We are one of the largest Catholic health care organizations in Canada.
At the heart of what we do is a deep respect for the value and dignity of every human, and an unwavering commitment to those we serve, especially society’s most vulnerable.
We are partners with our patients, residents and families and lead with compassion, innovation and social justice.
St. Paul’s Foundation plays an essential role in connecting donors with areas of care, and in ensuring Providence Health Care's hospitals and care homes have the money required to meet urgent and greatest needs. The activities of the Foundation are essential to countless programs and services and the benefits are counted in lives saved and transformed, research breakthroughs, and a healthy community.
Providence Health Care has been providing compassionate care to the people of BC, and beyond, for the past 125 years. For us, compassion and innovation are two sides of the same coin: serving with your heart creates a constant push to find ways to better relieve pain, eliminate disease, reduce harm and create safety.
A lot of the work that is making the most difference in the lives of those we serve is made possible by the unprecedented generosity of those who give through our fundraising partner, St. Paul’s Foundation. In light of our continuing strong relationship, this year, Providence and St. Paul’s Foundation are sharing the highlights of 2018/19 as we celebrate our 125-year legacy together.
Our 125 years of innovation has been driven by our compassion, and we’re just getting started.
2018/19 In Numbers
Total Patients Served
Total Annual Visits To The
(SPH & MSJ)
Transforming Our Care Homes
Guiding Principles Of
Emotional connections matter most.
Residents direct each moment.
Home is a feeling.
Our legacy of compassionate care began with the opening of St. Paul’s Hospital in 1894 by the Sisters of Providence. Over the years, additional congregations followed, establishing the hospitals and care homes that form the Providence that we are today. We have grown a lot over the past 125 years, but our commitment to serving those most in need has remained constant.
Vancouver Community Dialysis Unit
East Vancouver Community Dialysis Unit
North Shore Community Dialysis Unit
Richmond Community Dialysis Unit
Squamish Community Dialysis Unit
Powell River Community Dialysis Unit
Sechelt Community Dialysis Unit
Reflecting on our year
Each day Providence people demonstrate their profound convictions, responding with all their knowledge and skills to ease the suffering of patients, residents and families throughout our 17 sites and the communities they serve.
What a year! As we celebrate the 125th anniversary of St. Paul’s, we also celebrate an outstanding year for the Foundation, Providence Health Care, and the people of BC.
St. Paul’s Foundation Board Of Directors
- Ms. Kathryn Young, Chair
- Mr. John Montalbano, Vice Chair
- Mr. Ivor Luk, Treasurer
- Mr. Bill Maclagan, Q.C., Secretary
- Mr. Mark Blucher
- Dr. Ron Carere
- Ms. Peggy Chiu
- Dr. Mark Edwards
- Ms. Fiona Dalton
- Mr. Joe Gallagher
- Mr. Eric J. Harris, Q.C.
- Ms. Debra Hewson
- Mr. Paul Hollands
- Mr. Stuart Louie
- Mr. Michael Mjanes
- Mr. Bob Rai
- Mr. Tom Shepansky
- Ms. Patricia Yeo
St. Paul’s Foundation Governors Council
Thank you for your support. In 2018/2019, St. Paul’s Foundation’s revenue of $40,425,058 was used to support research, equipment, education and patient care.
Disbursement of Funds
Breakdown of Donation Revenue
Reflecting on the past 125 years is the perfect way to inspire our next 125 years, and beyond. Follow us along on Instagram and Facebook as we share our top 125 Stories for 125 Years.
St. Paul’s Hospital, built by the Sisters of Providence, opens.
The first graduating class of St. Paul's Nursing School.
Surgery patients receiving cold ether often went into shock, so Sister Charles Spinola invents a machine that warms ether gas before it’s administered, making receiving anaesthesia more comfortable.
Mount Saint Joseph Hospital opens.
Photo Credit: Courtesy of Vancouver Public Library
Holy Family Hospital opens.
These stories celebrate the exceptional work that our staff, medical staff, researchers and volunteers feel called to do each and every day, changing the lives of the people we serve within the walls of our facilities, and beyond.
Celebrating transplant milestones in BC
Marc Bains will always remember the call from St. Paul’s that changed his life.
After living with heart disease for 10 years, Marc learned a new heart was available for transplant. His surgery in June 2018 was a huge success – and also marked a major milestone.
His transplant was the 500th such operation in the province, nearly 30 years after the first transplant took place in BC.
But being part of history can’t compare to having a new and powerful heart.
“I’m excited about the freedom a new heart gives me to live my life. I will be able to play sports again, travel with my wife, attend events, all without struggling from heart failure,” says Marc, who co-founded a heart-failure patient advocacy group.
His procedure was performed by Dr. Anson Cheung, surgical director of the Cardiac Transplant Program of BC, who has performed a third of BC’s heart transplants. “I feel grateful to be part of this milestone,” says Cheung. “That moment when the newly transplanted heart begins to beat is something I never get tired of.”
In 2018, BC set a new record for the total number of transplants performed in a calendar year, at 502. Nearly half of these transplants – 220, in fact – took place at St. Paul’s, which also set a record for the total number of renal transplants in Canada in a single year, at 193.
This would not be possible without the gift of organ donors and their families. In BC, the need for organs still outstrips the supply.
“To my donor and donor family, thank you for the gift you have given me and my family,” says Marc. “You have given me a second chance to live a full life, and I’ll be forever grateful for that.”
Indigenous Health, Now and in the Future
Have Heart, Will Travel
By all accounts, Jordan Marcia shouldn’t even be alive. Born with a rare, congenital heart condition, he underwent multiple surgeries and spent most of his early years of life in the hospital.
At the age of three, he also contracted a rare lung disorder, which meant even more time in the hospital dealing with invasive procedures. Jordan’s 13th surgery was a heart transplant. Three years ago, when Jordan saw a YouTube video of someone who was traveling around the world, he didn’t just think about it, or plan for ‘sometime’ in the future. He came up with a plan, convinced his mom and his medical team at the Heart Transplant Clinic at St. Paul’s Hospital, and then got on an airplane. Jordan has been to 12 countries so far, including Thailand, Myanmar, India and Sri Lanka.
He will be celebrating 22 years with his gift of life soon, hopefully at his next destination, the Philippines.
See Jordan’s story in action
A Life Lived Well, Post-Diagnosis
“The greatest challenges newly diagnosed diabetes patients encounter are the overwhelming amount of information they must process, and the requirement to learn new habits and maintain that changed behaviour,” says Dr. Ehud Ur, director of the Diabetes Centre at St. Paul’s Hospital. And newly diagnosed Joseph Darrigan was no different. After struggling to find a medication plan that worked well with his body, the 57-year old hair stylist’s doctor sent him to the Diabetes Centre. By that point, he was so fatigued from not being able to keep his blood sugar normal that he could “fall asleep pinned up on a clothesline.” But his time with the Diabetes Centre staff changed everything. Their thoroughness, hands-on teaching and ongoing support with menu planning and finding food that worked for Joseph – even for breakfast, his least favourite meal! – put Joseph back in the driver’s seat of his condition, and his life.
Time is Function: A Physician Quality Improvement Project
After medical stabilization, earlier stroke rehabilitation is important for optimal recovery. Led by Dr. Evan Kwong, the aim of this quality improvement (QI) project is to improve the patient access to inpatient stroke rehabilitation – the current regional rehabilitation target is 14 days after admission to an acute hospital.
Holy Family Hospital has a long history of specialized rehabilitation for the older adult. Of the 65 inpatient rehabilitation beds, 30 are dedicated for neurological rehabilitation. Each year, approximately 180 patients are admitted for inpatient stroke rehabilitation from various areas of British Columbia.
The project started with a medicine unit at St. Paul’s Hospital. After the first Plan-Do-Study-Act (PDSA) cycle, the time to connect a patient with inpatient stroke rehab decreased from 22.5 to 20.2 days but this is not a clear significant trend. Length of stay in rehabilitation at Holy Family Hospital for the cases in the project decreased from 42.1 to 19.4 days, further helping to improve patient access. Work is now underway to examine the variability of the data, stroke outcomes, the next PDSA cycle, spread, and sustainability of the change initiatives.
Physician Led Quality Improvement (PLQI) is a quality improvement partnership among VCH, Providence and Specialist Services Committee (SSC) to strengthen the quality improvement capacity and culture within our physician community. Work is done collaboratively with Quality department colleagues and help physicians connect with operations and gain support from senior leadership. This project could not have been done without the support of Providence, the PLQI initiative, and the BC Patient Safety & Quality Council Summer Student Internship program.
The People We Serve and Their Families: Our Most Important Partners
In June 2018, teams from Providence headed to Baltimore to present at the 8th annual International Conference on Patient and Family-Centered Care, which focused on promoting equity and reducing disparities in health care.
Kate McNamee, practice consultant, Care Experience, and Neil Fowler, team leader, Indigenous Health & Wellness, presented on Providence’s journey to Indigenous, culturally competent care. Aggie Black, director, Health Services & Clinical Research and Knowledge Translation, and Christine Wallsworth, a patient-family partner, shared how to engage patients and families in research.
