Cliff Robinson poses with Jan Neale, RN; Susan Travanut, occupational therapist and physiotherapist Kelly McCrae – members of Royal Victoria Regional Health Centre’s (RVH) Day Rehabilitation team.

Cliff Robinson played too many games of golf. Or that’s what the avid golfer thought when his shoulder began giving him grief.

Very soon a little shoulder ache developed into unbearable pain and resulted in a visit to Royal Victoria Regional Health Centre’s  (RVH) Emergency department. That was on a Saturday; by Tuesday, Cliff had lost mobility in his legs and was having trouble walking.

A golf injury this was not.

CT and MRI tests confirmed the 59-year-old Barrie man had sustained an incomplete spinal cord injury due to a spinal staph infection and the prognosis looked grim.

“My option at this point was surgery which, if successful, would clean out the infection or I could be paralyzed from the waist down,” says Cliff.

Surgery took place in a Toronto hospital and Robinson woke up to good news and bad news. The infection was gone, but he was paralyzed.

“I did get a little despondent at that time and did the whole, ‘Why me?’ and  ‘This sucks’ thing, but then you realize life goes on and you have to get moving.”

And he did.  He moved his big toe. That was a sign of things to come. First there was a three-month stay at a rehabilitation centre in Toronto. When Cliff was discharged from the centre, he was using a wheelchair, but was told he would never walk again.

Now back home in Barrie, Cliff was referred to RVH’s Day Rehabilitation Program. That’s when the highly-skilled, multi-disciplinary team stepped up to the plate.

Cliff says he will never forget the day he met the team that would give him back his life, nor the words that were spoken to him on that first day.

“Nina (Martin) the physiotherapists was assessing me and as we went through some exercises she turned to me and said, ‘I think we have a shot here. I think you will walk again,’ ” says Robinson.

Those words made Robinson break down in tears.

“She was pretty optimistic and it was the first time someone other than my family was as equally positive about my recovery. It was so nice to hear.”

So began his year-long journey at RVH, where he was subsequently seen by physiotherapists Jay Meredith, Nina Martin, Therese Pedlow (pool therapy) and Kelly McCrae, as well as Susan Travanut (occupational therapist), and rehabilitation assistants Dani Ashberry and Nicole Percival with support of RN Jan Neale.

Three times a week they met and worked on his progress. Most times they made progress, sometimes they didn’t, but each time Cliff got an honest assessment of his recovery.

“They were super encouraging to me, but at the same time always genuinely assessing how I was doing. It was an incredible team effort. I can’t say enough.”

Cliff has gone from wheelchair, to walker to crutches in one year. The man who was not supposed to walk again did indeed walk.

Cliff’s RVH journey ended with a dance with Nina to the Beatles “Hey Jude”.

“I never dreamed I’d be doing that – it was wondrous. All the other patients were watching and I think it was inspirational for them because when we finished they applauded,” says Cliff. “This rehab team is both compassionate and professional. They were lifesavers – what I mean by that is they allowed me to regain a certain quality of life. I find that statement so trite though, because it doesn’t begin to cover what they did for me.”

Today, Cliff, with the constant support of his wife Louise, performs daily exercises to strengthen and improve his mobility. He was able to finally walkto the backyard to play with his two granddaughters and with another grandchild on the way, he has his sights set on taking the whole gang to Disney World.

And oddly, golfing doesn’t really matter anymore.

As part of Providence Healthcare’s falls prevention process, staff hand off a card between teams so changes in the patient’s treatment plan can be noted and discussed throughout the day and night.
Photo credit: Leo Audette

According to Health Canada, falls are by far the most common cause of major injury for seniors in Ontario, accounting for 90 per cent of hip fractures and 20 per cent of subsequent deaths within a year for those 65 and older. The team at Providence Healthcare has developed a strategy that is making a significant dent in this important aspect of seniors care.

Since the Toronto healthcare organization rolled out a Falls Risk Prevention Toolkit across its seven in-patient rehabilitation units in late 2011, falls among its patients have decreased by 24 per cent.

