Providence Health Care has opened a $1-million addition and renovation that expands the hemodialysis program at its St. Paul's Hospital site by more than a third.

Among other additions and improvements, 11 new hemodialysis stations have been added at St. Paul's, bringing the total at the hospital to 43, a 34 per cent increase. This allows the unit to provide an additional 850 treatments a month, giving the ever-growing number of dialysis patients, who come to St. Paul's from all parts of Greater Vancouver, greater access to the life-saving procedure.

"This expansion of services helps illustrate the leading role Providence Health Care plays in the provision of renal services in British Columbia," said Dr. Brian Warriner, the CEO and President of Providence Health Care. "We look forward to continued partnerships with the ministry, the region and other stakeholders as we plan for and manage the increasing demands for care, treatment and prevention of kidney disease."

Patients with end-stage kidney failure require regular dialysis or transplantation to survive. Dialysis is the process that performs the failed kidneys' function of filtering waste products and excess fluid from the blood. Patients must undergo dialysis three times a week, with each session lasting about four hours.

As well as the new stations, other renovations to the Dialysis Unit at St. Paul's include a new patient waiting room, a new peritoneal training area and office and an enlarged and improved area for the technicians who maintain the hemodialysis machines.

In-patient rooms for kidney disease patients were also upgraded and consolidated with Urology into a new 25-bed unit. There is also a new patient lounge and a new procedure room where physicians can do simple procedures on patients without transferring them to other parts of the hospital.

Providence Health Care is the provincial referral centre for a full range of care and treatment of kidney failure and disease, including hemodialysis, peritoneal dialysis training, pre-renal failure education and support and kidney transplants.

Providence performs 23% of all hemodialysis in BC, more than any other health care provider in the province. Satellite clinics in Sechelt, Squamish and on Cambie Street in Vancouver are also part of the Providence program.

In addition to the renovations, the Ministry of Health recently announced funding for new hemodialysis machines at facilities throughout BC, including about 20 at St. Paul's and three at the clinic in Squamish. Five new hemodialysis machines have been already purchased and installed at the Sechelt Unit.

Contact:
Gavin Wilson
Providence Health Care Communications
(604) 806-8583

Dr. Michael V. O'Shaughnessy has been named Vice President of Research for Providence Health Care and Assistant Dean of Research in the Faculty of Medicine at the University of British Columbia. In this role he will be responsible for the leadership, scientific direction and management of research activities at Providence Health Care, a group of eight Catholic health care facilities including St. Paul's Hospital. O'Shaughnessy will continue as Director of the B.C. Centre for Excellence in HIV/AIDS, a position he has held since 1992.

The Centre for Excellence has pioneered important initiatives including the development of Canada's first set of medical guidelines for the treatment of HIV and the earliest use in Canada of double and triple drug combination therapies. The centre's research activities have received international recognition and O'Shaughnessy has a distinguished academic career with extensive scientific publications.

O'Shaughnessy is also a Co-Director of the Canadian HIV Trials Network, a member of the Health Research & Evaluation Advisory Committee for the Vancouver/Richmond Health Board, was the chair of the National Advisory Committee on AIDS and is past-president of the Canadian Association of HIV Research.

He was a co-chair of the highly successful 11th International Conference on AIDS held in Vancouver in 1996, which was attended by nearly 15,000 international delegates. O'Shaughnessy was awarded the Order of British Columbia in 1998.

"Dr. O'Shaughnessy's appointment comes at an exciting time for us, as we build on our solid foundation in basic science, clinical and outcomes research with new initiatives such the iCAPTURE Centre, which will apply new knowledge from the Human Genome Project to seek cures for heart and lung disease," said Phil Hassen, President and CEO of Providence Health Care. "In Dr. O'Shaughnessy we have a Vice President who can provide the vision, leadership and strategic direction we need to take us into this new era."

Providence Health Care is a major affiliated teaching hospital of UBC. Members of the Faculty of Medicine, appointed at Providence, focus their work on the major research themes of HIV/AIDS, health outcomes, and lung and cardiovascular disease. O'Shaughnessy's joint role as Vice President and Assistant Dean, Research will sustain and strengthen the close collaboration between Providence Health Care and UBC.

Providence Health Care is the largest Catholic health care organization in Canada. Health care providers in the group are Holy Family Hospital, Mount Saint Joseph Hospital, St. Paul's Hospital, St. Vincent's Hospitals (Heather, Langara, Brock Fahrni and Arbutus) and Youville Residence. UBC's Faculty of Medicine, established in 1950, has more than 400 full-time faculty whose research funding represents more than 40 per cent of UBC's total research support.

Contact:
Gavin Wilson
Providence Health Care Communications
(604) 806-8583

Andy Poon
UBC Public Affairs
(604) 822-3213

Expanding research facilities and clinical services at St. Paul's Hospital are getting some badly needed space beginning this month as some administrative offices move out of the hospital's Burrard Building.