Something said at the conference resonated with Aggie: “If you want to go fast, go alone. If you want to go far, go together.”
How Crosstown Helped Spike Get His Life Back
Spike is an example of how the right treatment can transform lives.
For seven years, he has come to Crosstown Clinic daily for a dose of prescription heroin, the only thing that’s worked to control his chronic substance-use disorder.
A near-fatal 2007 bike accident set him on a course to serious dependence on opioid-based pain relievers he was given, and from which he was abruptly cut off.
He developed a $250-a-day opioid habit.
Thanks to our Crosstown Clinic, North America’s only clinic offering prescription heroin treatment, Spike is now stable and advocates for harm reduction and human rights. He even ran for Vancouver City Council in 2018, advocating for more spaces for injectable opioid treatment.
A Moveable Feast
Compassion underpins everything we do at Providence. For our patients with cystic fibrosis (CF), this means doing everything we can to support their increased nutritional needs.
For many years, there was a kitchen on the CF floor at St. Paul’s. But the limitations of an aging building meant it had to be replaced with an exam room and research area.
Dietitian Kathleen Lee stepped up with an idea for mobile kitchen carts: each cart has a fridge, a microwave, and a kettle. Patients can stock them with their favourite high-protein, high-fat foods and access them 24/7.
In short? On the 8th floor at St. Paul’s, don’t be surprised if compassion looks like a pepperoni pizza with extra cheese.
Improving Care for Our Hip Fracture Patients: A Physician Quality Improvement Project
Each year, approximately 300 people arrive at Providence with fractured hips. These patients are often elderly, frail, have multiple comorbidities, and pre-operative pain is typically managed through intravenous opioids, which can lead to delirium, decreased awareness and more medical complications.
There is strong evidence that if patients receive a pre-operative femoral nerve block, their pain will be dramatically reduced. Patients who receive this require much less opioid and have better pain control while they wait for surgery. Dr. Dr. Trina Montemurro has set-up a quality improvement project to develop and implement a pathway so that anesthesiologists can assess all hip-fracture patients and perform a femoral nerve block if appropriate as soon as these patients are admitted. This requires the involvement of many health care providers: emergency medicine, orthopedics, anesthesiologists, internal medicine and the acute pain service. Additionally, our emergency and ward nurses need to be involved and aware of the nerve block.
So far we have successfully begun to perform nerve blocks on many of our hip fracture patients and are assessing for decreases in opioid consumption and other complications. Although the pathway is in its infancy stages, it is gaining traction and we are hearing about great successes from individual patients.
Physician Led Quality Improvement (PLQI) is a quality improvement partnership among VCH, Providence and Specialist Services Committee (SSC) to strengthen the quality improvement capacity and culture within our physician community. Work is done collaboratively with Quality department colleagues and help physicians connect with operations and gain support from senior leadership.
Faster access to personalized treatment
When you’re dealing with thrombosis, your main enemy is time. If it’s not quickly treated, it could lead to serious medical problems.
St. Paul’s Hospital’s expansion of its Thrombosis Clinic to five days a week will help get patients who are newly diagnosed with venous thromboembolism (or blood clots) to the clinic quickly and on a personalized therapy.
Thrombosis is the most common vascular condition after heart attack and stroke.
The clinic’s expanded hours are helping people like Emergency Department visitors, who can be sent to the clinic within 72 hours for care, and those diagnosed by their family doctor.
Take-Away Treatment for People who Overdose on Opioids
A first-in-Canada pilot project in the St. Paul’s Hospital Emergency Department is giving opioid overdose patients take-away doses of Suboxone when they’re discharged.
Patients get three days of the Suboxone tablets, which stop cravings and withdrawal symptoms, and a follow-up plan.
Currently, overdose patients are resuscitated in an ED but never given a chance to start life-saving treatment. That’s like a heart-attack patient not getting treatment for heart disease before being discharged.
The pilot, which will run for the next two years, will be evaluated by Providence’s BC Centre for Substance Use (BCCSU) to assess the impact on overdoses, hospital visits, mortality and engagement in care. If the St. Paul’s project proves successful, it could be expanded to include other patients in the ED identified with opioid use disorder. Eventually, this model could be adopted by all emergency departments in the province.
Better Understanding Patient Satisfaction: A Physician Quality Improvement Project
Dr. Patrick Vos, radiologist at St. Paul’s Hospital, together with Sheila Boyd, site coordinator for Radiology and Medical Imaging, are co-leading a quality improvement project focused on understanding patient satisfaction.
Data from 498 surveys from three different departments (i.e., Computed Tomography, Magnetic Resonance and Ultrasound) were collected and analyzed.
Although opportunities for improvement were identified around areas such as “waiting time to appointment”, “waiting in reception”, “wayfinding”, and “informed how to prepare”, a happy surprise was that there more positive comments than negative, including shout-outs to specific staff members for being “nice”, “great”, or “excellent”.
Improvement actions have been taken to address the areas of opportunity, and the survey is in the process of being used in two additional departments: General Radiology and Nuclear Medicine.
One Successful Stroke Protocol Inspiring The Next
When we think about strokes, we often think of incidents that happen outside of the hospital, which are then treated by health care professionals. But strokes can happen at any time, including in our hospitals’ inpatient units.
At Mount Saint Joseph Hospital, a new inpatient stroke protocol has been implemented to our existing list of stroke protocols. This unique protocol helps identify patients who are having a new stroke and require expedited assessment, investigation and treatment. This particular protocol is inspired by the successful implementation of an inpatient stroke protocol at St. Paul’s Hospital.
Expanding Code H for Patients & Families
Code Help, or Code H, is a patient- and family-activated safety system for patients that supplements existing care. It’s been in place at Providence since 2013, and expanded to cardiac units 5A and 5B on August 1, 2018. Patients and families who have questions about their care plan, or notice a serious medical change that’s not being addressed, can activate Code H and get connected to the Critical Care Outreach Team (CCOT), 24 hours a day, seven days a week.
Leaving Against Medical Advice: A Physician Quality Improvement Project
Dr. Trudy Nasmith, who works in Internal Medicine at St. Paul’s Hospital, first began her quality improvement efforts with understanding the characteristics of patients who leave against medical advice (AMA).
After collecting and reviewing data from more than 400 records to better understand the factors or conditions of patients who leave AMA, she chose to focus on improving communication with Primary Care Provider (PCP) and follow-up arranged.
Dr. Nasmith has been working with physicians and residents to improve and document communication with PCPs; she has also used surveys to collect feedback. Her work has allowed her to join a multi-disciplinary working group focused on addressing the issue of patients who leave AMA that includes members from diverse groups such as Infectious Diseases, Addictions, General Medicine and the Medicine Program.
Physician Led Quality Improvement (PLQI) is a quality improvement partnership among VCH, Providence and Specialist Services Committee (SSC) to strengthen the quality improvement capacity and culture within our physician community. Work is done collaboratively with Quality department colleagues and help physicians connect with operations and gain support from senior leadership.
Partnering for Patients
A partnership between St. Paul’s Hospital’s Maternity Services and Spiritual Health programs brought a brand new, shared space for prayer, meditation and breastfeeding.
It can be challenging for mothers to find a space that is comfortable, quiet and private for pumping and breastfeeding – this new space aims to be that space.
The room, located in the Burrard Building, can be used by patients, families and even staff members. This space was funded by the St. Paul’s Foundation.
What If We Took The Walls Off The ICU?
In the early ’90s, research identified that patients who went into cardiac arrest had documented signs of clinical deterioration 8 to 24 hours prior to coding. Upon further investigation, these patients progressed to cardiac arrest because of one (or more) of these three factors: failure to recognize early signs of clinical deterioration, failure to communicate, and/or failure to intervene. The solution? What if we “took the walls” off of our ICU? Which is essentially the concept of our CCOT (or, Critical Care Outreach Team) which, within its first 48 hours after launching at St. Paul’s, had supported 28 patient visits. A multidisciplinary critical care team made up of registered nurses, registered respiratory therapists and physicians act as an on-demand consult team for other program areas throughout the hospital, responding within 5 minutes of a call. Early intervention is key,” says ICU CNE Mia Marles. “Successful outreach teams depend on the unit team to call early, and call often. You don’t have to be able to put a finger on “the why” – just that you have a feeling that something isn’t right with your patient is enough of a reason to pick up the phone and call us.”
The next era of caring
We’ve embarked on a journey to make life better in our care homes, and for our residents. And it began by asking, what makes a home feel like home?
This simple question has been transformational. Site by site, we’ve gathered ideas and insights from staff, residents and families and put them into practice over a two-week testing period. We’re guided by three themes: residents direct each moment, emotional connections matter most and home is a feeling.
The project is called Megamorphosis. “Part of the beauty of Megamorphosis is trying to honour the uniqueness that each resident brings,” says Sonia Hardern, Performance Improvement Consultant at Providence.