The toolkit consists of falls risk information and identifiers for patients/caregivers. But the really innovative aspect is a process whereby a patient’s risk assessment and treatment plan is passed between healthcare providers for the first 24 hours.

“We were doing assessments before, but we saw silos occurring. People weren’t talking to each other, so the assessments weren’t going any further,” says Leo Audette, Professional Practice Leader, Nursing. “This [process] ensures all team members are aware of falls risks and that a treatment plan is carried out.”

The process starts with a falls risk assessment of the patient within three hours of admission from acute care that is completed by the occupational therapist (OT) or physiotherapist (PT). Those deemed high risk for falls get a yellow bracelet to wear, as well as a magnet at their beside so they’re easily identified by staff. The other key element is a 4×6 card detailing a patient’s potential fall risks and possible interventions, which is passed between healthcare providers so that a face-to-face conversation about the patient is part of the process. This chain of communication continues between teams so changes in the patient and treatment plan can be noted and discussed throughout the day and night.

Eventually the card comes full circle when it’s handed back to the OT or PT the next day to determine if the intervention worked and if the treatment plan needs to be adjusted. “Having a card to hand off forces face-to-face communication,” says Shawn Brady, Director, Interprofessional Practice.

It also promotes accountability, says Audette. “Having to physically hand off the card gives a sense of this being important and something they have to follow through on,” he says. “We know it’s had a remarkable effect on staff.”

The proof is in the numbers—and in the response from Providence staff. Within the first three months of rolling out the program, compliance among employees was at 80 per cent. A presentation about the falls prevention program also earned the Providence team a 2013 People’s Choice Award at the GTA Rehab Network’s annual Best Practices conference.

But both Brady and Audette admit that changes in processes like these take some getting used to. The two, along with Professional Practice Leader of Physiotherapy Anna Marie Sneath, worked with OT, PT and nursing practice consultants who have been key to the program’s success.

“We identified one champion per unit to provide input on the tools and processes and to assist us in rolling out the education,” says Brady. “They were also our eyes and ears on the ground if something wasn’t working or staff weren’t using the tools properly.”

In addition, the toolkit is put into all orientation packages for new staff and Brady says it’s imperative to have a “refresh” around the process with new employees to ensure it is sustained.

With the program up and running successfully, the team is now working on several other initiatives to reduce the number of patients’ falls even further. An interprofessional approach to dealing with incontinence is one focus as is a better structure for assessing falls risk over the long-term. “Some patients come in low risk and fairly immobile, but as they progress with therapy they start to move more and may become high risk,” says Brady.

Overall, the Falls Risk program is just one of the ways Providence Healthcare is meeting its quality and safety promise to its patients, residents and clients.

The gift of a donated cornea restored Jennifer Barton’s vision and changed her life.

The gift of vision changed Jennifer Barton’s life.

The effects of chronic eye rubbing as a child from uncontrolled allergies left Jennifer with corneas so thin she couldn’t read the largest letter on a vision test.

She realized her vision was slipping away as she sat through lectures in university. Her friends would comment on how much she was squinting.

“I didn’t think it was that serious, and just thought I might need glasses,” said Jennifer.

Jennifer’s optometrist diagnosed her with keratoconus, or deformed corneas. She spent the following two years at multiple eye appointments each week, often getting up  at  4 a.m. to begin the two-and-a-half-hour process of preparing her eyes for the day – first putting in soft contact lenses, then hard contacts overtop, only to have them fall out by noon.

“I didn’t have a life-threatening illness, but the daily frustration of losing my vision was very emotional,” she said.

Jennifer had a vision for her life; graduate and specialize in respiratory therapy, get married and have children. As her condition worsened, her future became less certain.

“I was so worried I wouldn’t be able to see my children grow.”

She was able to graduate from university with a lot of help from her friends and began her new career as a respiratory therapist, even though she had trouble seeing monitors at work.

After her optometrist had done everything she could to help Jennifer see, she referred her to a surgeon.  Within 48 hours, Jennifer was on an operating table receiving the gift of a new cornea in her right eye. Her vision was restored within three weeks.

