.
• medications are stored in secure areas accessible only by authorized staff.

 

Focus on Culture of Safety
Disclosure Audit Form: aid for oncologists

In the last issue of the Link, we profiled the Patient Safety Learning System, an electronic tracking system to record near misses, unusual occurrences and critical incidents. The Agency has a policy and provides support to help guide staff through critical incidences.

While any staff can report on near misses, unusual occurrences and critical incidents, because of the sensitive nature of communicating this information to patients, it is the patient’s primary care physician who usually informs the patient and/or family about a critical incident. A new list of “Steps in Disclosing a Critical Incident to a Patient & Family” is now available to help oncologists through a critical incident.

Steps for Disclosure  

1. Stabilize the patient 
2. Report incident 
3. Discuss events with patient, family 
4. Discuss events with appropriate staff 
5. Acknowledge or apologize for the event 
6. Review actions taken to mitigate circumstances surrounding event 
7. Discuss corrective action to prevent further similar adverse events 
8. Respond to patient, family, staff or service provider questions 
9. Offer counseling to staff, service providers and patients/families 
10. Document incident and follow-up with family 
11. Monitor and manage possible late/long term effects

“Our staff recognizes the importance of not only learning from our mistakes internally, but also fully explaining an incident and potential harm it may cause to a patient. The checklist is an added tool to help busy physicians ensure all appropriate steps have been taken,” says Dr. Charles Blanke, head of systemic therapy at the BC Cancer Agency.

The definition of a critical patient incident is when: 

• a patient’s well-being has been or has potentially been affected.
• a significant number of patients have been affected by the same or similar incident. 
• a change in the patient’s medical treatment becomes necessary because of the incident.

Incidents, in addition to being reported on the PSLS, will be documented in the patient’s health record, and staff involved in the incident will be provided the necessary support.

“It’s important that the information is shared in a timely fashion,” says Anne Burgess, team lead for the Accreditation Culture of Safety area, and director of regional operations for the Vancouver Island Centre. “For example, if a patient is given a wrong dose, other care providers need to alerted as soon as possible, so they can adjust future treatments, and patients need to be aware of any potential side-effects.”

“Unfortunately, as hard as we try and with all the checks we have in place, mistakes do occasionally happen,” says Anne. “Given the number of patients we care for and treatments we deliver every day, the mistakes are very minuscule, so we can all be proud of our safety record. However, when they do happen, we need to learn from them, and to help others in the organization learn from them, so we can try to prevent them from recurring.”

All critical incidents are reported to the BC Cancer Agency’s Quality Council outlining the steps that have been taken and recommendations on how to prevent the incident from happening again. The Agency’s Quality Council reports these to the Medical Advisory Council which briefs the PHSA Board. 


Focus on Worklife/Workforce
In case of fire: remain calm and keep safe

“Fire” is a word that strikes immediate anxiety in the hearts of most people, but having a plan in place helps to alleviate some of that fear and can save lives.

“In a crisis situation, you’re not likely to remember a long list of things to do,” says Doreen Myers, corporate director, Emergency Management.

The four key points that staff need to remember are: 

1. People first; make sure everyone is safe 
2. Pull the fire alarm 
3. Dial the telephone number you’ve been provided for emergency response at your centre
4. Evacuate or extinguish the fire if you feel it’s safe

To help staff remember the emergency response numbers (these are different at each centre), Emergency Preparedness and Safety will be distributing stickers that can be placed directly on phones; handy plasticized code cards that can be attached to lanyards; and posters for bulletin boards for quick reference.

“When there’s a fire, or a potential threat of a fire, you need to react quickly,” says Doreen. “The longer you wait to report an incident, the greater the potential for loss of life or property.

"So, if you smell or see smoke, immediately alert those who can assess the situation by using the emergency response number at your centre." 

Keep yourself safe by: 

• identifying where the closest exits to you are (you won’t be able to use elevators). 
• knowing where the fire extinguishers and alarm pulls are located.
• listening for instructions from your fire warden or fire personnel.

Preventing a Fire

• Keep all heat-producing appliances away from the wall and away from anything that might burn. Leave plenty of space for air to circulate around equipment that normally gives off heat.
•  Make sure all appliances if your area – such as coffee makers and hot plates –are turned off when not in use. It’s best to assign one person to make this check every day.
• Do your part to keep storage areas, stairway landings and other out-of-way locations free of waste paper, empty cartons, dirty rags and other material that could fuel a fire.