At Mount Saint Joseph Residence, residents can have tea served from the nurses’ station, which was transformed to look like a Chinese tea house. At Youville, music therapy brings out people’s creative sides. Common areas were redecorated to be warm and welcoming. Robotic pets are cheery new companions.
“It goes beyond their care needs, medical conditions, and daily supports to get to the heart of what brings each resident comfort and joy.”
The future is bright for Megamorphosis. A $3-million donation by the Jurazs family has allowed the team to refurbish the Holy Family home. The project will become the blueprint for the Providence Residential and Community Care Services Society’s (PRCC) planned dementia villages at Providence’s St. Vincent’s: Heather site and at The Views at St. Joseph’s site in Comox, BC. In April 2019, Megamorphosis was recognized for its achievements and awarded the prestigious 3M Health Care Quality Team Award by the Canadian College of Health Leaders.
Best of all, for our residents, home doesn’t feel like living in a hospital setting. It just feels like home.
PRCC: Transforming Care
Providence Residential & Community Care Services Society (PRCC) is a non-profit Catholic health care society initiated by Providence Health Care in 2017 and operationalized in 2019 with ownership of The Views at St. Joseph’s in Comox, BC.
PRCC’s mission and values are rooted in the history and tradition of the founding congregations of Sisters that arrived in Comox and Vancouver over 100 years ago. PRCC’s mandate is to deliver compassionate and exceptional seniors care and community services through innovative new solutions.
While distinct from Providence Health Care, PRCC shares the belief that providing compassionate care connected to faith-based principles provides residents and families care that comes from a place that truly feels like home. PRCC is at the forefront of thinking about transforming care – reinventing, researching, educating and delivering compassionate care in support of healthy aging.
Welcoming The Views
On April 1, 2019, The Views at St. Joseph’s in Comox joined Providence Residential & Community Care Services Society (PRCC). When St. Joseph’s acute care services moved to the new Comox Valley Hospital in 2017, The Views saw an opportunity to reposition itself and its services.
PRCC and The Views felt that, together, they could best achieve their long-term missions of providing innovative care for seniors in the Comox Valley. The Views is the first organization to join PRCC. As part of the strategy to ensure sustainability and renewal of its Long Term Care homes, Providence Health Care intends to transfer all of its existing homes to PRCC at a future date, yet to be determined.
The Abundant Benefit of Art
Started by the Department of Veteran Affairs in 1946, Artworks was instituted as a quality-of-life program to help veterans recuperate once they had returned home. The program was situated in Shaughnessy Hospital for many years before moving in 1983 to St. Vincent’s: Brock Fahrni, which is home to 148 residents, many of them armed forces veterans. The non-profit program is just as impactful now as it was 73 years ago. From improved mental health to a better sense of wellbeing, the benefits of art therapy for seniors are abundant.
The Montessori Method at Youville
Youville Residence has embraced a Montessori approach in its caregiving efforts thanks to the co-location of a Montessori school on its campus. With the Montessori method, dementia caregiving aims to stimulate sensory perception in people with dementia to help them rediscover and engage in the world around them. Children from the onsite Montessori school participate in monthly activities with the Youville residents and members of the adult day program, such as making ice cream and crafts. Photo courtesy of the Vancouver Sun.
Dementia Village and Community of Care: One Step Closer
Thanks to a partnership with Island Health and the Ministry of Health, Providence Residential & Community Care Services Society (PRCC) is one step closer to developing a dementia village and community of care in Comox on Vancouver Island. The first step will be the redevelopment of the Views long-term care, through the construction of a modern and innovative new building to be located on a vacant portion of the St. Joseph’s Hospital site. PRCC’s goal is to create vibrancy and a sense of community with amenities that are of interest for people and their families to enjoy, such as a grocery store, pub, and music room.
Once a musician, always a musician
Artsway concerts take place at St. Vincent’s: Langara twice a month, to the enjoyment of everyone who lives there.
During an Artsway Concert on Feb 2, 2019 featuring Jon Roper, David Branter and Alan Matheson, St. Vincent’s: Langara’s very own resident, Eve Duke, was invited to sing with them.
Alan (jazz trumpet and piano) recognized Eve from previous encounters in their music careers and before they performed, Alan acknowledged Eve and her accomplishments as a musician who performed with Duke Ellington. He even bought the album to show his support of Duke Ellington and Eve’s music.
It was a warm moment to have a current musician acknowledge Eve, even though she is no longer performing professionally. Without any prior rehearsal, Jon, David, Alan and Eve brilliantly performed “Love You Madly” and “Sentimental Reason.” We would also like to acknowledge that Eve celebrated her one-year anniversary in performing at Eve’s Café.
Eve’s Café is held the first Thursday of the month at St. Vincent’s: Langara where Eve performs with Wendy, music therapist.
Once a musician, always a musician. Photo courtesy of CBC.
If you had to live in long-term care, what would make it feel like home?
Our long-term care teams are making sure that emotional connections matter most; residents direct each moment; and home is not a place, it’s a feeling.
In this spirit, each month, St. Vincent’s: Langara residents plan and cook dishes from a variety of cultures and cuisines, and share a delicious meal together.
Youville residents enjoy musical instruments, CDs, and in-house concerts. Support from a music therapist offers them profound opportunities for inclusion and creativity.
To encourage seniors to drink more fluids, Holy Family Hospital installed a slushy machine – a creative and fun way to stay hydrated and feel healthy.
The generous support of our donors to greatest needs across St. Paul’s helps purchase urgently needed equipment, life-saving research, and community programs that wouldn’t be otherwise funded through traditional channels. It’s helping us transform our culture of care – and improving the quality of life of all our residents.
Research & Culture Makes for a Unique Hospice
St. John Hospice is unique in its commitment to investigating best practices for end-of-life care and for the training of health professionals. Our hospice staff, in conjunction with members of the UBC Faculty of Medicine, collect general data that helps to develop innovative, multidisciplinary palliative care practices. This research, when coupled with the heart of those who work there, makes for a truly distinct culture, as evidenced by some of the following soundbites that were shared at St. John’s Hospice recent Long Service recognition event:
- “I’m proud of the work we do; I haven’t longed to go anywhere but here. Providence’s Mission and Values align with my practice as a nurse.”
- “I like working here because it’s a team; we create value for families, touch their lives and ensure they experience peace and comfort.”
- “As a volunteer, that feeling of team, and family, is extrapolated to use. We’re a valued part of team.”
- “When I first started at St. Paul’s I was casual on all floors and then I was introduced to palliative, I thought that the camaraderie and interdisciplinary support was above and beyond anywhere else.”
Thanks to our remarkable hospice staff, and the strengthened palliative care knowledge and practice that is yielded through research, more British Columbians will experience compassionate, quality care in their final days.
Laying the Foundation For Dementia Villages and Seniors Community of Care
More than $3 million from the estates of Beatris and Peter Jurazs is being used in the delivery of Holy Family’s household innovation project (HIP), with the goal of adapting the existing care home into one that feels more like a home than a work space.
The changes to the north wing of Holy Family reflect the attributes of the new dementia villages and community of care Providence Residential & Community Care Services Society (PRCC) envisions for both Vancouver and Comox, based on the principles of the De Hogeweyk model in the Netherlands.
A Surprise Valentine’s Day Visit for Our Residents
This year Valentine’s Day proved to be especially memorable for the people, many of whom are war veterans, who live at St. Vincent’s: Brock Fahrni. A surprise visit from Phillippe Sutter, the Consul General of France in Vancouver, had been arranged by Veteran Affairs Canada. Mr. Sutter delivered Valentine’s Day cards, which were written in both English and French, that had been created by elementary school students for our veterans. St. Vincent’s: Brock Fahrni veterans gathered together to read the Valentine cards, many embracing the French language by reading the card aloud and chatting to Mr. Sutter in French. One card, which was written by an 11-year old girl, stood out above the rest. Its sentiment saw many of our residents who had fought in a war tearing up while reading it. This joyful day had a lasting impact for many of our residents, and we are thankful for Mr. Sutter’s visit.
Food is Medicine: A Physician Quality Improvement Project
Did you know that the average raw food budget in long-term care facilities in BC is $8.00/day per resident?
Medical Coordinator Dr. Eileen Wong has been working on a quality improvement project to improve the food experience of residents living at our Holy Family Hospital (HFH) Extended Care Unit (ECU). Dr. Wong believes the quality of life includes good food. Together with her team consisting of a dietitian, registered nurses, registered care aids, volunteers, and recreation therapists, the project identifies residents’ values, which includes good taste and variety of food.
The Holy Family Hospital ECU Cooking Show, funded by St. Paul’s Foundation, is an example of a fun way for staff to interact with residents to enhance the food experience.
Ongoing education of staff, residents and their families and caregivers is another important part of the process to help understand not only budgetary constraints but also the complex system of food production as we together aim for better food experiences. Despite these limitations, staff at HFH ECU endeavour to continuously improve the food experience for our residents.
Physician Led Quality Improvement (PLQI) is a quality improvement partnership among VCH, Providence and Specialist Services Committee (SSC) to strengthen the quality improvement capacity and culture within our physician community. Work is done collaboratively with Quality department colleagues and help physicians connect with operations and gain support from senior leadership.