Since 2006, Hamilton Health Sciences (HHS) has had a culture that embraces organ and tissue donation as an integral part of end-of-life care. We have been a provincial leader in donation for many years, working closely with Trillium Gift of Life Network (TGLN) in its mission to increase the availability of organs and tissues for transplant.

In 2012, HHS expanded its partnership with TGLN by implementing Routine Notification and its tissue donation process to all inpatient units at the General and Juravinski Hospitals and McMaster University Medical Centre.

This expansion means an increase in the availability of tissue for transplant, which can be life-changing and even life-saving for a recipient:

• After sight-restoring corneal transplant surgery facilitated through the gift of eye donation, recipients can return to work or school.
• Donated skin can mean the difference between life and death for burn survivors.
• Donated heart valves are used to replace the diseased or damaged valves of young children, giving them the chance to live  normal, healthy  lives.
• Bone transplants return full mobility to patients of all ages, allowing them to resume active hobbies and live independently.

“Honouring and respecting the wishes of our patients and families enhances the lives of others in our community,”  said Nancy Glover, donation coordinator, Trillium Gift of Life.

Last year at HHS, 114 patients donated their corneas, restoring the gift of sight for 228 grateful recipients, and 11 multi-tissue donors resulted in potentially enhancing up to 750 individuals. Additionally, 34 families generously consented to organ donation after their loved one passed away, saving 129 lives through organ transplant.

Jennifer received the gift of a cornea from a  young child. “It  was overwhelmingly emotional to know that there were parents who were brave enough to change someone else’s life.”

“Skin and tissue is such a huge part of donation,” she adds. “It changes so much.”

Jennifer’s outcome was the best her surgeon could have hoped for with  20/25 vision in her right eye. She now has a successful career as a charge respiratory therapist at Hamilton General Hospital, is married and will continue to watch her four-and seven-year-old daughters grow.

Organ and Tissue Donation Awareness Week is April 21 – 28. In recognition, HHS is flying the Trillium Gift of Life flag for the month.

Register to be a donor at Beadonor.ca

From left to right:Dr. David Higgins, President, St. Joseph’s Healthcare Hamilton; Mr. Rick Badzioch, Clinical Director, Nephrology Program, St. Joseph’s Healthcare Hamilton; Ms. Sera Filice-Armenio, President & CEO, St. Joseph’s Healthcare Foundation
Dr. Darin Treleaven, Head of Service, Nephrology Program, St.Joseph’s Healthcare Hamilton; Mr. Saurabh Popat, Director Government Affairs & Public Policy, Baxter Corporation.

Dialysis patients living with chronic kidney disease face many challenges. In addition to the physical symptoms of the disease, further emotional strain and disruption in living patterns is caused by the need for ongoing treatment several times a week in a clinical hospital environment.

Studies reveal that many patients who currently dialyze in acute care hospitals are eligible for personal home-based or peritoneal dialysis (PD) systems. However, those same patients may lack the confidence and knowledge required to play such a leadership role in the management of their disease. Successful treatment with home-based or peritoneal dialysis depends in great degree on good training and proper education of patients and their caregivers.

St Joseph’s Healthcare Hamilton is a regional centre for renal care and one of the busiest dialysis centres in South Central Ontario serving thousands of patients who rely on the hospital’s Kidney and Urinary program. While the vast majority of dialysis patients currently choose to receive their treatment in-hospital, St Joseph’s Strategic Plan, which is aligned with the provincial initiatives of the Ontario Renal Network, aims to increase the number of patients using home-based or peritoneal dialysis methods for those patients who qualify for at home care options. In addition to offering dialysis patients unprecedented flexibility, statistics show that home-based peritoneal dialysis may have significant psychosocial advantages, especially for younger patients and those who are employed or pursuing an education.

Currently, patients living with chronic kidney disease who are beginning to examine various treatment options are provided with handouts and booklets complemented by approximately five in-person meetings with a dialysis support worker or nurse. In an effort to further assist in the process of making patients better positioned to choose treatment options and confidently manage their own care, St. Joseph’s Hospital recently received a $250,000 commitment from Baxter Corporation, a leading manufacturer of products that save and sustain the lives of people with kidney disease and other chronic and acute medical conditions.