Also, most centres are now conducting test fire drills, and staff should be aware of the assigned meeting point if they need to evacuate. Check with the fire captain in your area or supervisor if you don’t know.

“Each Agency centre is providing fire wardens with refresher courses on what to do in the event of a fire,” continues Doreen. “To ensure we have fire wardens for each key area, we train three deep, so if someone is off sick or on vacation, there are two other people who can cover.”

At most centres, fire wardens wear red hats and orange vests, so they are readily visible for staff needing assistance.

“However, fire safety is everyone’s responsibility,” says Doreen. "You need to think about what you’d do in the event of a fire, and an evacuation, and how you’d keep yourself and your patients safe."

If you’d like to volunteer to be a fire warden, please inform your supervisor or regional leader.

For a copy of the Fire Safety Guide, please visit:
http://pod/BUILDSECEMERG/FS/pages/Default.aspx  

Dr. François Bénard: BC Leadership Chair in Functional Imaging

In April, the province, the BC Cancer Agency, the BC Cancer Foundation and the University of British Columbia announced that Dr. François Bénard has been the appointed B.C. Leadership Chair in Functional Cancer Imaging.

Francois – one of Canada’s foremost nuclear medicine researchers – has been internationally recognized for developing novel radiopharmaceuticals that zero in on tumours too small to be found otherwise, and that allow doctors to see quickly whether a cancer is responding to treatment.

As well as continuing his work on isotopes, François will combine gene science with advanced nuclear medicine imaging to study breast cancer, prostate cancer and lymphoma.

He will use genetic predictors of how aggressive these cancers will be – and how likely a specific treatment will be to fail – together with positron emission tomography and computed tomography scanning. This will identify patients who are unlikely to be helped through conventional therapies, and allow them to be offered more promising alternatives.

For a full copy of the press release, please visit www.bccancer.bc.ca/ABCCA/NewsCentre/2009/leef.htm  

Dr. François Bénard

François is an MD who trained as a specialist in nuclear medicine and biotracers and is rated among the top five in his field in Canada.

Before accepting positions with UBC and the BC Cancer Agency, François was chief of the molecular imaging centre at the Centre Hospitalier Universitaire de Sherbrooke in Quebec, and professor of nuclear medicine and radiobiology at the Université de Sherbrooke.

He has appointments at both the University of British Columbia faculty of medicine and the BC Cancer Agency and works closely with colleagues in radiology, and the TRIUMF research facility on the development and use of novel radiopharmaceuticals and tracers.

He is a lead member of the Centre of Excellence for Functional Cancer Imaging (located at the BC Cancer Agency’s Vancouver Centre), which is a partnership between the BC Cancer Agency, the Children’s and Vancouver hospitals, UBC and TRIUMF, and which is supported by the governments of Canada and B.C.

He entered medical school at the Université de Sherbrooke in Quebec when he was 18, having also considered becoming an electrical engineer, organic chemist or biologist.

Advancing Strategic Direction #1
Sustain and advance the BC Cancer Agency's system of cancer control. 

First study of its kind reveals educational outcomes of childhood cancer survivors

A new population-based study shows that some childhood cancer survivors, in particular those diagnosed with brain tumours, experience learning difficulties in school.

This is the first comprehensive study examining educational late effects of survivors of all forms of childhood cancers. Late effects are problems that occur or persist after cancer treatment and may be related to the disease or its treatment.

The study found that brain tumour survivors had significant problems in the areas of math and reading compared to the general student population, while survivors of other cancers performed as well as other students in most educational areas. Survivors were also twice as likely to be enrolled in special education; and females and those who have received radiation treatment (particularly cranial radiation) were at increased risk for poor educational outcomes.

“Because our study was based on population databases, we were able to look at educational outcomes for all childhood cancer survivors in the province, including those with rare diagnoses or those who might be missed in a questionnaire-based study,” says Maria Lorenzi, biostatistician for the Childhood, Adolescent, and Young Adult Cancer Survivors (CAYACS) study. 

“In addition to updating our survivor cohort to extend the follow-up period and include individuals diagnosed more recently, we are planning a linkage to post-secondary outcomes to see if childhood cancer survivors are attending university with the same frequency as their peers and what types of programs they are choosing.” 

For a full copy of the press release, please visit: www.bccancer.bc.ca/ABCCA/NewsCentre/2009/cayacs.htm  

Advancing Strategic Direction #2
Establish the knowledge generation and application model within the provincial cancer control platform.