125 Years Of Innovation Driven By Compassion:
What we think makes the work we do so powerful is that the ability to change the lives of others is held in the hands of the people who work here. Through our compassion, our excellence, our commitment to social justice, our desire to bring about change. There are no bounds to what we will do for our patients and residents, not just here but around the world.
When Your Calling Is To Care
For most of us, a vacation entails going away to sandy beaches, frosty glasses and plenty of time to unwind.
For 20 nurses and doctors from St. Paul’s Hospital, “going away” is working unpaid, assuming your own travel and accommodation costs, and helping to fundraise before you even leave.
This cohort of nurses and doctors have been taking part in health-care missions to developing countries, year after year.
One of these people is Dr. Joe Del Vicario, a St. Paul’s anesthesiologist, who is the current president with the Canadian not-for-profit, volunteer-run organization, Health 4 Humanity (H4H). He’s made 14 trips to Guatemala through the non-profit, including a three-week trip in late 2018. Dr. Tom Goetz, a St. Paul’s orthopedic surgeon, is another volunteer. He’s been going on missions for the past two years. St. Paul’s anesthesiologist Dr. Jim Prentice has come for about a decade. Other members of the team from St. Paul’s include recovery room nurses, operating nurses, orthopedic nurses and general surgeons, like Dr. Tracy Scott.
“It’s a very committed group,” says Dr. Vicario. “And three quarters of the volunteers return the next year because they find the trip so fulfilling. The gratitude from the patients we help is moving.”
The Canadian volunteers carried out their first mission in Guatemala in 2001 because of a personal contact in the country and have gone there annually ever since. They care for patients at Las Obras Sociales del Santo Hermano Pedro Catholic Hospital in Antigua, run by Franciscan friars.
Dr. Del Vicario says the medical care is on a par with Canadian health care due in part to the modern equipment, all donated, the team procures. There are enough operating room (OR) supplies to fit a 40-foot container, shipped before the team arrives each year.
The need for more supplies and equipment always exists, he says. “But financially, I think we’ve touched enough hearts that funds come our way.”
Celebrating Long Service
More than 1,000 Providence staff, physicians and volunteers were honoured during this year’s Long Service Awards. Providence’s annual recognition program saw our longest serving staff honoured throughout the months of April and May at site celebration events; the program capped off with a gala dinner on May 24, which included for the first time, the presentation of some of our organization’s most prestigious awards: the Faye Meuser Memorial Leadership Award; the “Best” Patient Safety and Quality Award; the Research and Mission Award; the individual and team Mission Awards; and, the Keeping the Promise Award in addition to the 25+ year Long Service Awards.
Mitigating Tension With Early Access to Food & Water
Our two Emergency Departments (ED) located at St. Paul’s and Mount Saint Joseph hospitals served nearly 123,000 people in the last year alone. Meeting this demand is made possible by our incredible physicians and staff who provide exceptional above-and-beyond care to our patients each and every day.
An example of this care in action is a quality improvement project launched by Dr. David Agulnik, an emergency physician who works at both hospitals, last summer that provides early access to food and water in the ED at St. Paul’s Hospital in an effort to reduce aggressive behaviour. Recognizing that most of the population he serves are marginalized, low income and individuals with mental health/substance-use issues, Dr. Agulnik believes that tensions in the Emergency Department that lead to escalating behaviour can be mitigated by providing patients with early access to food and water while they are in the waiting room.
A preliminary survey of more than a dozen nurses and registration clerks affirmed that they believed the initiative introduced by Dr. Agulnik could lead to improved behaviour of patients, more compassionate care, addressing food needs and fewer staff interruptions. Dr. Agulnik was able to test out his theory with support from the Physician Led Quality Improvement Program (PLQI). Dr. Agulnik’s project was also recognized with a Golden Apple Award in 2018 by the Health Employers Association of BC (HEABC).
Dr. Scott MacDonald Represents Crosstown Clinic at North American Conference
Crosstown Clinic’s Dr. Scott MacDonald spoke in spring 2019 at a prestigious American conference on opioids and harm reduction.
The event organizer, Washington, DC-based think tank, The Cato Institute, is known for its libertarian public-policy research. But it has championed the work of Crosstown Clinic, North America’s only clinic offering prescription heroin treatment, and says the US government’s strategy around illicit opioids isn’t working.
Dr. MacDonald, who previously testified before a US Senate Committee on Crosstown, emphasized its safe, cost-effective — and lifesaving — work.
He says the illicit drug overdose problem cuts across the political spectrum and that prohibition simply hasn’t worked.
Spreading Hand Hygiene, Not Infection
As health care providers, we know that hand hygiene is the number one way to prevent the spread of infection.
However, for many of our patients and residents, their ability to effectively access hand hygiene can be compromised due to mobility issues. Our leadership in patients’ and residents’ hand hygiene has involved a number of innovative projects and approaches, one of which happening last fall with the launch of a collaborative pilot project between Volunteer Resources and Infection Prevention and Control (IPAC), which led to amazing results.
In early September, a dozen of Providence Health Care volunteers, called “Hand Hygiene Ambassadors,” were trained by members of IPAC team to educate volunteers on the importance of hand hygiene, the five moments of hand hygiene and correct handwashing techniques. A month later, these Hand Hygiene Ambassador Volunteers, who are incredibly passionate about enhancing patients’ and residents’ hand hygiene experiences, 83 fellow volunteers had been trained. The goal of this collaboration was to reach and educate more volunteers before the start of flu season and, given its success, the intention for next year is to grow this program to further support the health and well-being of our patients and residents.
International Attention Given to Holy Family’s Renowned Services
Last spring, the social work team at Holy Family Hospital hosted five social workers from Singapore who were keen to learn about Providence Health Care’s programs and services. The delegates were particularly interested in the transition from rehabilitation to home. They spent time shadowing Providence social workers, meeting with patients, reviewing cases through individual social work shadowing, participating in rounds and speaking to different interdisciplinary team members. This orientation was a joint project with Vancouver General Hospital and Fraser Health social workers.
Jumping Into Action to Save A Life – At Work and On Vacation
Jeff Vopni was expecting a relaxing weekend while visiting his parents in Osoyoos. What he wasn’t expecting was that by the end of the weekend, he’d be a hero (though he insists he isn’t).
While walking back to his parent’s house following a day of paddle boarding, he noticed something strange – someone floating face-down about 40 feet from the shore.
Thanks to his quick thinking and background in nursing, Jeff was able to jump into action, ultimately saving his neighbour.
Patient Safety: How Can We Adapt and Maintain a Resilient Culture?
Attended by 150 clinical, non-clinical staff, patient partners, and corporate leaders in addition to frontline clinicians, the aim of this year’s Patient Safety Retreat was to provide the tools, resources and space for leaders to think, discuss and ask critical questions, specifically focussed on unpacking one central question: How can we – as a leader, team and organization – adapt and maintain a resilient culture during times of uncertainty?
A diverse lineup of exceptional speakers reflected, coached, shared and challenged participants in large group sessions, in addition to being broken out into three main topic sessions: leader (bring our best selves to our team), team (inspire the team), and organization (resilience through uncertainty).
At the end of this raw, interactive day, participants left feeling that we are at the forefront of advancing patient safety, the care experience, and health care outcomes by learning from everyday work. Through sense-making, relatedness and looking at what allows us to provide care that goes right, we have the chance to make things safer for those who we serve and be world leaders.
Caring For Our Community At Large
It’s been 17 years since our inaugural Providence in the Park outreach event at Oppenheimer Park took place. Established in 2002 by the late Sister Margaret Vickers, she saw the event as “a great opportunity for us to go outside ourselves and show that we care for the larger community.”
Now a semi-annual occurrence, Providence people gather together twice a year to hand out warm clothing, bagged lunches, snacks, haircuts and compassion back to our community members and residents in the Downtown Eastside.
For many, our semi-annual event is the embodiment of what Providence Health Care stands for: compassion, mission and meeting the people we serve where they’re at.
A Small Act Of Kindness Can Make A World Of Difference
It’s not just a haircut – it’s an internal transformation.
Many of our hairdresser volunteers provide these transformations at St. Paul’s, working on our mental health units 9A, 2N, and 8C. These units are primarily for patients with a dual diagnosis of mental illness and substance-use issues; the majority of whom are from the Downtown Eastside. Many of these patients lack the funds to go to a hairdresser and when they receive a haircut, staff notice a change in their appearance and behaviour.
Jay Hartnell has volunteered as a hairdresser at St. Paul’s Hospital since May 2017 and has provided more than 75 haircuts to patients.
She shares her reason for volunteering at St. Paul’s as a hairdresser: “I love the fact that such a small act of kindness can make a world of difference in someone’s life.”
Simulation Olympiad: Residents For The Win
A team of University of British Columbia residents, including some from St. Paul’s Hospital, won a Simulation Olympiad in Toronto.