As more Canadians are turning to the Internet and using smart phone and tablet technologies for health information, Baxter and St. Joseph’s are planning to harness the power of these digital devices to help further educate and engage dialysis patients in the management of their own care. These digital tools have an incredible capacity to enable patients to interact with an ongoing authoritative resource and feel constantly connected in new and powerful ways.

In three phases, the program aptly named “Patient First” will focus on pre-dialysis education, peritoneal dialysis education, and self-management education. Through its subsequent program, “Pathways to Empowerment” Baxter will also support health coaching by dialysis nurses to help implement patient self-management into daily practice while aligning with the Registered Nurses Association of Ontario best practice guidelines.

Through an innovative Plan-Do-Study-Act methodology, Baxter and St. Joseph’s will also closely monitor and evaluate the impact of these new digital educational tools to ensure they are meeting the needs of patients and their care providers. Furthermore Baxter’s gift will augment St. Joe’s research into kidney home dialysis and allow the Hospital to develop new ground breaking digitally-enhanced education and patient training opportunities for both home and peritoneal dialysis patients.

Dr. Darin Treleaven, head of St. Joseph’s Nephrology Program is committed to the implementation and execution of this new program. “At St. Joe’s we’re not just interested in treating kidney disease. Through projects like “Patient First” we are delving into the management and prevention of disease and evaluating the tools we are using with our patients to better understand their needs, and the impact of the care we’re providing. It’s not just about enhancing care, it’s about research that informs the future of care as well,” he said.

Rehabilitation provided in the LTLD program is designed to cater to each patient’s unique needs and home environment.

May 14, 2013, will mark the one year anniversary of the opening of the Low Tolerance Long Duration (LTLD) Rehabilitation program at Runnymede Healthcare Centre. The LTLD program has enabled the hospital to create job opportunities for over 60 employees and provide a much-needed, specialized rehabilitation program in the local community.

Sometimes referred to as slow-stream rehab, LTLD rehabilitation is a low to moderate intensity program for patients who need slower paced rehabilitation for a longer period of time, to maximize their potential of regaining functional skills and returning home.

The LTLD program is beneficial for patients like 94-year-old Mabel Kitson, who has rheumatoid arthritis and fractured her pelvis after a recent fall in her apartment. After a one-week stay at St. Joseph’s Health Centre Toronto, she was transferred to Runnymede where she was expected to benefit from 24-hour hospital care and LTLD rehabilitation provided by an interprofessional team consisting of physicians, nurses, physiotherapists, occupational therapists, social workers, speech-language pathologists, pharmacists, and clinical dietitians.

Rehabilitation provided in the LTLD program is designed to cater to each patient’s unique needs and home environment. Since Kitson will return to an independent lifestyle where she likes to attend monthly luncheons at her church, spend time on her computer sending emails and volunteer at the Salvation Army Church, her physiotherapists worked with her to regain her ability to walk on her own using a cane and a rollator. In group therapy, she worked on balance and standing exercises and in her spare time she continued to practice skills of daily living, such as dressing and getting in and out of bed, with the assistance of nurses.

“This rehabilitation program ensures patients that require a slower pace less intensive rehabilitation will receive the right care in the right place,” says President & Chief Executive Officer Connie Dejak. “RHC has built a reputation for excellence and as we set our strategy to move forward in our hospital we embrace opportunities for growth and expansion to better serve our communities.”

After seven weeks in the program, Kitson is scheduled to return home. “I just can’t wait to go home,” says Kitson, “but since I had to be in hospital, I’m glad it was Runnymede. I couldn’t be more pleased with the nurses who were all very kind and the therapists who helped me regain my balance and walking ability.”