Make the sustainability shift: use resources wisely

Sustainability is one of the environmental buzz words that we’ve all been hearing lately, but we may not be quite sure what it means. It’s a rather simple concept: use only the resources you need to reduce your impact on the environment and if enough people invest in the strategy, big pay-offs are possible.

“Recent surveys show that 80 percent of Canadians support sustainability initiatives,” says Ruth Abramson, PHSA corporate manager, Environmental Sustainability. “I’ve had a lot of interest from BC Cancer Agency staff about sustainable initiatives. There’s an understanding that reducing materials use, energy and resource use and how and what we buy makes good sense from environmental, health and economic perspectives.”

Ruth is overseeing a PHSA wide campaign which includes reducing paper consumption and energy/electricity used for buildings, and working with Supply Chain to encourage the purchase of environmentally and socially (i.e. knowing where an item is produced) responsible goods. The goal by 2010 is to see a measurable reduction in these key areas.

“My role is to be a catalyst and help BC Cancer Agency staff, who are already working on some great initiatives – such as changing to lower wattage lighting in parking lots and giving patients cloth bags to put their clothing in when they come in for treatment – sustain that momentum so they can make an even greater impact.”

Five easy eco-steps you can take for starters

1. Turn off your lights and computer monitor if you're out of the office for more than 15 minutes.
2. Reduce the amount of paper you use (newer printers have a doublesided copy option)
3. Bring your own mug instead of using disposables.
4. Come to work by bus, walking, biking, or carpooling and use the same to get around during the day.
5. Share your great ideas with your colleagues and other departments

Chris Simms, research operations manager for Advanced Therapeutics, is a member of a new PHSA Sustainability Committee that will help encourage “green” ideas at the BC Cancer Agency’s regional centres.

Advanced Therapeutics is already setting a good example by encouraging the use of double-sided printing and on newer printers using economode which uses less toner, encouraging staff to turn off monitors, and using coffee mugs rather than disposable cups for coffee at staff meetings.

Bike to Work Week takes place May 11-17, 2009

Join more than 8,000 participants from 1,143 registered workplaces and make the move to cleaner, greener, healthier transportation.

PHSA has set up a team for this year’s event – visit the Vancouver Area Cycling Coalition’s Bike to Work website, find Provincial Health Services Authority in the list of participating teams and join the team.

During bike week, log your bike trips online to win daily prizes, find out how many CO2 emissions you’re offsetting, and how the PHSA’s team measures up against others.

If you have a passion for cycling and would like to set up a team at the BC Cancer Agency, or get more involved in cycling initiatives at PHSA, contact Deming Smith, transportation coordinator at dsmith5@phsa.ca or 604.875.2000 x 6865.
Chris has also gotten into the habit of electronic paper storage on a common drive which can be shared by administrative staff, so materials don’t need to be stored in expensive filing cabinets or in binders on bookshelves. He tries to review documents on-line whenever possible and has started taking a laptop to meetings to record minutes rather than pen and paper.

“Budgets aren’t increasing, but that doesn’t mean you can’t squeeze more out of what you have – saving money means the organization can redirect such saving to patient care – that is a good thing,” says Chris.


“And, it’s also smart thing to do”, says Chris, “because younger people who have grown up being 'green' want to work for an organization that values sustainability. It also demonstrates leadership in caring for our environment and our community.”

“It’s amazing, but doing a few simple things – that do not require a lot of thought or planning – can provide enormous benefits.”

If you have examples of what you’re doing in your department or centre, please send them to Ruth at rabramson@phsa.ca  We will profile some of the best stories in future issues of the Link. Ruth is also interested in hearing your ideas on what the Agency can do to be more sustainable. 

 Advancing Strategic Direction #4
Ensure we have the resources to achieve maximal organizational effectiveness.

Surgical oncology adds more OR capacity and reaps unexpected gains through imPROVE

In our February issue, we told you about the extra capacity Surgical Oncology added to its Prostate Brachytherapy program through their last imPROVE workshop. The team returned at the end of March for another imPROVE workshop, with a more ambitious agenda – to improve efficiencies in scheduling all other procedures.

“We learned from last time that, by re-modeling our scheduling system to reflect the actual time physicians took to perform a procedure, we were able to achieve a 25 percent increase of OR capacity for Prostate Brachytherapy, within the existing resources. This time we looked at applying that same principle to all of our procedures,” explains John French, team lead, and director of Surgical Oncology.