The Olympiad judges residents’ skill in diagnosing and treating a “patient” (a mannequin) quickly and with scant information. One “patient” was agitated and feverish. Acting quickly, the team discovered he was a drug mule who had ingested a packet of cocaine that later ruptured, causing massive drug poisoning. Though it’s a simulation, it feels real. Adrenaline runs high. Decisions are made quickly. The contest tests their ability to communicate as a team, which is key because though the knowledge may be there, often residents don’t get enough time to practice those skills.
The Joy Of Working Together
Much of the joy of working at Providence comes from connecting with each other around our passion for exceptional patient care. That’s why medical staff are excited to be involved in the provincial Facility Engagement Initiative. Over the past year, it has created many new opportunities for physicians, surgeons and medical leaders to forge stronger, collaborative relationships with Providence’s CEO and senior leadership, administrators and support staff.
It enables medical staff to work together more often on plans for patient care, our workplace and health care transformation. Notably, last fall saw more than 120 physicians contribute 250+ ideas to Providence’s seven-year strategic plan. This collaboration has been pivotal to inform our new strategic directions and goals, and will continue as we work together to bring our new plan to life. Our enthusiastic medical staff executive, with the Providence Physicians and Surgeons Society, provides leadership for engagement activities and, in 2018, launched a new medical staff website in partnership with Medical Affairs at www.phcmedstaff.ca.
Small Step, Huge Impact
For years, Mount Saint Joseph Hospital provided a plastic bag for the personal items of patients leaving the Emergency Department. But a small change brought in by an MSJ porter aide is making the hospital more green.
Thanks to Tracy Waldron, they get a plain paper bag now and that’s fewer plastic bags in the dump.
Her small step keeps about 8,750 soft plastic bags per year out of the landfill.
New St. Paul’s hospital is officially moving forward
It’s the beginning of a new era of health care for British Columbians!
With the approval of the business plan for a new St. Paul’s hospital on February 15, 2019, came a once-in-a-lifetime opportunity to create a purpose-built facility that puts people first.
“One hundred and twenty five years ago, St. Paul’s Hospital was established by the Sisters of Providence. The provincial government’s visionary commitment and investment into the new St. Paul’s will enable us to take this commitment forward for the next 125 years,” says Fiona Dalton, Providence’s president and CEO.
Over time, the new St. Paul’s at the Jim Pattison Medical Centre will be a complex of state-of-the-art buildings that will form a gateway to a campus devoted to compassionate health care; life sciences; and innovative research, teaching, and technology.
As the largest hospital redevelopment in BC’s history, the new St. Paul’s will have capacity for up to 548 beds, including 115 new beds. The site will be the home of leading provincial programs and referral centres, including for heart and lung care, renal, eating disorders, and specialty surgeries and transplants; and will offer a diverse range of general and specialized care, from HIV/AIDS, to mental health and addictions, to Indigenous health, among others.
Our patients will have digital access to their own medical files and quicker diagnostic times, with treatments harnessing things like immunotherapy, virtual reality, robotics, 3D printing and artificial intelligence.
As we prepare to build the new St. Paul’s, we’re more grateful than ever for the leadership, vision and compassion of the founding Sisters of Providence. And we’re grateful for the generous support of our donors to help transform the way we deliver and receive care in BC.
Doors of the new $1.9-billion St. Paul’s hospital are expected to open in 2026.
Celebrating 10 Years of Care at St. Vincent’s: Honoria Conway-Heather
Staff, tenants, volunteers and family members gathered on September 7, 2018, to celebrate an important milestone: the 10-year anniversary of St. Vincent’s: Honoria Conway-Heather.
The celebration included a prayer, songs, speeches, a commemorative video and an official cake cutting ceremony led by two of the most senior tenants, 99-year old Isabel McGladrey and 101-year old Arcady Kay.
The event signified a common theme: one of incredible thankfulness for ten blessed years. Happy 10th Anniversary, St. Vincent’s: Honoria Conway-Heather!
In Memory of Sister Margaret Vickers
Sister Margaret Vickers, previous Providence Society and Board member, passed away on Sunday, February 10, 2019. Up until her passing, Sister Vickers was still very much involved in caring for the Sisters at a Catholic retirement center and the Sisters of Charity of the Immaculate Conception in Saint John, New Brunswick. Sister Vickers loved Providence Health Care and her time at St. Vincent’s: Brock Farhni as well as starting and organizing Providence in the Park for the Vancouver community.
Sister Vickers was also a passionate advocate for bringing innovation to health care services across Canada. As a senior hospital administrator in New Brunswick, she introduced many beneficial services for patients and their families, including a community health centre and a diagnostic hostel that helped reduce the use of acute-care beds. She has contributed to the health care system as a committed board member, volunteer and fundraiser, notably with Providence Health Care and will be missed by her family, friends, colleagues and the community.
Foundational To Our Future
The Clinical and Systems Transformation (CST) project will be foundational to our future of improving the safety, quality and consistency of patient and resident care; this transformation will be coming to Providence Health Care beginning in the first two weeks of November 2019!
The CST project will be going live starting at St. Paul’s Hospital, Mount Saint Joseph Hospital and Holy Family Hospital. Providence’s care homes, including St. Vincent’s: Brock Farhni, St. Vincent’s: Langara, and Youville Residence will be going live in a second wave, likely two to three months after the November go-live.
Reflecting on 30 Years of the Pacific Adult Congenital Heart (PACH) Clinic
Did you know? The Pacific Adult Congenital Heart (PACH) Clinic cares for more than 6,000 patients and is the only clinic in BC caring for adults born with congenital heart disease. However, this was not always the case.
Dr. Doris Kavanagh-Gray recalls that initially “there was very little to do because surgery was just beginning to open. But by 1960, we were closing holes in the heart with the first open heart surgeries in Vancouver.”
As her patients grew up, Dr. Kavanagh-Gray continued to look after them as there weren’t many adult cardiologists specializing in congenital heart disease (CHD) survivors.
Then Dr. Marla Kiess arrived at St. Paul’s and, with a group of interested adult and pediatric cardiologists, launched the Pacific Adult Congenital Heart (PACH) Clinic in 1988, which went on to expand and grow at Shaughnessy Hospital and then St. Paul’s.
Now, more than 30 years later, the clinic at St. Paul’s sees around 100 patients a week. The multi- disciplinary team has grown to 13, and the most complex cases are reviewed by a team of 15 or more! Hear more about the story of PACH here!
Holy Family Opens New Pharmacy Department
The new pharmacy department at Holy Family Hospital officially opened on March 13, 2019. Serving long-term care, rehabilitation medicine and tertiary mental health programs at Holy Family, St. Vincent’s: Langara, Brock Fahrni, Youville, and Mount Saint Joseph Hospital, the dispensary is a busy place operating seven days a week with five technicians to provide medications to almost 750 residents, patients, and clients across these five locations.
Offering A Spectrum Of Care To Patients Across the Province
One of just two centres in BC for comprehensive renal care including kidney transplantation, St. Paul’s takes a patient-centred approach to caring for people at every stage of the disease. “Our job is not just to focus on people with chronic kidney disease who need transplant or dialysis, but also to keep the other 80 per cent well by helping them avoid the pitfalls that might lead to kidney failure,” says St. Paul’s nephrologist and head of Providence Health Care’s Division of Nephrology, Dr. Monica Beaulieu.
The Renal program at St. Paul’s, which has provided a full range of services for kidney patients for over 30 years, supports those suffering from kidney disease in multiple ways and in multiple venues.
- It serves patients at clinics around the province and makes outreach visits in addition to caring for them at the hospital in Vancouver.
- In-hospital services include vascular access (establishing and maintaining access points on the body for dialysis), transplant surgery and dialysis, among others.
- Patients from across BC come to St. Paul’s for transplantation and for post-transplant follow-up care. St. Paul’s also treats people who experience sudden kidney damage, including those who require dialysis or therapeutic plasma exchange.
- Patients with multiple conditions – kidney disease in combination with diabetes, for example – are steered to the Integrated Care Clinic, the first such clinic of its kind in Canada, which offers the services of subspecialties including endocrinology. Specialists from dermatology and psychiatry also provide integrated care for many kidney patients.
- People with chronic kidney disease from across the Lower Mainland, up the coast and even from Whitehorse in the Yukon receive care at or under the guidance of St. Paul’s renal program.
Scotiabank Feast of Fortune raised over $1 million
In support of greatest needs across Mount Saint Joseph Hospital, St. Paul’s Foundation hosted the 12th annual Scotiabank Feast of Fortune gala in January 2019, coinciding with Lunar New Year.
This incredible evening of generosity brought together approximately 700 business leaders, community ambassadors, and philanthropists, raising $1,008,993 for critical care equipment including cardiology, surgery, emergency, and imaging.
The event honoured gala founder Sim Lim Yeo for his ongoing personal commitment and long-time contributions to MSJ.
Daily Scan – Telling Timely Stories About All Things Providence!
Whether you’re on your break, on the bus, or even lounging at home, The Daily Scan is the best source for your daily dose of health care news.
Launched in October 2018, The Daily Scan is an emerging digital news site that tells the most recent health care news from Providence Health Care. We know our staff do great work every day to provide compassionate and innovative health care, and this news site puts this great work in the spotlight.