"The move will free up urgently needed space at our facilities for patient care, teaching and research, which are our top priorities," said Neil MacConnell, leader of Corporate Planning.

The need for expansion became critical in July when St. Paul's researchers received a $6.5 million boost from the Canada Foundation for Innovation to create the iCAPTURE Centre. The iCAPTURE Centre will seek cures for heart, lung and blood vessel disease using the hospital's extensive collection of human tissue samples and new knowledge of genetics discovered by the Human Genome Project.

By the time it is fully operational in 2003, the $17 million iCAPTURE Centre will need an additional 20,000 square feet beyond what is now allocated for research at the hospital. St. Paul's, affiliated with the University of British Columbia, is already a major centre for medical research in BC.

Additional space freed up by the move will also benefit patient care. It will help improve services for out-patients attending hospital clinics, move physicians' offices closer to patient care areas; and better use patient bed space in the Providence building now taken up by offices.

More than 100 corporate and support staff from Providence Health Care are moving this fall to leased office space at 1190 Hornby Street, located about two blocks from St. Paul's Hospital.

Departments moving to 1190 Hornby include Finance, Corporate Planning and Human Development. The phased-in move began September 23 and is expected to be completed in November.

More changes to the St. Paul's site are expected in the near future. The Comox Building is slated for demolition to make way for construction of a new Emergency Department and mental health facilities. Known as Providence Phase 3A, the proposed building is the Vancouver Richmond Health Board's top-priority capital project and has been submitted to the Ministry of Health for funding approval.

Providence Health Care is Canada's largest Catholic-operated health care organization and the second largest health care organization in British Columbia. Created in 1997 through the consolidation of eight Catholic health care facilities in the Vancouver/Richmond health region, it offers programs and services across the full continuum of care, including rehabilitation, residential and long term care, community based primary and secondary care, tertiary care, teaching and research.

Heart Function Clinic aims to help patients live longer with better quality of life and fewer hospital admissions

On October 30, 2000 Cardiac care specialists at St. Paul's Hospital in Vancouver opened a new Heart Function Clinic to treat the growing number of British Columbians with congestive heart failure. This event represents the culmination of more than years of planning and enthusiastic support from hard working care givers, hospital administrators and a generous donation from AstraZeneca Canada Inc.

Congestive heart failure (CHF) is a condition resulting from damage to the heart muscle or valves. Symptoms include severe shortness of breath, increasing fatigue, decreased exercise capacity, swelling of the legs, lung and kidney complications and poor quality of life. Aggressive treatment with several medications, diet and exercise can improve the patient outcome, but many of the drugs require closer monitoring than is currently available in the community.

Although the incidence and death rate of many forms of cardiovascular disease has declined over the past several decades, the rate of the disease and the resulting death from congestive heart failure has increased by about 60 per cent since 1970. In British Columbia alone, more than 7,500 people are hospitalized for heart failure each year, at an annual cost of more than 38 million dollars.

"Heart failure is a growing problem and a complicated disease to treat," says Dr. Andy Ignaszewski, the director of the new clinic at St. Paul's Hospital. "Patients with congestive heart failure are admitted to hospital on average four times a year for an average of 11 days, much longer than for most other hospital patients. With good medical and lifestyle management and a better understanding of their disease, these patients can have a better quality of life and far fewer stays in hospital."

The St. Paul's Heart Function Clinic is staffed by a multi-disciplinary team of health care professionals including physicians, nurses, dietitians, pharmacists, social workers, psychologists, physiotherapists and occupational therapists. Clinic nurses also provide telephone support for patients with questions or concerns relating to their condition.

"Thanks to the support of hard working care givers, our hospital administrators and a significant private-sector partnership with AstraZeneca Canada Inc., the future for congestive heart failure patients has just become considerably brighter," Dr. Ignaszewski concluded.

AstraZeneca Canada Inc. has made a million-dollar commitment to establishing several similar heart function clinics across Canada, including the one at St. Paul's Hospital. "AstraZeneca's main focus is research," says Gerry McDole, president and CEO of AstraZeneca Canada Inc. "These clinics will be able to administer innovative medical regimens that require intensive monitoring not available through community physicians. We hope that this commitment will help find imaginative solutions to the serious problem of congestive heart failure."

The AstraZeneca portfolio of cardiovascular medications, including Atacand®, Zestril®, Betaloc®, Tenormin® and Plendil®, has already contributed to reducing the risk, prevalence and impact of many cardiovascular diseases. Committed to health care in Canada, AstraZeneca Canada Inc. currently invests more than $1.3 million every week on research and development in Canada alone. With more than 65 ongoing basic and clinical research projects in Canada, AstraZeneca Canada Inc.'s active research and development program aims to find innovative treatments for many forms of heart disease.