The team looked at 18 months of data and calculated actual versus scheduled times for all surgical and endoscopy procedures. At the end of the week, they produced a new schedule which reduced the OR time required for gynecological brachytherapy insertion procedures by 42 percent allowing more OR cases to be booked; The new schedule also enabled the OR to increase the number of GI endoscopy cases by 15 percent.

“That was the first part. We also wanted to develop a waitlist management system to allow us to accurately track how many patients are waiting at any given time, and for how long,” says John.

The team inserted three time stamps into the OR booking process: OR decision date, patient decision date, and date booked, and devised a new OR Booking Form to reflect these additions.

“This process of reviewing our booking system turned out to be really rewarding. It revealed several areas of inefficiencies in our previous data collection process. So midway through the week, we decided to take on a third goal: to enhance our data collection process,” added John.

Three tedious and time-consuming data entry forms, along with other multiple forms and unnecessary duplication, were eliminated. The new process projects a 50 percent reduction of time spent on data collection, and up to 100 percent reduction of time spent on doing OR stats.

This is the last of the three imPROVE workshops for Surgical Oncology. For the previous two workshops, please refer to the October 2008 and February 2009 issues of the Link.

imPROVE is based on the lean principles of Toyota Production System, and is aimed at fostering long-term cultural changes to encourage employees to improve their work processes for better quality, safety, outcomes, and to reduce waste.

Advancing Strategic Direction #1
Sustain and advance the BC Cancer Agency's system of cancer control.

National Summit features BC Cancer Agency Education Day

Now is the time to register for the 7th National Summit on Community Cancer Control, scheduled for Prince George, B.C., June 11 to 13, 2009 (go to www.cancersummit.ca, where on-line registration is fast and easy).

Hosted by Northern Health under the auspices of the Canadian Association of Provincial Cancer Agencies (CAPCA), and supported by the BC Cancer Agency and the BC Cancer Foundation, the Summit features three full days of interactive, inspiring and multidisciplinary learning opportunities following the theme: Innovative Solutions for Rural & Remote Cancer Control Issues: Today and Tomorrow.

On June 11, the BC Cancer Agency Professional Education Day offers 20 presenters in six concurrent specialty discipline sessions including: Aboriginal Cancer Care, Nursing Oncology, Nutrition Oncology, Oral Oncology, Pain and Symptom Management/Palliative Care and Psychosocial Oncology.

Plus the BC Cancer Agency is teaming up with Northern Health to offer a separate public cancer forum in Prince George on June 11 for the community.

On June 12 and 13, Northern Health presents more than 70 dynamic presenters in six concurrent sessions. The six summit sub-themes for the concurrent sessions can be found at the Summit web site. Speakers from Quebec, Nova Scotia, Saskatchewan, Alberta, B.C., Ontario, Manitoba, the Northwest Territories, the Yukon and North Carolina will share their success stories in the delivery of cancer control services in rural and remote communities.

Several renowned speakers include: Stephen Lewis, international humanitarian; Dr. Richard Heinzl, founder of Doctors Without Borders; Dr. Simon Sutcliffe, past president of BC Cancer Agency; Dr. Tony Fields, VP, medical affairs & community oncology, Alberta Cancer Board; Dr. Andrew Padmos, CEO, Royal College of Physicians & Surgeons of Canada, and panels from both CAPCA and the Canadian Partnership Against Cancer.

Together with 35 posters, an Internet lounge, and activities and special events that promise to add value and entertain delegates, the three-day professional development event promises to be an outstanding networking and content-rich meeting.

Advancing Strategic Direction #1
Sustain and advance the BC Cancer Agency's system of cancer control.


Stop! Make sure to complete our newest Accreditation Quiz: Are you smarter than an Accreditation Surveyor: the Sequel. You'll have a chance to win one of two $50 gift certificates to the Cactus Club.

Click here for the survey:
http://www.surveymonkey.com/s.aspx?sm=M_2b0_2biOJYDgjpGsGLwhMRig_3d_3d  

Centre for the North: RFP release milestone

The implementation of the Northern Cancer Control Strategy has taken a major step forward with the release of the request for proposals (RFP) for the new regional cancer centre in Prince George. The RFP release for the BC Cancer Agency Centre for the North was officially announced on April 3.

The new cancer centre is a key component of the Northern Cancer Control Strategy, a joint initiative of the Provincial Health Services Authority, the BC Cancer Agency and Northern Health. The strategy is focused on improving the full spectrum of cancer services in communities across the North, including cancer prevention initiatives, health promotion, detection and diagnosis, treatment, and home-based and palliative end of life care.