Get your health news, daily, on the Daily Scan! http://thedailyscan.providencehealthcare.org
Lights of Hope raised over $3.2 million for Providence’s greatest needs
St. Paul’s Foundation’s 21st annual Lights of Hope campaign raised over $3.2 million during the 2018 holiday season. Donations fund greatest needs across Providence, including vital equipment, research and teaching, and patient and resident care. Built by over 150 volunteers, the traditional display is comprised of over 100,000 sparkling lights and 200 stars. This year, for the first time, Lights of Hope displays shone at other Providence hospitals and care homes across Vancouver.
HUB ED and VPF TCC officially launched
A substantial rise in overdoses led BC to declare a public health emergency in 2016 and emphasized the urgent need for improved treatment options for a vulnerable population.
In July 2018, BC’s Minister of Mental Health and Addictions, Hon. Judy Darcy, announced the launch of the HUB Emergency Department and Vancouver Police Foundation Transitional Care Centre (VPF TCC) at St. Paul’s. Along with the Rapid Access Addiction Clinic (RAAC), they provide a continuum of care for people needing specialized mental health and substance use treatment, and help transitioning back into their communities. The culturally appropriate care includes an integrated Indigenous health team and connections to Indigenous healing programs.
This innovative care model was made possible with the investment of a number of community, health care, and industry partners. As the St. Paul’s Emergency Department receives nearly 11,000 mental health and substance-use-related visits each year, the HUB ED and VPF TCC are consistently at full capacity.
“The extra HUB beds are already easing the flow of our ED,” says Dr. Dan Kalla, Head of ED at St. Paul’s.
Supporting Our Commitment To Providing the Best Care Experience
Providence got an early Christmas gift in 2018 – the gift of Wi-Fi. Starting at St. Paul’s Hospital, enhanced Wi-Fi for staff and new Public Wi-Fi was rolled out across the organization. Our new enhanced Wi-Fi brought better, higher quality and more accessible Wi-Fi across our sites. This means we’re in a better position to provide the best patient care and put our best foot forward for the implementation of the new CST Cerner system coming in 2019.
We heard when patients, residents and families asked for public Wi-Fi. This new service allows our people to log on for free basic Wi-Fi, or pay for a premium Wi-Fi service. Public Wi-Fi is just one way that we are fulfilling our commitment to providing the best possible experience for our patients and their loved ones during their time in our facilities.
Digital technology supercluster announces first projects
We took a giant leap forward into the future of health care in November 2018 with the official launch of Canada’s Digital Technology Supercluster (CDTS) by the Ministry of Innovation, Science and Economic Development.
Superclusters are industry-led incubators of innovation. The Government of Canada is investing up to $950 million over five years to support superclusters across the country. The The BC-led CDTS will receive $153 million of this funding. As a founding member, Providence will be part of a group tacking ambitious challenges, including transforming the delivery of health care in BC and Canada.
CDTS was created as a collaborative effort of over 200 organisations, involving some of Canada’s biggest names in healthcare, telecommunications, natural resources, computing, and transportation. As BC has the fastest-growing tech sector in Canada, the CDTS will leverage our strengths in data analytics; genomics; quantum computing; and virtual, mixed and augmented reality.
Project teams within the supercluster are comprised of five to nine partners including industry adopters, technology leaders, start-ups, small and mid-sized businesses, digital innovators and research organizations. Collectively, teams will take on technology development projects, including those addressing the most pressing concerns in health care.
One of the first projects, announced in March 2019, will help a growing number of Canadians each year who develop some form of skin cancer. A medical imaging network, powered by artificial intelligence, will enable a preliminary diagnosis within days, instead of the current wait time of about six months. This will speed up referrals and triage of urgent cases, and improve survival rates. The project is expected to roll out in different regions of BC in multiple phases in 2019 and 2020.
Is cannabis a budding treatment for seniors’ ailments?
According to recent media reports and a geriatric specialist at Providence Health Care, the answer is a cautious yes. The confluence of our aging population with the legalization of cannabis means seniors are turning over a new leaf with regard to pain management in order to optimize quality of life and enjoyment of their golden years.
While little scientific data exists about cannabis use among the elderly and the risks involved, the movement towards cannabis treatment is a trend geriatric specialists are carefully observing.
Diamond Foundation’s million dollar gift will tackle addiction
In first nine months of 2018, over 1,100 British Columbians died from opioid-related overdoses. Providence hospitals and care sites sit at the epicentre of this crisis, providing care to one of Canada’s most vulnerable populations.
In November 2018, St. Paul’s Foundation announced the newly-created Steven Diamond Professorship in Addiction Care Innovation at the BC Centre on Substance Use (BCCSU), thanks to a generous $1 million gift from Vancouver’s Diamond Foundation, matched with an additional $1 million from the Foundation.
The Professorship will advance the BCCSU’s mandate to help people wherever they are on the spectrum of addiction and recovery. Working with the BCCSU and the UBC Department of Medicine, the Professorship will develop an innovative research program focused on addiction treatment and recovery as well as an education program to train health care practitioners in leading-edge, evidence-based approaches.
“Research and education will significantly reduce population harms, yield financial savings and, most importantly, improve the lives of individuals, families, and communities affected by addiction,” says Dr. Evan Wood, BCCSU’s executive director.
The team expects to announce the new clinician-scientist in spring 2019.
Women’s Heart Health
Heart disease is a leading cause of death among women in Canada. And yet, the bulk of heart disease research focuses on men. Not only are females with heart disease under-researched, they are also under-diagnosed and under-treated.
One Providence Health Care scientist who is working to close the research gap and stop women from dying unnecessarily is Dr. Karin Humphries. Thanks to a $1.6 million federal grant, Dr. Humphries and her team are investigating whether one simple change in how we diagnose a heart attack — using a diagnostic cut-point that is specific for women, rather than an overall cut-point — could improve care for women and reduce their risk of dying.
Virtual Reality Stroke Rehab
It seems like there are new technologies coming out every day, so much so it can be hard to keep up.
How do we introduce these exciting new technologies into care?
How do our staff adapt them into their practice?
Are our patients better off?
Those are some of the questions Holy Family Hospital’s (HFH) Occupational Therapy department is trying to answer. In 2018, they were invited to participate in a nine-month research project on the integration of Virtual Reality (VR) into stroke rehabilitation by the University of Ottawa Bruyere Research Institute, sponsored by the Canadian Partnership for Stroke Recovery and a personal donation from Tony and Elizabeth Graham.
The HFH team was given a VR program to integrate into their care. It has new, fun and engaging games and activities for our rehabilitation patients who have experience stroke so they can relearn and better control their movements.
The Ability to Date “Hibernating” Strains of HIV
Dormant strains of HIV can remain in the body for decades and are unreachable by antiretroviral treatments and the immune system. They can reactivate at any time, which is why HIV treatment needs to be maintained for life.
Researchers at the BC Centre for Excellence in HIV/AIDS (BC-CfE) and their partners have developed a novel way to date these “hibernating” strains, marking a significant advancement in the pursuit of a cure.
This research provides further clues in the pursuit of an HIV cure – which will ultimately require the complete eradication of dormant HIV strains.
Greater HCV Treatment Needed for People Who Inject Drugs
People who inject drugs are at a higher risk of contracting hepatitis C, yet few treatment programs for the viral infection are integrated into addiction care.
A lack of treatment increases the risk of end-stage liver disease as well as further transmission and places a higher burden on the health-care system.
According to researchers, there is a need to develop and implement community-based, low-threshold hep C testing, as well as treatment services within existing addiction treatment programs.
However, there are several challenges that need to be addressed before this can happen.
No Cure Yet, But Now It’s Believed To Be Possible
When Dr. Zabrina Brumme was in grad school, the idea of finding a cure for HIV was little more than science fiction.
Now over a decade later, HIV cure research is one of her main focuses as Laboratory Director at the BC Centre for Excellence in HIV/AIDS (BC-CfE) at St. Paul’s Hospital. While the field is still in its infancy and a cure for HIV is not yet in sight, many people – including Dr. Brumme – are now convinced it’s possible.
Patient Involvement in Per-SVR study Helping to Target Hep C Strategy
The hepatitis C epidemic disproportionately affects people who are marginalized and may face barriers to care, such as people who inject drugs. Baby boomers also have high rates of hep C.
Through its Per-SVR study (pronounced “persevere”) the BC Centre for Excellence in HIV/AIDS (BC-CfE) is conducting research to determine thresholds of prevention methods, such as harm reduction and safer sexual practices, to prevent hep C reinfection among key populations.
This multi-year study is observing people who have been successfully treated for the virus with the latest generation of hep C drugs.
Extra Oxygen Helps People With Lung Disease Stay Active
Barbara Deglau always enjoyed skiing, snowshoeing and cycling but when symptoms of lung disease started creeping up on her, exercise became challenging.