AstraZeneca is one of the world's leading pharmaceutical companies with a formidable product portfolio spanning seven major therapeutic areas: cardiovascular, gastrointestinal, oncology, pain control, respiratory, central nervous system and infection. AstraZeneca's brands include Atacand®, Losec®, Zestril®, Xylocaine®, Arimidex®, Zoladex®, Diprivan®, Pulmicort®, Zomig®, and Seroquel®. The Canadian headquarters and manufacturing facilities of AstraZeneca are located in Mississauga, Ontario, with a state-of-the art research centre based in Montreal, Quebec. For more information, visit the company's web site at www.astrazeneca.ca.

Part of Providence Health Care, St. Paul's Hospital is a major teaching and research facility affiliated with the University of B.C. St. Paul's Hospital Heart Centre provides everything from heart attack prevention programs to transplants. In 1999 -2000, specialists performed 1034 open-heart surgeries, 12 heart transplants, 113 implantable defibrillators, 1116 cardiac angioplasties and 2053 cardiac angiograms.

Other specialized services provided by St. Paul's Hospital include HIV/AIDS, the renal program, eating disorders, adult cystic fibrosis, palliative care, diabetes, pain management, Gastro-Intestinal Clinic and sinus surgery. For more information, please visit the web site, www.providencehealthcare.com.

For more information:
Anne McLaughlin
Director, Community Awareness and Media Relations
St. Paul's Hospital Foundation
604-806-8917
amclaughlin@providencehealth.bc.ca

Felicia Shiu
Manager, External Communications
AstraZeneca Canada Inc.
905-615-6865
felicia.shiu@astrazeneca.com

Pulmonary researcher Dr. Jim Hogg has received $1.26 million Cdn over four years from the US funding agency, National Institutes of Health, to pursue his groundbreaking research on the causes of emphysema. His proposal to the NIH was top-ranked in its field of international competitors.

Although cigarette smoking is known to be a major factor for emphysema, only 15-20% of smokers ever develop it. Dr. Hogg believes that a latent viral infection adds to the risk of developing emphysema. The viral infection, he says, aggravates the inflammation of the airways that cigarette smoke causes.

A UBC Professor of Pathology and Vice-president of Research at Providence Health Care, Dr. Hogg, has gathered much evidence during 10 years of research that shows the adenovirus is a contributing factor to the disease. His goal is to understand how emphysema works at the molecular level.

This could have a major impact on the treatment and prevention of the disease. Currently, emphysema can be controlled if caught early enough, but doctors do not know how to prevent emphysema and there is no cure. Currently, doctors prescribe various bronchial dilating medications to treat the asthma that often co-exists with emphysema. As well, antibiotics are used for acute chest infections and some patients benefit from oxygen therapy.

Emphysema, in combination of chronic bronchitis, is the most common form of Chronic Lung Disease (COPD). COPD is the fifth most common cause of death in North America today and is the only leading cause of death that is rising in prevalence.

When you think of health research, you probably believe it happens at a university or college. But in fact most health research in B.C. actually takes place in the major teaching hospitals. Providence Health Care is no exception. Research here takes many forms, from patient questionnaires and new drug tests to laboratory science.

Over 350 Providence people — full-time scientists, students, physicians and other health care professionals — are involved in research. Last year they received more than $17 million in funding from 100 different granting agencies to launch 275 new research projects.

Research has grown over the years under the leadership of Dr. Jim Hogg, who retires at year-end. Our new Vice President of Research will be Dr. Michael O'Shaughnessy.

O'Shaughnessy's appointment comes at an exciting time for research at Providence. The recently announced iCAPTURE Centre, led by Drs. Bruce McManus and Peter Pareé, will build on existing research strengths and apply new genetics knowledge, seeking cures for heart, blood vessel and lung disease.

O'Shaughnessy is well known as the director of the BC Centre for Excellence in HIV/AIDS, a position he has held since 1992. Under his guidance, the centre has pioneered HIV/AIDS treatment and research, including the earliest use in Canada of double and triple drug combination therapies.

Being in hospital can be a scary experience — the unfamiliar surroundings, the medical lingo, all those tests and procedures. If you speak no or limited English, the experience can be all the more confusing. It can also be a challenge for care givers to provide the best in care. That's why Providence Health Care has a 24-hour interpretation service. Since the service was launched last October, requests for interpreters have increased from under 50 per month to over 300 monthly. The top three languages requested? Cantonese, Punjabi and Vietnamese. If your loved one is in a Providence hospital and needs interpretation services, speak to a care provider.

Some countries may have had impressive medal hauls at the Sydney Olympics this year, but it was two Providence staffers who came back with the real gold — a handful of Australian nurses.

Recruitment specialist Linda Diamond and patient care leader Wendy Scott travelled to Melbourne and Sydney for a whirlwind, five-day recruitment trip in September (to save money and avoid crowds, they went before the Olympics started). Their mission? To try to fill some of the 100 desperately-needed nursing positions at Providence.