Helping patients return to the community is the primary goal of the LTLD program and thus far has been a key area of success. Over 190 patients have been admitted to the program since it opened in May 2012. With many acute care beds in the Toronto Central LHIN being tied up with alternate level of care patients, Runnymede’s LTLD program is able to alleviate system pressures by transitioning patients to a more appropriate setting.

At Runnymede, Kitson has also been able to learn strategies to improve her safety at home and prevent future falls through the hospital’s
Falls Prevention program. Led by an interdisciplinary committee, the program ensures that best practices are used in identifying patients at risk for falls. Clinical staff implement fall prevention interventions and educate patients and staff about risk assessment and risk minimization. Moreover, the committee monitors and evaluates the program on a regular basis to ensure ongoing quality improvement and safety, and to eliminate barriers to compliance.

Effective fall prevention strategies that have been implemented at Runnymede include:

• Using a cheat sheet to assist in identifying the cause of falls and the actions taken.
• Consulting a falls protocol checklist to ensure 100% compliance with post fall documentation.
• Enhancing the availability of equipment such as bed mats, chair alarms and bed alarms.
• Continually monitoring and adjusting a patient’s environment to reduce risks, such as putting the bed in a lower position and freeing spaces of clutter.
• Labeling patients’ mobility aids with colour tape to indicate the level of falls risk, thereby helping clinical staff identify immediately, the degree of assistance a patient requires with ambulation and transfers.

“Educating patients on how they can continue to reduce risks and prevent future falls is a crucial component of the program,” says Manager, Pharmacy and Allied Health Luba Kelebay. “As we are increasingly positioned to provide rehabilitative services in the journey between acute care and the return to the community, we want to ensure that we can maximize not only our patients’ potential to regain their activities of daily living, but also their potential to enhance their quality of life for as long as possible.”

There are many areas of controversy about how dialysis should be administered to patients with acute kidney injury.

During his training as a nephrologist, Dr. Ron Wald became interested in conducting clinical trials to determine the best way to treat patients with severe kidney problems.

Acute kidney injury refers to the abrupt decline of the kidneys’ ability to function, which leads to the buildup of fluid, electrolytes, acid and other toxins. It is common among patients admitted to intensive care units, especially those with severe infections or after cardiac and vascular surgery.

“As a nephrologist in a busy tertiary care hospital, acute kidney injury is one of the most common reasons why I am asked for consultation,” says Dr. Wald. “Each year, about 100 St. Michael’s patients go on acute dialysis because of AKI.”

For patients who experience acute kidney injury and require dialysis, the 30-day mortality rate is a staggering 50 to 60 per cent.

There are many areas of controversy about how dialysis should be administered to patients with acute kidney injury. One of these relates to the best time to start dialysis in patients with acute kidney injury. And that’s where Dr. Wald’s research comes in.

Dr. Wald is conducting a 100-patient pilot randomized, controlled trial to test which approach to dialysis is more effective – early, pre-emptive dialysis vs. reserving dialysis for patients when they absolutely need it.

Recruitment for the pilot trial is about 80 per cent complete.

“We expect the first results will likely be available in the fall and that we will be able to publish by the end of the year,” Dr. Wald said.

A random sample of patients will be assigned to each treatment from 12 academic health sciences centres across Canada, including St. Michael’s Hospital; The Ottawa Hospital – both the General and Civic campuses; University Health Network – Toronto General and Toronto Western sites; Sunnybrook Health Sciences Centre; Mt. Sinai Hospital; St. Joseph’s Health Care Hamilton; London Health Sciences Centre – Victoria and University hospitals; University of Alberta Hospital; and Sherbrooke University Hospital Centre.

Once the protocol has been tested in the pilot, the goal will be to conduct a much larger trial that will address whether the timing of dialysis has an impact on mortality rates. At this point, Dr. Wald expects to be applying for research funding in 2014 to conduct the larger trial.

The trial is also benefiting from the expert management of the Applied Health Research Centre, which is based at St. Michael’s. AHRC provides comprehensive research services, including coordination of clinical trials (Phase II-IV), observational research, epidemiological research, qualitative studies, patient registries, financial and contract management, biostatistical and methodological support and industry-leading IT.

