[Heather McDonald, occupational therapist]: Responsive behaviors is a term that
actually originated from persons who
have dementia themselves, and it's a term that we prefer to use because it gets
that the fact that somebody is responding to something that's important
to them, whether it be in the environment or something that's internal to them, and
it changes the way that we understand behaviour.
That problem that we tackled we did through a staff education program,
and associated processes of care to improve person-centred care for people
who demonstrate responsive behaviours.
[Allison Rinne, occupational therapist]: What's been helpful for us in
doing the high observation rounds is that it's given our team
a chance to come together and work with patients and families
to come up with strategies that work for them. The most valuable part for
me has been that people are talking about it more and people are
problem-solving more together, whereas I think a lot of that used to happen in
silos, and so I think recognizing the different skills of each health professional
brings and can use to help serve patients better has been a really valuable experience for me.
[Heather McDonald]: How can we address responsive behaviors in the
acute care environment? It's a relatively new conversation for hospitals to be
having, and I think that we can really position ourselves as leaders who've
done something innovative, who've used the collaborative approach to address a
challenge that was concerning to both staff and clients and families.
[Hennie Wei, pharmacy student]: I've never had an experience with a
student support website such as this one.
It's new, and I feel like as a student coming into St. Mike's, it's very helpful
as someone who is starting a rotation. Usually we have a lot of questions
before we even come to ask our preceptors, but this way we're oriented
even before we start.
[Aimee McDonald, physiotherapy student]: So I feel like this really supports me as a health
discipline student, because the website really makes me feel like students are
important at St. Mike's Hospital, and even before I got started here I already
felt like I was part of the team and I already had answers to my questions, and
I really like the different sections because me, as a physiotherapy student,
I can go specifically to the health discipline section for my own profession
and get all the answers I need without having to filter through everything else.
[Hennie Wei]: I love that I can access a site from my own cell phone and I don't even need a
computer, and I can look for answers wherever and whenever.
[Connie Martins, respiratory therapist]: The reason we in our department got
involved in the use of the esophageal balloon is because we wanted to be able
to help our critically ill patients who are ventilated
and who have developed ARDS (acute respiratory distress syndrome).
We wanted to be able to do more for those patients, because they are really difficult to manage.
[Kurtis Salway, respiratory therapist]: We are able to bring in the nurses and the doctors and
actually kind of teach them as we do it as well.
[Connie Martins]: People will look to us in our centre for training and understanding of
how to use it and perhaps implement it in their own centres.
[Kurtis Salway]: But our role is instrumental in actually performing the measurments.
So we actually insert the esophageal balloons at the bedside,
and then we are responsible for doing all the maneuvers on the ventilator to
produce the measurements that we use to guide us.
[Connie Martins]: Our role also includes helping identify patients that would potentially benefit
from having the measurements done on them, and then we then bring our results
to team, the medical team, and we discuss sort of strategies from there on in.
[Jeena Parmar, Occupational Therapy/physiotherapy assistant]: So the project that we got involved in
was the health disciplines holiday coverage last year. This was a new initiative for the health disciplines
and what drew me specifically to this initiative was being able to see the
possible positive impact that it would have on patients and families.
[Zuleikha Wadhwaniya, speech-language pathologist]: The most striking thing for me was
a patient who we were able to give a speaking valve to,
along in combination with the RT who was actually able to communicate the next day verbally
and we had everything set up for her to have a swallow study with radiology just after the holidays.
That wouldn't have happened if we did not have coverage across holidays.
[Jeena Parmar]: But the fact that the consistency was there, you can see that the therapists, for in my case,
could come back on Monday and possibly see this patient for discharge, because now they
had actually progressed over the weekend. So I can see this as being positive and
actually something that we would actually continue here at St. Michael's Hospital.
[Zuleikha Wadhwaniya]: There was a lot of excitement from the physicians, from the nurses,
especially because it facilitated the flow of patients.
Across the two holiday blocks, 175 patients were seen for a total of 312 visits
by members of different disciplines.
[Mackenzie Munroe, social worker]: So I think we know that emergency situations,
and crisis situations and patient care needs don't just happen during business hours.
So previously there wasn't a social worker in the Emergency Department past 4:30 or 5 p.m.
So now when a patient comes in at 5:30 or 7:30 or 10:30 at night
and they have those psychosocial issues, it could be looking for housing or shelter,
they might need grief support, they might be an elderly person going back to an apartment all by themselves
after their visit, there's now a social worker on the team who can support them with our needs.
St. Michael's Hospital as a whole has decided to create a permanent position,
so I'm so excited, I'm so happy for patients and families, and I think it's
going to be great going forward.