"We did something we've never done before and that was get on a plane and go to the overseas nurses," Diamond says. "Of the 43 we interviewed, all expressed an interest in coming to Canada," she says. "And B.C. is their first choice. They seem fascinated with Canada."

Of course it's not completely straightforward. Although all those interviewed were highly experienced and had specialty training, roughly a third of them won't be eligible for registration here because they don't have the breadth of academic training required by Canada, Diamond says.

Then they have to meet Canadian visa requirements and satisfy the B.C. Nurses Union, which requires that eight Canadian nurses receive specialty training for each foreign nurse admitted. Still, it's a good start. Diamond hopes that within four months, roughly 20 nurses will be "talking Aussie" in the halls of Providence and helping relieve the burden on overworked existing staff.

When the weather gets colder, the days shorter, and the rains even more relentless than usual, Vancouverites know winter has truly arrived. Hospital staff know it too — because the emergency rooms are suddenly filled to overflowing. How can you keep your health intact during the winter and avoid the crush? Here's our guide:

Get a flu shot: There's no easier and cheaper measure to protect your health. People tend to think of the flu as a nuisance, like the snow. It's not, says emergency physician leader Dr. Jeremy Etherington. "It's a debilitating illness — and for the very young, elderly and ill it can be fatal." The flu will kill about 4,500 Canadians this year alone. That number climbs to 6,000 if you include those who die from complications such as pneumonia. Immunization, however, can prevent flu in between 70 and 90 per cent of healthy recipients. And, contrary to popular belief, because the vaccine is made from a dead virus, it cannot cause you to get sick. The flu shot will be provided for all Providence staff. You should consider it too.

Use your family doctor: Don't visit Emergency for sore throats, colds, ear aches or flu (unless it's likely to be life threatening). "There's no question we spend a lot of time with people who could have gone to their family doctor or clinic first," Etherington says. Some people are reluctant to call their GP after 6 p.m., but that's silly if you're sick. Your doctor should be part of a "call group" set up to assess your health problem over the phone (and then direct you to Emergency if necessary.) If you don't have a family doctor, you can call the College of Physicians and Surgeons of B.C., (604) 733-7758, local 253, for a list of doctors accepting new patients.

Prepare for the weather: Drivers should slow down when the streets are slippery and visibility poor. But don't be smug because you're on foot. Twenty-two pedestrians were killed in Greater Vancouver last year and most of them during the winter months. Be smart: Invest in a brightly colored hat, coat or jacket and always wear something reflective at dusk or dark. Velcro-strapped reflective wristlets or anklets are convenient, cheap and flexible. There are also some great reflective umbrellas on the market now.

Monitor your mood: Depression is a major problem in the winter, particularly at Christmas. If you have feelings of extreme unhappiness, worthlessness or exhaustion, be sure to talk to your doctor. There are lots of good options, from simple measures like sitting under a light for 20 minutes a day and getting more exercise, to a new range of low-side-effect drugs. But don't diagnose yourself and get help. If you're a senior (or if you have aging parents) keep in mind depression is particularly common among the elderly.

Use Emergency wisely: Don't be reluctant to use the Emergency Department if necessary. "If you think you have a life- or limb-threatening condition, this is the place to come," says Etherington. "As well, many GPs aren't set up to deal with fractures and lacerations." Other good reasons to head for emergency: chest pain, shortness of breath and severe abdominal pain.

As we approach Christmas, the foundations that support Providence Health Care facilities are shifting into high gear to prepare for seasonal campaigns. In spite of the government's recent announcement of additional funds, donations are as essential as ever for purchasing equipment and developing new programs. The $5 million allocated to Providence from the government this fiscal year for capital equipment will not cover the "mission critical" list, let alone purchase less critical, but necessary, equipment. Your support makes a huge difference in the lives of our patients, residents and staff. Please give generously this Christmas.

St. Paul's Hospital:
The third annual Lights of Hope campaign at St. Paul's Hospital will be launched on December 12th. The St. Paul's foundation hopes to beat last year's campaign, which helped the Foundation surpass its annual goal, raising $4.1 million in 1999-2000. Funds raised during Lights of Hope are used to purchase medical equipment and support research into heart and lung diseases. To make a donation, call the foundation at (604) 682-8206 or visit its new website: www.helpstpauls.com

St. Vincent's Hospital
With the eye-catching slogan "Be An Angel," St. Vincent's Foundation kicks off the eighth year of its highly successful Christmas direct mail campaign. The foundation's goal? To raise $100,000 to help fund the first comprehensive and interdisciplinary in-house dental program at a hospital in Canada. If you'd like more information, call (604) 877-3193.

Mount Saint Joseph Hospital:
In keeping with its strong roots in the Asian community, Mount Saint Joseph focuses its holiday fundraising efforts on the Chinese New Year, which falls on January 25th this year. The foundation sends out the traditional Chinese red envelopes with its newsletter, asking for a donation and inviting people to make a special wish. The foundation is raising funds for priority needs, such as the hospital's first CT Scanner. Interested? Call (604) 877-8336.