Following a diagnosis of pulmonary fibrosis, Barbara participated in a study at the Centre for Heart Lung Innovation (HLI) at St. Paul’s Hospital. Researchers were investigating whether high levels of oxygen would reduce breathing discomfort for individuals with chronic lung disease during exercise. Funding from St. Paul’s Foundation made the purchase of the exercise equipment for this study possible.
Based on promising preliminary results, the research team has been able to take their clinical trial across the country.
Biomarker Brings Hope
Scientists have discovered a new way to identify people at risk of chronic obstructive pulmonary disease (COPD). This significant finding could lead to earlier detection of the progressive lung disease and ultimately transform how patients are treated.
Researchers from the Centre for Heart Lung Innovation at St. Paul’s Hospital, in collaboration with partners, found a novel non-invasive imaging biological marker, or “biomarker,” that detects damage to the small airways.
The team hopes this biomarker will provide a way to identify patients who are likely to progress to symptomatic lung disease before they can be diagnosed using traditional methods.
Who Cares for the Caregivers?
Almost half of interdisciplinary care staff at Providence Health Care’s long-term care facilities exhibit signs of burnout, according to research published by a team of long-term care staff funded in the Providence Practice-Based Research Challenge.
The researchers wanted to understand how interdisciplinary long-term care team members are affected by the death of residents they are caring for. They also sought to identify strategies to help staff better cope with death. Supports that staff considered helpful included debriefing with staff and families, effective interaction between care team members, and educational workshops about death and dying.
Four New Inflammatory Disease Trials
Dr. Del Dorscheid, a critical care and respiratory physician at St. Paul’s Hospital and a researcher at the Centre for Heart Lung Innovation (HLI), is leading four new inflammatory airway disease trials.
Three of the studies are examining treatment for asthma while the fourth is testing a novel treatment for chronic bronchitis, a form of chronic obstructive pulmonary disease (COPD).
The studies are underway with the support of the Centre for Health Evaluation and Outcome Sciences (CHÉOS).
COPD: Lung Damage Starts Earlier Than Previously Thought
A recent study found that permanent lung damage caused by chronic obstructive pulmonary disease (COPD) starts much earlier than previously thought, even before patients start showing symptoms.
The findings, published in The Lancet Respiratory Medicine, could dramatically change how patients are treated for the progressive lung condition.
Dr. Tillie-Louise Hackett, a researcher at the Centre for Heart Lung Innovation at St. Paul’s Hospital and her research team made the discovery. They found that patients diagnosed with mild COPD have already lost a significant portion of their small airways – more than 40 per cent on average.
A new study led by Dr. Eugenia Oviedo-Joekes is continuing research into the use of injectable opioid agonist treatment as a way to help address the overdose crisis.
The “PORTIA” study follows up on earlier research that showed injectable opioids like diacetylmorphine, the active ingredient in heroin, and hydromorphone, the licensed pain medication commonly known as Dilaudid, are effective at attracting and retaining people in treatment who haven’t had success with methadone.
This latest study is investigating how injectable treatment can be scaled-up into effective and affordable services.
Supporting Staff’s Desire to Pursue Answers and Mobilize Their Learnings
As a teaching and research hospital, continually endeavouring to provide all staff with opportunities that support their desire to explore and share research ideas and evidence-based practice is paramount.
The Practice-based Research Challenge is now in its ninth year, having provided support to 584 clinical and allied staff who have little to no research knowledge or experience and funding 95 projects that have led to practice change, local and international conference presentations, and published findings.
The Knowledge Translation (KT) challenge is a joint regional initiative between Providence and Vancouver Coastal Health. Now in its third year, this challenge has seen seven projects be supported and funded, implementing research findings into practice. KT Pathways sees Providence partnered with the Michael Smith Foundation for Health Research to create a training tool for researchers, health professionals, decision makers, knowledge brokers and policy makers looking to be trained up in the way of KT. Increased understanding of KT and the skills to do it will inevitably increase the use of health research evidence in future research, practice, policy in BC.
Team grants for transplant-related research see a $30,000 grant to pursue issues that are directly relevant to current health care issues within Providence, thanks to a partnership with the Transplant Research Foundation and VCHRI, Vancouver Coastal Health’s Research Institute.
Hospital design for the future
The Holodeck looks like any other treatment room, except for one thing: it’s not real. It’s a holographic simulation – and a radical new approach to how we design health care spaces.
Located at Coquitlam’s Finger Food Studios, the Holodeck is actually an empty warehouse space. There, participants put on a virtual reality headset called a HoloLens. This self-contained holographic computer is programmed with full-scale, mixed-reality models that participants can interact with in real time.
“Finger Food is using HoloLens to map out our space and our equipment,” says Amanda Harvey, Providence’s Program Director, Acute & Access Services. “It’s allowing us to see first-hand where things work, and as importantly, where they don’t work . . . It’s an absolute game changer for clinical space design.”
Given Providence’s leadership role in Canada’s Digital Technology Supercluster, the collaboration between Finger Food, Providence, and St. Paul’s Foundation is an example of how innovative industry partnerships can radically change and improve how we do things.
Trauma-Informed Yoga: Helping Young People with Depression & Anxiety
Yoga is gaining momentum as a therapeutic option for people with various physical and mental health issues and new research suggests its benefits extend to youth who have experienced trauma.
A research team led by Sarah Cochrane, Nurse Practitioner at Foundry Vancouver-Granville, found young people with diagnoses of depression, anxiety and/or post-traumatic stress disorder saw positive results from participating in trauma-sensitive yoga.
The research showed that yoga helped participants reduce and manage anxiety, helped with chronic pain, increased mindful awareness, and helped with structure and routine in their lives.
Hear more about trauma-informed yoga and the impact it’s having:
Investigating the Benefits of Early Diagnosis
For the 25,000 Canadians who are diagnosed with Alzheimer’s disease every year, an earlier diagnosis can help them access the right treatment and plan for the future before their symptoms worsen.
Currently, physicians rely on traditional imaging tests and observing signs and symptoms to diagnose Alzheimer’s. For individuals with cognitive difficulties, measuring the proteins in their cerebrospinal fluid (a.k.a. biomarkers) has been shown to help identify the underlying disease.
A new study based at St. Paul’s Hospital is investigating how Alzheimer’s biomarker testing affects individuals and their families, medical decision-making and health care costs.
Generous donation supports chair in heart lung innovation
With a generous $3 million donation from Michael and Carmelina De Lazzari, St. Paul’s appointed internationally renowned lung scientist Dr. Don Sin as the inaugural holder of the De Lazzari Family Chair in Heart Lung Innovation (HLI) and director of the Centre of HLI.
“St. Paul’s Hospital is a hub for innovative research in Chronic Obstructive Pulmonary Disease (COPD),” says Dr. Sin. “I believe we will see treatments improve dramatically in our life time, thanks to world-leading research being done right here in Vancouver.”
125 Years Of Innovation Driven By Compassion:
Community & Beyond
The care we provide extends far outside the walls of our sites. The people who work here know that finding and delivering the care solutions of tomorrow means getting outside of our traditional thinking – outside of our traditional comfort zones, and outside of our traditional settings such as hospitals. Our care is only as good as people’s ability to access it which makes working closely with our partners in the community, exploring digital solutions, sharing our knowledge locally and globally, and finding ways to bring care to where people are at will always be top of mind for us.
Foundry goes “Boots on Ground” to battle opioid crisis
The waiting room of Foundry’s Granville Street location is awash with cheerful, bright colours, but just below the surface there is anguish.
“We’ve lost so many clients,” says Keren Mitchell, nurse practitioner. “We build close relationships with the youth in our programs, so it’s been a really difficult time for the staff here.”
There were 382 deaths in the City of Vancouver from opioids in 2018. It’s not just lives that are lost; many who survive their overdoses are left with significant, life-limiting brain injuries. This crisis has highlighted the need to step out of the box and do things differently.
Providence is the host organization for Foundry, which provides a one-stop-shop for young people to access mental health care, substance use services, primary care and more. Its model founded on the St. Paul’s Youth Mental Health Initiative and has grown into a province-wide network.
In February 2018, the team introduced Microdose Mondays, which uses a microdose protocol to initiate on-the-spot, regular dosing of Suboxone in youth with significant barriers to induction, such as homelessness, psychosis or developmental disabilities.
Microdose induction involves introducing a very low dose of Suboxone and gradually increasing it over five to seven days, thereby allowing the brain to adjust without precipitating withdrawal. As the Microdose Monday project progressed, the team added other forms of Opiate Agonist Therapy (OAT) and additional interventions to support youth with adherence.
In February of this year, the team launched a program called OATreach for Foundry clients who are living at the St. Helen’s Hotel who have an opioid use disorder. St. Helen’s, operated by COAST Mental Health, offers low-barrier housing to youth, many of whom are right off the street. The Foundry team employs a variety of hands-on outreach methods to initiate relationships and build trust.
“Youth are very vulnerable, but they’re also incredibly resilient,” says Keren. “Recovery looks different for everyone, but OAT can provide these young adults with a chance to stabilize and connect with care providers, as well as with their family and friends.”