“During the pilot, we are also testing our ability to ensure consistency and quality across multiple centres,” Dr. Wald said. “This is particularly important as we look at running an international trial that will involve thousands of patients in the next stage.”

Dr. Wald is also studying the impact of acute kidney injury on long-term outcomes using Ontario-wide data. Research shows that a substantial proportion of patients with acute kidney injury end up with chronic irreversible kidney disease. He is conducting research to determine whether long-term kidney function can be affected by the way in which acute kidney injury is treated at the outset.

Heba Fakhir uses adaptive technology to express her passion for clothing design at Holland Bloorview.

With determination, imagination and a lot of specialized skill, Holland Bloorview’s staff and clients are revolutionizing the way technology and equipment enables children and youth with disabilities.

Heba Fakhir, 18, has muscular dystrophy. Heba has adapted to many physical challenges in her life, including losing the ability to walk, losing the ability to look down, and learning to breathe with a ventilator. Her dream is to be a fashion designer and she is well on her way. “Fashion has always been my passion.  I hope my clothes will inspire people one day,” says Heba.

Working together with an occupational therapist and art therapist at Holland Bloorview, Heba used a sewing machine controlled by an adaptive switch to make a dress from her sketches. The switch allows Heba to use a sewing machine to sew a pattern as any fashion designer would, just in a different way. Susie Rothman, occupational therapist, says, “We adapted this technology in innovative ways to maximize her independent participation, increase her self-determination and give her creative control over her project.”

“Technology is a huge part of my life”, says Heba “I use it every day for basic daily tasks, education and drawing.  It has really helped me see what I am capable of and show others.” The dress that Heba designed was a wonderful success. Heba proudly proclaimed that it “Looks better than I thought.  The dress turned out fantastic and exactly how I pictured it. I felt good that I did most of it myself.”

Registered practice nurse Zou Jaijai connects with a patient online via Skype for a follow-up appointment after his surgery.

A new program offered for surgical programs at Rouge Valley Health System (RVHS) is allowing patients to get the follow-up care they need from the comfort of their own home.

Patients who have had surgery at either of the hospital’s two hospital campuses – Rouge Valley Centenary (RVC) in east Toronto and Rouge Valley Ajax and Pickering (RVAP) in Durham Region – can choose to have their post-surgery follow-up appointment done via Skype, a popular software application that allows users to make voice and video calls over the Internet. The appointment is done with a nurse from the hospital’s pre-operative assessment clinic in the ambulatory care unit (ACU) at RVAP

The service, which has been offered at RVAP for Rouge Valley patients since last November, allows patients to stay at home and do their follow-up appointment over Skype with the nurse. The idea to use the service came about when RVAP ACU and surgical program staff were brainstorming ways in which to improve the patient experience for surgical patients.

How is works

The patient is given instructions on how to set up Skype during their pre-operative assessment clinic appointment at the hospital, before their surgery. A date is then set up to connect with the nurse over Skype. During the appointment, the nurse is able to speak to the patient and address any concerns that they may have. Since they are also able to see each other face-to-face, the nurse is able to see the patient’s progress.

So far, Rouge Valley is the only hospital within the Central East Local Health Integration Network (CE LHIN) and in the Greater Toronto Area to offer post-op follow-up via Skype.

“We’re encouraging more of our patients to take advantage of the Skype option, as it allows the nurse to see how the patient is doing, offering a more comprehensive follow-up appointment. Although it’s an Internet-based service, it still allows for a personalized touch with the patient’s care,” explains Amber Curry, manager of the ACU at RVAP.

After Gordon Regan’s total hip replacement surgery in November, the Ajax resident and grandfather of two became one of the first patients at Rouge Valley to have their follow-up done over Skype. “I think having Skype available for patients is great, especially if the patient lives in a remote area or is unable to travel. It was easy to use, and certainly a great option,” he says.

While Skype follow-up appointments don’t replace patient visits, it’s a helpful option for patients who are unable to travel to the hospital. Patients can still opt for traditional appointments in the ACU.