Dr. Brian Warriner has been appointed President and Chief Executive Officer (Acting) for Providence Health Care. His appointment effective October 26th, 2000 will continue until we have successfully completed our search for a new CEO.

Dr. Warriner has been a vice president and member of the senior leadership team for the past 2 years, leading Medical Affairs, Medical Education, FOI/Risk Management and Utilization Management. He is a Clinical Professor in the Faculty of Medicine (Anaesthesia), UBC and will continue his clinical practice in Anaesthesiology, working reduced hours at St. Paul's Hospital.

A new research centre at St. Paul's Hospital — the iCapture Centre — will soon give scientist the tools to better seek cures for heart, blood vessel and lung diseases.

Scientists at St. Paul's already perform laboratory-based research into the prevention, diagnosis and treatment of these diseases. The iCapture Centre will give them the latest technology for examining molecules, cells, tissues, whole organs and organisms. They will also be able to apply new knowledge about normal genes acquired from the Human Genome Project.

The iCapture Centre will be based on the large collection of abnormal lung, blood vessel and heart tissue — among the most extensive in North America — located at St. Paul's McDonald Research Laboratories.

"Heart, blood vessel and lung diseases cause suffering or death to millions of Canadians each year," said Dr. James Hogg, Vice-President of Research at Providence Health Care. "We need to better understand why some people develop serious health problems like asthma, emphysema, heart attacks and blocked blood vessels while others with the same known risk factors do not."

The iCapture Centre, created in partnership with Vancouver Hospital and Health Sciences Centre and the University of B.C., recently received a $6.5 million boost from the Canada Foundation for Innovation. It will receive a further $2.4 million from UBC and $1.3 million in donated equipment from technology companies. The Heart and Stroke Foundation of B.C. and the Yukon and B.C. Lung Association have also committed funds. The centre should be fully functional by 2003.

Although the St. Paul's Hospital Foundation had a $3.5 million goal for 1999, by year-end $4.1 million had been raised to support research, purchase equipment and enhance patient care. The goal was surpassed thanks, in part, to the Lights of Hope campaign. The community involvement was impressive, says executive director Jane Adams. "It involved more than 75,000 volunteer hours."

Last year, the foundation continued to support research at St. Paul's and purchased important equipment, including a mammography machine, patient monitors and gastro-intestinal scopes. This year, the foundation hopes to build on the 1999 success. To contribute, call (604)682-8206.

Poverty... addiction... mental illness... disease.

Vancouver's Downtown Eastside is famous not only for the mind-numbing array of social problems it faces, but also for the severity of them. And with these problems come serious health concerns - hepatitis, HIV/AIDS, tuberculosis, bone infections and trauma.

Serving the sick and the terribly disadvantaged is simply part of the proud history of Catholic hospitals. After all, Mount Saint Joseph was born to serve immigrant railway workers. Youville Residence to care for destitute men during the Depression. Holy Family to meet the needs of single women. St. Vincent's to care for the elderly. And St. Paul's - founded more than 100 years ago - to serve not only the city's population, but the miners, loggers and homesteaders "up-country."

That history is still alive today as St. Paul's continues to work with the poorest of the poor in the Downtown Eastside.

"Poverty is almost a definition of the community," says Dr. Jim Thorsteinson, who is chair of the department of family and community medicine. He's worked in the area, in a variety of roles, for more than eight years and understands well the cycle of desperation.

"Poverty is very destabilizing, especially with housing," he says. "The current (low) housing allowance within the welfare system exacerbates a lot of the health problems."

While that's not an issue the hospital can directly influence, St. Paul's is working hard to contribute in other areas.

"We have family practice residents working in the community, along with nutrition, pharmacy and social work staff," Thorsteinson says. As well, the hospital is developing an injection drug program. "We're opening some support beds and we believe an ambulatory substance-withdrawal program can work."

• develop a community-based IV treatment program;
• support initiatives to help the dying stay in their own homes (and in some cases to find better homes for them); and
• encourage specialists to spend more time in the community.

The hospital's efforts have not gone unnoticed by others in the city. Vancouver-Burrard MLA Tim Stevenson appreciates the hospital's programs and innovation. "When I think of St. Paul's, it always reminds me of how lucky we are to have such a quality hospital serving our community. With programs such as the AIDS clinic and the Heart Centre, I see this hospital playing an active role in keeping us healthy and in developing new ideas."

Cst. Anne Drennan, spokes-person for the Vancouver Police Department, also has high praise for the hospital. "One of the reasons our homicide rate has gone down in the last 10 years is because of the efforts of the B.C. Ambulance Service and the St. Paul's emergency and operating room staff," she says. "People, who in the past would have died, are surviving as a result of the service." Major Samuel Fame, executive director for the Salvation Army's Harbour Light Treatment Centre, says he's impressed with the hospital's treatment of street people. "They've made an effort to get closer to the needs of the people."