The three teams participating in the RFP are Northern Gateway Health; Plenary Health; and Sequence Health. Once submissions to the RFP are received and evaluated, a preferred proponent will be selected and offered the opportunity to negotiate an agreement to design, build and finance the cancer centre, as well as provide facility maintenance services in the long run. The selection of the preferred proponent is expected to occur this coming fall.

For a full copy of the press release, please visit: http://www.bccancer.bc.ca/ABCCA/NewsCentre/2009/
release+of+RFP+for+Centre+for+the+North.htm

Advancing Strategic Direction #1
Sustain and advance the BC Cancer Agency's system of cancer control.

Carole and Ruth say “goodbye”

After almost 19 years at the BC Cancer Agency, Carole Treloar, who is one of the friendly voices that answers the Vancouver Centre switchboard, is hanging up her headphones for good.

She hasn’t always been at switchboard – she took a few detours along the way, including working for Dr. Greg Hislop’s Diet & Breast Cancer Research Study for three and a half years – but for the last eight years, she’s been back at a job she thoroughly enjoys.

“It’s never boring. You’re always so busy taking call after call, and being a bit of an investigator because people sometimes don’t know what department they need,” says Carole. “You have to be compassionate and caring and a good listener, and try and help as best you can, because often it’s frightened and anxious patients who are calling."

Carole often stayed after her shift because she didn’t want to leave a caller stranded, and wanted to make sure they were taken care of, says Amy Barr, a colleague. “We often worked together, handling the more difficult calls, so patient calls were directed appropriately as quickly as possible.”

It’s that warmth and caring that staff, volunteers, and patients will miss when Carole leaves at the end of the month.

“I have thoroughly enjoyed getting to know Carole,” says Paul Stouse, Corporate Manager, Telecommunication Operations, PHSA, who has been Carole’s direct report since April of last year. “She comes to work every day with a smile on her face, a professional attitude and continuously seeks to improve customer service.

“Carole will retire from the PHSA and the BC Cancer Agency, knowing she has made a difference. On behalf of the department, I want to thank Carole for her years of dedicated service, and to wish her, and her husband Doug, many happy, relaxing, memorable trips on their boat.”

Carole says while she’s really looking forward to having the time to enjoy hobbies, and spending more time with her friends and family at her summer place on Pender Island, she’ll miss her colleagues, volunteers, and patients. “I’ve made some wonderful friends, and I’m going to miss them.”

Ruth Heiland is the friendly face that greets patients and visitors when they enter the front doors of the BC Cancer Agency’s Vancouver Centre.

Like Carole, Ruth has worked in several departments including Admitting, Radiation Therapy, Ambulatory Care, Non-gynecological Cytology, Diagnostic Imaging and Health Records.

“I think Ruth is the ideal person to be the one to greet patients when they arrive for their first visit because of her welcoming disposition and pleasant demeanor,” says Sharon Hamilton, PHSA Health Information Coordinator. “She puts a friendly face to what might be perceived as a frightening place to someone who has never been here before. It will be very difficult to replace her!”

She often brightens her colleagues' days with her trademark phrase, “you go girl”, when she feels they need an extra boost of encouragement. Ruth has a positive attitude and a smile that is engaging and infectious.

“She has a personal touch,” says Fran Holmes-Green, a volunteer at the Vancouver Centre. “She’s really interested in other people: their interests, their families, and what’s going on in their lives. She’s quick to give you a hug if she thinks you need it. The world would be a much better place if there were more people who have Ruth’s warmth and compassion.”

In retirement, Ruth plans to “explore, dream, and discover. I plan on having fun and keeping young, and learning something new every day.”

“I will treasure my 33 years at the Agency and all the wonderful people I’ve met and the experiences and friendships I’ve encountered. To all my colleagues and volunteers, my wish for you is to have fun and stay young.”

"Go to person" leaves large shoes to fill

Joanne Egan will be greatly missed at the Vancouver Island Centre. “Joanne is the ‘go to’ person here!,” says Anne Burgess, director of Operations.

Joanne’s 11 years at the Agency have made her a central member of the team, says Anne. “She is hard working, kind, compassionate, thoughtful, and funny.”

The job title “executive assistant” could never describe everything she does from managing the operations of the building, to organizing events, and – most memorably – always being warm, friendly and helpful to her colleagues.