Be A Donor (left to right): Rik Ganderton, President & CEO, RVHS; the Gibson family (Muriel, Brandon, Emily, Krystyna [not pictured] and David); with Ronnie Gavsie, President & CEO, Trillium Gift of Life Network, hold Trillium’s flag during the April 2 kick-off event. Brandon, who has Cystic Fibrosis, is currently awaiting a double-lung transplant.

The 20-year-old Pickering resident was three months old when he was diagnosed with cystic fibrosis (CF). The build-up of thick mucus in the lungs, caused by CF, resulted in severe damage to Brandon’s lungs.

In 2006 at the age of 14, Brandon received a double-lung transplant improving his quality of life significantly. “I lived a normal teenage life. I played hockey and lacrosse in high school. I was pretty much like any other teenager,” explains Brandon, whose mom Muriel Gibson works at Rouge Valley Health System.

But by June 2011, things began to change. “I noticed that I wasn’t doing as well as I was before. Little things, like walking up the stairs, became harder.”  As Brandon’s health declined, his family soon learned that his body was rejecting his new lungs. For the past 14 months, Brandon, who now depends on an oxygen tank to help him breathe, has remained on Trillium Gift of Life Network’s organ recipient wait list. He continues to hope for news that a new set of lungs is ready for him.

Despite his challenges, Brandon makes it a priority to help raise awareness about the impact organ and tissue donation has on Canadians. He frequently speaks to local groups, sharing how organ donation can save lives. “To know that one person can save up to eight lives is amazing,” Brandon says.

More than 1,500 people in Ontario are waiting to receive a life-saving organ donation. Every three days one of them dies because there is no organ available in time for them. Rouge Valley Health System (RVHS) hopes to increase the number of organ and tissue donors, and for the first time, has partnered with the Trillium Gift of Life Network in its Gift of 8 campaign to inspire 200 Ontarians to visit the online registry at www.BeADonor.ca.

Trillium Gift of Life Network, a not-for-profit agency of the Government of Ontario, is responsible for managing the process of organ and tissue donation for transplantation in the province. Rouge Valley’s Gift of 8 campaign ran throughout the month of April to include National Organ and Tissue Donation Awareness Week (April 21 – 27). The Gift of 8 refers to the fact that each organ donor has the potential to save up to eight lives and enhance the lives of as many as 75 others through tissue donation. While 80 per cent of Ontarians say that giving consent for organ and tissue donation in advance is very important to them, fewer than 25 per cent of them have registered.

“In Ontario, there are far too many people waiting for organ and tissue donations,” says Rik Ganderton, president and chief executive officer, RVHS. “While the decision to become an organ donor is a personal one, each day our staff, physicians and volunteers meet patients whose lives are forever changed by organ and tissue donation. This campaign is just one way Rouge Valley can help to raise awareness.”

Be A Donor

Through stories in the local media, and hospital-wide events for staff, physicians, volunteers, RVHS has helped to spread the message of how organ and tissue donation saves lives. By setting up its own Gift of 8 pages for staff and the public to register, the hospital has helped to engage both its staff and the community to help with the challenge. One site has been set up for each of Rouge Valley’s two hospital campuses:

• Rouge Valley Centenary (www.beadonor.ca/rougevalleycentenary);
• Rouge Valley Ajax and Pickering (www.beadonor.ca/rougevalleyajaxandpickering).

Many Ontarians mistakenly believe that they are already registered because they have signed their donor cards. But the paper donor card is no longer an effective way to register your consent, Trillium advises. Ontarians need to visit Beadonor.ca to register or check their registration status.

“Encouraging more Ontarians to register as organ and tissue donors is critically important because too many Ontarians die before receiving the organ transplant they need,” said Ronnie Gavise, president and chief executive officer of Trillium Gift of Life Network. “When we launched Beadonor.ca in 2011, we made it easier for Ontarians to register their consent. Now, by bringing this awareness into the workplace, we are making it even easier for organizations like Rouge Valley to engage their employees and to make a difference in the lives of Ontarians.”