For Thorsteinson, it's a service that just comes with the territory. "It's consistent with Catholic hospitals," he says. "There's a different sort of spirit here — more personable, more person-centred — willing to work with the person as they are and not be judgmental."

Not all the saints at Providence Health Care are found in the names of hospitals. Each of our facilities relies heavily on the saintly behaviour of thousands of volunteers. Sister Thérèse Kergoat is one such person. A former nurse and long-time volunteer at St. Vincent's Hospital, Heather, she was recently awarded the Governor General's Caring Canadian Award for her many years of volunteer service.

Water was the theme this past year at Holy Family Hospital Foundation, where the number one goal was to rebuild the hydrotherapy pool. "It officially opened May 30," says executive director Glen Mitchell, with some pride. The campaign was called "Waterpower" and it raised the necessary $550,000. The pool is central to Holy Family's comprehensive rehabilitation programs, which help adults in their senior years live independent lives. This year the foundation hopes to replace the hospital's mechanical beds and lifts with electric versions. Anyone wishing to donate can call (604)322-2604.

Say the words "brain injury" and many people think of a motor vehicle or skiing accident. But the most common brain injury is actually a stroke. A stroke most often occurs when the blood supply to part of the brain is cut off, says Fiona Larson, rehabilitation clinical coordinator for Holy Family Hospital. "The lack of oxygen is what leads to damage."

Strokes, which can occur on either side of the brain, will affect the opposite side of the body. For example, if one occurs in the left brain, the patient may have some paralysis on the right side of his body. A stroke in the left brain is also more likely to affect speech and behaviour — and make the person slower and more cautious. A right-brain stroke is more likely to affect spatial relations and perception and make the person more impulsive.

If you think you or a loved one might be having a stroke — watch for loss of speech, sudden weakness or numbness (usually one-sided), loss of coordination and balance or sudden unexplained and severe headaches — get to emergency as quickly as possible. Emergency staff can administer a new drug called Tissue Plasminogen Activator (TPA), which, if taken within three hours, will dramatically improve the chance of recovery.

Depending on the severity of the stroke, patients should expect to be in acute care for about two weeks and in rehabilitative care for four to eight weeks. Recovery can take many months, even years.

"Holy Family really takes a multidisciplinary approach to strokes," Larson says. "Rehab makes a huge difference, so physiotherapy/occupational therapy is very important, and so is family education. We also offer patient counseling and pastoral care."

It's not easy being an emergency medicine resident in St. Paul's emergency department. The pace is hectic and you don't know if your next patient will have a sore throat or a gunshot wound.

But few complain — they know it is an invaluable opportunity to learn.

The St. Paul's ER is where UBC's Family Practice graduates do their year-long residency in Emergency Medicine. Most Canadian emergency departments are staffed by family physicians, so learning the unique skill-set required in Emergency Medicine is an important part of their training.

"The residents can find it difficult at times, but they appreciate what a strong program it is," says program director Julian Marsden, MD.

The variety of patients, the severity of their illnesses and the exceptional expertise of hospital ER staff give residents a wealth of experience.

"It's very good experience in terms of teaching. The residents like the teamwork here — the physicians and nurses work well together — and they value the fact patients are treated with compassion and respect regardless of who they are," Marsden says.

Residents also appreciate what they can learn from the hospital's strengths in heart disease, kidney disease, HIV/AIDS, psychiatry and toxicology.

Question:
My mother is 83 and can no longer live alone. When she moves into a residential care facility, what can we do to ease the transition?

Answer:
Feelings of guilt, worry and concern about "doing the right thing" are common for grown children who must move their aging parents into residential care. Moving into care means giving up control of some aspects of life and that can be a difficult adjustment for your mom... and for you.

To make the transition easier, one of the best things you can do is some serious advanced planning. If you're able, talk to your mom about plans for her future while she's still healthy and well.

Find out what's most important. Does she want to be close to grandchildren? Is a private room essential or is she social enough to enjoy the company of a roommate? Don't forget language concerns (Is your mom comfortable with English?) and religious beliefs (Youville Residence, for example, is the only one in Providence Health Care that holds a daily Mass for Catholics). Make a list of priorities.

At the same time, be sure to consider your financial circumstances. The government funds some facilities — others are private, which means you will pay the full cost. Talk to your mom and plan for what you can afford.

Of course, some parents absolutely refuse to consider the possibility of care. If your mom falls into that category, then don't wait until a crisis occurs — make up your own list of priorities, based on your knowledge of her likes, dislikes and financial situation.

The next step is to visit a number of facilities — again, before your mom becomes frail. The BC Health Ministry has published a very helpful booklet, Choosing A Care Facility, with an excellent checklist of questions to ask. Phone your local health unit and ask for a copy.