Although she will miss the sociable atmosphere at work, Joanne says “I value the close friends that I have been honoured to know during my career here and will take these friendships with me into retirement.”

What’s next for Joanne? “Travelling with my husband is number one on my list. I yearn for the freedom to pack up and go with no return restrictions.” But home and family are also important, and Joanne will enjoy spending time in her home in Sidney by the Sea; and spending more time with her children and six-year-old granddaughter Emma.

As someone who has been an integral part of the Vancouver Island Centre ever since the new building opened in 2001, Joanne will not be forgotten; and she won’t forget us either. She says, “I will forever be proud of my association with the BC Cancer Agency. I believe the best care in the world is offered to cancer patients at our centre.”

We wish Joanne all the best for a happy and fulfilling retirement.

BC Cancer Foundation goes 2.0!

Contact the BC Cancer Foundation

Provincial Office:
604.877.6040
infobccf@bccancer.bc.ca  

Abbotsford:
Liz Harris
604.851.4736
lharris3@bccancer.bc.ca  

Fraser Valley:
Kate Ludlam
604.930.4083
kludlam@bccancer.bc.ca  

Southern Interior:
Cynthia Waldek-Peters
250.712.3910
cwaldekpeters@bccancer.bc.ca  

Vancouver Island:
Laura Walsh
250.519.5554
lwalsh@bccancer.bc.ca  

Vancouver:
Sharon Kennedy
604.877.6040
skennedy@bccancer.bc.ca  Have you noticed the “buzz” around social media lately? Social networking sites such as Facebook, MySpace and Linkedin are rapidly becoming a regular part of our daily conversations with family and friends. And increasingly, we are also using social networking to interact with our favorite brands and organizations.

BC Cancer Foundation has now become part of the conversation with the launch of “Nick’s Blog” at
www.bccancerfoundation  wordpress.com   

Who is Nick, you ask? He is the BC Cancer Foundation’s Senior Vice President of Development, Nick Locke who heads the Foundation’s fundraising programs and events – and takes part in most of them.

“Nick’s Blog” is your “one-stop-shop” for news, current affairs and events from both the BC Cancer Foundation, as well as a regular source for other exciting news and developments in cancer research and control.

The BC Cancer Foundation feels strongly that its story is the story of the BC Cancer Agency. So “Nick’s Blog” will highlight the life-saving work that goes on at the Agency every day and how the Agency serves and supports people and families living with cancer in B.C.

“Nick’s Blog” will also bring you all the BC Cancer Foundation’s news and tell you how Foundation donors step up to support the BC Cancer Agency.

While you’re online, check out the BC Cancer Foundation on Facebook. You can become a BC Cancer Foundation fan or join the BC Cancer Foundation group. Or you can also follow on Twitter (twitter.com/bccancer) to find out the latest news in 140 characters or less!

To give us feedback on “Nick’s Blog” – follow the link to bccancerfoundation.wordpress.com and add your comments. And of course your suggestions for topics and conversations are welcome!

Advancing Strategic Direction #4
Ensure we have the resources to achieve maximal organizational effectiveness.

Newsmakers 

First BC Cancer Agency Retreat to “Bridge the Gulf between BC Cancer Clinicians and Scientists”
In April, the first BCCA Retreat to bridge the gulf between BC Cancer Agency clinicians and scientists took place at the Sea to Sky Conference Centre in Squamish.

“By all accounts, it was a great success in bringing scientists, clinicians and trainees together to get to know each other better in order to promote more translational research projects and clinical trials,” says Dr. Gerry Krystal, senior scientist, BC Cancer Agency's Terry Fox Laboratory, and one of the organizers.

Thanks to the generous sponsorship and frugality of Gerry and co-organizer Randy Gascoyne, pathology, costs for registration were kept and the meeting ended-up "in the black."

“It is hoped that this retreat will become one of many activities to promote interactions between BC Cancer clinicians and scientists and will become a tradition we look forward to on a regular basis,” says Gerry. 




Congratulations to Dr. Phil White, leader of the BC Cancer Agency’s Family Practice Oncology Network, on receiving the BC Medical Association’s Primary Health Care Leadership Award in recognition of his contribution and commitment to the Practice Support Program. The Practice Support Program helps recent graduates establish themselves in a full-service family practice in a community of need.

The award recognizes Phil’s generosity in coaching and mentoring to help fellow physicians improve practice management, achieve better patient health outcomes and enhance their professional satisfaction.