The 500th heart transplant patient was already in the hospital, waiting for a heart, when one became available. He’d heard about the approaching milestone and told the staff he had a premonition that he would be number 500

If they weren’t such a modest lot—and if they hadn’t been quite so tired—you might have heard the sounds of celebration at the University of Ottawa Heart Institute last November.

It was an occasion truly worth celebrating—the Heart Institute’s 500th heart transplant since the program began in 1984. At the same time, they were counting the 498th and 499th. In fact, thanks to the generous gift of families who consented to donation, two records were set between November 22 and 23—not only the 500 milestone but also the first time three transplants had been completed in one 24-hour period; two of them actually overlapped, with two full teams working in parallel.

“It was a great time,” said Cardiac Surgeon and Chief of the Division of Cardiac Surgery at the Heart Institute Dr. Marc Ruel. “We were in a state of very positive elation.” He compared the transplant process to something like Christmas. “You take out the old heart that isn’t working anymore and you put in this new, usually younger heart,” he said. “It’s like a Christmas gift for the patient. We get a real adrenaline surge from it.”

The 500th heart transplant patient was already in the hospital, waiting for a heart, when one became available. He’d heard about the approaching milestone and told the staff he had a premonition that he would be number 500. “He represents all the great transplant patients we’ve ever had,” added Dr. Ruel.

Dr. Ruel has been performing heart transplants at the Heart Institute for more than a decade. Not much has changed during that time in terms of technique, he explained. The transplants performed November 22 to 23 were not substantially different from the first one performed in Canada, back in 1968. What’s changed is our understanding of the heart and how it operates. That has led to improvements in anesthesiology, in immunosuppression (necessary to keep the recipient’s body from rejecting the new heart) and in the treatment and rehabilitation process after the transplant.

It is these advances, outside of the operating room, that led to Dr. Ruel’s findings when, last year, he reported on research following up on all of the patients who had had heart transplants at the Heart Institute since 1984. He and his colleagues found that survival rates from heart transplant have increased more than 20 per cent over the years, with the major changes coming after 2003. They found that nearly 90 per cent of recipients from that time were alive eight years post-surgery. And that, said Dr. Ruel, is better than pretty much all other published outcomes, testament to the high quality of care provided by the transplant team at the Heart Institute.

And, he added, he’s a very small part of that team. It’s the cardiologists and multidisciplinary team, responsible for care of heart failure patients prior to transplant and afterward who bear far more responsibility for those improved survival rates.

Cardiologist Dr. Haissam Haddad is Director of the Heart Failure Program and Medical Director of Heart Transplantation at the Heart Institute. He and his team see some patients for as many as 10 years before transplant and follow them for the rest of their lives afterward. In the first year after transplantation alone, he performs 10 to 12 biopsies on the patient, looking for signs of rejection so they can intervene early.

It’s a unique relationship,” said Dr. Haddad. “We see these people very often. We know them; we know when they’re not doing well. We suffer with them; we celebrate with them.”

Jackie Grenon agrees. An advanced practice nurse, Grenon is the coordinator of the transplantation program, the core that unites physicians, surgeons, dietitians, social workers, pharmacists, nurses, physiotherapists and all the other health professionals who together help heart failure patients survive and thrive. She said the patients and caregivers are like family, and her words were borne out by the atmosphere at a reception celebrating the transplantation milestone. Transplant recipients and staff members were hugging and catching up on one anothers’ lives. The warmth and connection were tangible.

In the words of transplant recipient Daniel Shipman at that reception, “You have given us a chance to live with our family, our friends, to go on with our lives. You are my family.”

There are currently 80 people in Canada waiting for a heart transplant, according to the Trillium Gift of Life, the Ontario agency that coordinates organ donation. The wait can last for days or months, depending on the available hearts and the patients’ needs. The Heart Institute’s first transplant was performed in 1984 by surgeon and Heart Institute founder Dr. Wilbert Keon. Today, the Heart Institute is one of the top hospitals in Canada for heart transplants, performing nearly 30 each year.

To register as an organ donor, please visit www.BeADonor.ca.