If this all sounds like too much advanced planning, remember that many facilities have long waiting lists (It's a two-year wait for Providence's Youville Residence). Although you won't be able to get on a list until your mom is actually assessed as needing care, some advance work — when you're not stressed by her illness or growing frailty — means you'll get on the wait list you want just as soon as possible.

It also means you'll be as prepared as possible for one of life's most difficult challenges. It won't be easy, but it will be easier.

Marguerite Millar
Residential Care Leader
Youville Residence

Answer:
Arthroscopy, or knee surgery, is a very common, straightforward surgery. Perhaps your husband has arthritis, or maybe he has an old injury from soccer or skiing that's causing him knee pain. This surgery fixes the problem.

On the appointed day, you should enter the hospital through the admissions office. Your husband will have been advised to fast from midnight the night before. This is to ensure he doesn't get sick from the anesthetic.

You'll do some paperwork, then one of the volunteers will direct you to the daycare area. Your husband will be taken to a room where he'll need to change into a hospital gown and answer questions about allergies and medications.

When the operating room is free, he'll be taken in and you'll be asked to go to the waiting room or grab a coffee. You might want to bring a book or some work to keep you busy while you wait.

The surgery itself usually takes only about 40 minutes, but your husband will need to spend about an hour in the recovery area where he can be observed. He'll have received a very light anesthetic, so he should be alert quite quickly.

After recovery, he'll be moved back to the ward where you can visit with him. An hour later he'll be discharged. You'll have to drive him home — in fact, he won't be driving for several days!

Expect the first few days to be a little painful. He'll go home with a prescription for pain medication. He should do minimal walking for the first 48 hours and may want to use crutches or a cane for the first three days. After that, the pain should ease off.

He'll have a bandage on his knee, which he'll need to keep dry (therefore no baths or showers) but this can be removed on the third day. It's often a good idea to ice the knee to help reduce pain and swelling. There are no dietary concerns, so he can eat as he would normally.

Your husband should have a follow-up appointment with his doctor in 10 days and should be back to normal activity in a few weeks. Physiotherapy may help speed the process.

Sheilah Salvatore, RN
Daycare Surgery
St. Vincent's Hospital, Heather

Answer:
The most helpful thing is just to be there. These days, most of us don't have much experience with death. It's strange, foreign and frightening — and it forces us to think about our own mortality.

We particularly worry about "doing the wrong thing." The trouble is, this stops us from doing the right thing, which is spending some very precious time with those we love.

I encourage you to visit your friend. It's important for people in hospital to know they are still cared about and loved, and it's important for you to connect with your friend at this very meaningful time in her life.

So what can you say? Your friend will probably appreciate hearing news of your life. Remember, it's often very isolating to be in hospital. You can bring your world or community to her.

If you want to bring a gift, keep it simple — some flowers from the garden, a book, some poetry or some music. These very simple acts of caring will reflect your love.

Try to give your friend the opportunity to talk about what's important to her, whether it's fears or concerns. It's always okay to share your tears with your friend. People often worry that they'll "lose it" and become a burden to the dying person. In fact, the chances of that happening are pretty remote, but if you do, you can always excuse yourself.

If we cry with people we can say, "I'm just really touched by what you're going through." Maybe it will allow them to share some tears too, which can be a real gift.

Remember, people who are sick often tire easily, so keep your visits short — 20 minutes to half an hour. If your friend is on oxygen or having trouble breathing, encourage her not to talk. If there are too many people in the room visiting, then excuse yourself and come back later.

As the time of death approaches, be aware that people often start to withdraw. This is the time to be a loving presence. Don't feel you have to talk — just being there is enough. Bring a loving energy to the bedside. That's the best possible gift you can give your friend.

Mary Ellen deGrace
Social Worker, Palliative Care
St. Paul's Hospital

Few illnesses cause as much family grief as dementia. That's why the dementia treatment program at St. Vincent's Hospital, Heather takes a holistic approach.

"We look at the whole person," says Dr. Akber Mithani, associate vice president for Providence Health Care. "The goal is to improve the quality of life for that particular patient — and the family."

Helping the patient through a detailed assessment and developing a complete management plan requires a whole host of health professionals, and that's where the St. Vincent's team swings into action.

The hospital can call on geriatric psychiatrists to assess someone's function, recreational therapists to develop activities, nutritionists to help plan meals and social workers and pastoral care experts to provide support and counseling.

As well, occupational therapists, physiotherapists, pharmacists and geriatricians are all available. Nurses who have expertise in this field provide daily care to the patient.

"Many times it's not the loss of memory that's the problem," Mithani says. "It's the complications of dementia that require close attention — everything from agitation and aggression to depression."

In addition to working with patients, the hospital takes an active role in research. As a result, patients may have the opportunity to take medications that are part of a clinical trial. The hospital has recently been chosen as a site in the Canadian Outcome Study in Dementia, sponsored by Jannssen.