Significant donation in support of new St. Paul’s
St. Paul’s Foundation announced a significant $6.5 million donation by London Drugs and Tong and Geraldine Louie Family Foundations in support of the provincial Heart Centre at the new St. Paul’s. Named in recognition, the Tong Louie Cardiac Wing will impact future generations of British Columbians requiring specialized cardiac care. The donation will allow the Heart Centre to offer more treatments and clinics, and recruit more cardiologists and cardiac surgeons.
Overdose Prevention Site Celebrates a Year in the Community
An Overdose Prevention Site opened May 2018 behind St. Paul’s Hospital has helped save lives for a year. The tent lets people use substances in the presence of trained staff and a peer support worker. There’s sterile equipment and access to emergency care.
Over the past year, over 8,880 visitors came by.
The tent, the first of its kind outside the Downtown Eastside, is part of Providence’s wraparound care for people who use drugs and fits with its mission of providing care to all, particularly society’s most vulnerable.
There’s a wall full of grateful notes. One says: “We love this place.”
Mobile Medical Unit – Evaluating The Success of a Hospital On Wheels
In late 2016, the opioid crisis was ravaging Vancouver’s Downtown Eastside. Emergency Departments were overloaded. In response, Vancouver Coastal Health, BC Emergency Health Services, the City of Vancouver, nurses and social workers joined to bring in the Mobile Medical Unit (MMU) – a hospital on wheels owned by the Provincial Health Services Authority.
The idea was that low-risk patients with presumed fentanyl overdoses did not need the advanced care of an ED: the mobile unit could more efficiently care for them. A February 2019 study in the Journal of Urban Health led by St. Paul’s ED’s Dr. Frank Scheuermeyer demonstrate the program’s success.
Between December 2016 and March 2017, 269 cases of opioid overdose were treated at the MMU. None had serious adverse events. Only three patients were taken to emergency for reasons unrelated to their overdose.
Global leaders in Transanal Endoscopic Microsurgery (TEM)
At St. Paul’s Hospital, the colorectal surgery team, led by Dr. Carl Brown, are global leaders when it comes to Transanal Endoscopic Microsurgery (TEM). This technique allows for the removal of premalignant lesions and some early rectal cancers without the need for an abdominal incision.
Last year, Dr. Brown and his team reported on their experience performing TEM: “In most centres around the world, surgeons perform TEM surgery and admit patients to hospital for at least one day, often longer,” Dr. Brown shares, “but over the past few years we have challenged that paradigm. Patients prefer to be at home, and with adequate support from our team, most patients can safely leave hospital on the day of surgery.”
Dr. Brown emphasized that a team approach to care was critical to achieving this success.
“At Providence, we have an Enhanced Recovery after Surgery (ERAS) program, co-led by Drs. Ahmer Karimuddin and Jill Osborne, which aims to provide the best peri-operative care. Without the collaboration of the entire team, this work wouldn’t have been possible.”
200 lives saved in BC because of SPH’s VAD program
For 67 year-old Scott Wilson, the trickiest part of his ventricular assist device (VAD) is getting the car seat belt over it. Only a small annoyance to have to deal with so that his heart continues to beat.
“It’s keeping me on the correct side of the ground!” says Scott.
Since 2002, when the VAD program came to St. Paul’s Hospital, this simple life saving device has saved 200 lives in BC. A VAD is surgically implanted in the chest and works by helping to pump blood from the heart to the rest of the body. For now, VADs are only implanted as a bridge to transplant in BC, which can be a wait of several months or even years.
National and International Attention for a Revolutionary Approach
A team of researchers and clinical staff at St. Paul’s Hospital have earned some national and international attention for a revolutionary approach to treatment for patients with eating disorders. They developed a new BC clinical practice guideline and a tool, titled the Short Treatment Allocation Tool for Eating Disorders (STATED). Together, these two tools provide a new way of describing patients with eating disorders and allocating treatment for them in a manner that is simple, patient-centred and cost-effective.
The BC clinical practice guidelines and STATED use three variables for allocating patients to treatment: medical acuity (eg. How urgently does the patient require medical care), life interference (eg. How much of the patient’s life is impacted by the eating disorder), and readiness and motivation for change. They integrate the growing evidence that poor motivation is associated with eating disorders treatment non-completion, poor outcome, and relapse.
The days of fasting before a cholesterol test are over
The province mandated labs to change their requisition forms by the end of 2018, based on Canadian Cardiovascular Guidelines, to indicate fasting is no longer required for lipid testing.
The change is big. More than 1.2 million lipid profiles are done annually in BC. The change means more convenience for patients. For diabetics, the rules can reduce potentially risky drops in blood sugar levels fasting can cause.
Evidence shows results from non-fasting lipid tests better predict heart attack, stroke and total mortality versus fasting results, since they capture other harmful lipids present after eating.
A Blueprint for Future Regional Initiatives
Thanks to a shared program between Providence and Vancouver Coastal Health, moving evidence into practice to improve patient care has been made a lot easier. An example of the important work being mobilized through the regional Providence/VCH Knowledge Translation (KT) Challenge is being done by a team of point-of-care clinicians and led by Michelle Carter, a Clinical Nurse Specialist in the Mental Health Program at Providence, and mentor and CHEOS scientist, Dr. Joseph Puyat. The team is looking at the implementation of a clinical toolkit for monitoring people on clozapine, a medication used for treatment-resistant schizophrenia. Clozapine is very effective but carries with it increased risk of side effects compared to other antipsychotics. The two primary side effects are agranulocytosis, a serious condition that results in a reduced white blood cell count and a compromised immune system, and myocarditis, an inflammatory disease of the heart muscle.
Specifically, the team will adapt a clinical toolkit that was developed and implemented at St. Paul’s Hospital in 2015 and apply it to Vancouver General Hospital (VGH).
“This project is one of the first clinical practice collaborations in psychiatry between PHC and VCH – it could provide a blueprint for future regional initiatives,” says Michelle.
Drug Implant As New Therapy For Opioid Dependence
A drug for opioid dependence that is inserted under a person’s skin and lasts for six months is a positive addition to the array of existing treatment options, says Dr. Seonaid Nolan, an addictions medicine doctor at St. Paul’s Hospital and clinical researcher with the BC Centre on Substance Use (BCCSU).
The matchstick-sized rods, which contain the drug Suboxone, are implanted by physicians under the skin of the arm. The therapy, which goes under the brand name Probuphine, has been approved by Health Canada.
Expanding The Role of Nurse Practitioners in BC
In August of last year, the BC Centre for Excellence in HIV/AIDS (BC-CfE) launched an educational initiative to expand the role of nurse practitioners in BC as antiretroviral prescribers for HIV prevention and treatment. The BC-CfE and the College of Registered Nurses of BC have been working together to expand the role of nurse practitioners to close the gaps in accessing HIV prevention and treatment.
The initiative consists of two tiers – the first focuses on training nurse practitioners so that they will have the competencies to prescribe PEP and PrEP. The second, coming late Spring 2019, focuses on the prescribing of antiretrovirals.
“How to Not Die from AIDS”
BC Centre for Excellence in HIV/AIDS Executive Director and Physician-in-Chief Dr. Julio Montaner pioneered life-changing treatment for HIV/AIDS patients to the point where the sick “literally rose out of their death beds,” according to the National Post.
Hear the story behind how Dr. Montaner and his clinic’s work now means a diagnosis is no longer a death sentence.
Tenant-led intervention: very successful in responding to overdoses in SROs
The majority of fatal opioid overdoses occur alone and inside the home. With that being the case, tenant-led interventions in single room occupancy hotels are urgently needed, according to research from the BC Centre on Substance Use and UBC.
As part of a six-month pilot program, 18 people were hired to work with nurses to provide overdose response training and deliver harm reduction education and supplies to tenants and landlords.
The researchers found this tenant-led intervention is very successful in responding to overdoses in SRO hotels.
Report Recommendation: Controlled Regulation of Heroin Sales in BC
A report from the BC Centre on Substance Use recommends the controlled regulation of heroin sales in BC. This model, the authors say, would reduce overdose deaths while also combating organized crime and the profitability of the unregulated fentanyl market.
Under this model, the BCCSU envisions the establishment of “heroin compassion clubs” where opioid-using members can purchase non-fentanyl-adulterated heroin. Closely regulated heroin compassion clubs could drastically cut fentanyl overdose deaths attributable to organized crime’s grip on the illicit heroin market, the report suggests.
We are at the beginning of Providence’s newly launched seven-year strategic plan, Mission: Forward. In this our 125th Anniversary year, perhaps more than ever, Providence is explicitly drawing attention to what we have always known: from the beginning, it was a mission dedicated to caring, research, and education. This was our founders’ mission, as it is ours today. And we are confident that it will be our mission tomorrow. Responding to this fundamental mission is how we all move forward, together. After all, it is Providence’s mission that drives the culture that, in turn, drives our strategy.
We have a comprehensive performance management and measurement system, including regular tracking of performance indicators, which are used to guide our operational and strategic decision making to improve patient and resident care. Below are some common indicators that we use to measure our performance and inform our improvement activities.