Patients are referred to St. Vincent's by their family doctor. The hospital treats approximately 200 patients per year for inpatient care and approximately 1,200 out-patients each year for dementia-related concerns.

Living with heart disease involves a lot of anxiety and lifestyle changes for both patients and their families, so it's vital they get the best information available.

That's now much easier thanks to a new resource for heart patients at St. Paul's Hospital.

The Patient and Family Resource Centre is a collaboration between the hospital, the St. Paul's Hospital Foundation and the Heart and Stroke Foundation. It's a comfortable and cheerful facility that houses state-of-the-art education and information resources for heart patients and their families during their hospital stay.

The resource centre provides interactive education and information in print, video, audio and via computer on Internet sites. It also introduces patients to programs and services they can find when they return to their community.

St. Paul's is BC's Heart Centre and is the only hospital in the province to provide everything from heart attack prevention programs to open heart surgery and transplants.

At St. Vincent's Hospital Foundation, executive director Joan Williams says their "Be An Angel" campaign succeeded in raising $100,000. "It was a direct mail effort," she says. "We sent out angels and when people donated, their name went on a tree." Thanks to the campaign, St. Vincent's was able to buy electric beds, which are essential to the comfort of the largely geriatric population St. Vincent's serves. For the coming year, the foundation's goal is to buy electric lifts, oxygen concentrators and other equipment. Anyone wanting to contribute can call (604) 877-3193.

Thinking about the unthinkable is all in a day's work for Denys Carrier. That's because he's leader of the emergency preparedness program for Providence.

At the top of his mind these days is "the big one" — the earthquake everyone expects to hit Vancouver sooner or later.

Carrier certainly hopes it's later, because St. Paul's emergency department is housed in a building made of unreinforced brick, and it isn't likely to withstand such a catastrophe. "It will probably collapse," he says of the 88-year-old building. "It will be very damaged and unable to operate."

That's bad news for the downtown core, which could have half a million people, many of them injured, depending on St. Paul's. To make matters worse, a major quake is likely to knock out the bridges and fill the streets with glass, isolating workers and residents from any other help.

The good news is the Vancouver/Richmond Health Board has approved a plan for a new Emergency and Psychiatry building for St. Paul's. Now Providence is waiting for the provincial government to give final approval and the $50 million in required funding.

"We need to get the green light soon," says Neil MacConnell, who is Providence's planning leader. "It's a five-year plan to complete this building, so even if we get approval this Fall, it won't be finished until 2005."

Ron Martin, who is Vancouver's emergency planning coordinator, says the city's current back-up plans for a catastrophe involve using portable hospitals called "Casualty Clearing Units," which were put in place during the Cold War. But that's not a pretty picture. "Given the potential number of casualties, the hospital emergency rooms are critical," he says.

Denys Carrier agrees. "From a structural point of view, there's not much more I can do. This new building can't come soon enough."

Patients at St. Paul's Hospital will receive better care now that 72 state-of-the-art cardiac monitors are being installed in critical care units and emergency.

This equipment is used to monitor heart rate, blood pressure, the amount of oxygen in the blood and to perform bedside electro-cardiograms.

The new monitors are better at capturing patient information. The data can be transferred electronically around the hospital or physically via cassettes that can be removed from one monitor and inserted into another. This means no crucial data is lost while patients are moved for tests or admitted to another unit.

The new equipment will also help reduce workplace injury for nurses. They maneuver freely on adjustable swivel arms, reducing the amount of fixed and cumbersome equipment around each bedside.

The monitors they replaced were so old that some nurses carried screwdrivers to repair them.

The installations will be completed by mid-June thanks to $2.6 million in new funding from the Ministry of Health.

One staff recruitment tool that's exceeding expectations is the Providence website. When a recent nurse recruitment ad appeared in Australia, the Providence website recorded 88 visitors from that country in a matter of days. In the past six months, over 120 applications have been submitted electronically.

The site, which records 500 visitors on a busy day, is receiving kudos from Health Match, a health professionals recruitment service funded by the BC Ministry of Health.

"We use it all the time at our nursing recruitment job fairs," says director Leslie Arnold. "We like it because you can move quickly through the site. It has lots of information and is really easy to navigate. It also has a very nice description of what Providence is all about."

Learning that you're diabetic and must change your eating habits can be tough news to hear.

But how much tougher if you don't speak English and your food preferences are based on an entirely different culture!

Addressing that challenge is the goal of the Asian Diabetes Clinic. Based at Mount Saint Joseph Hospital and established in 1995, the program offers diabetes education in both Cantonese and Mandarin.

Participants meet with a nurse and nutritionist for four hours every Tuesday from 10 a.m. to 2 p.m. And they not only get education in their language — they get a Chinese-style lunch, so they can see and eat the food they've been learning about.

"They're very keen," says Valli Fraser, who is professional practice leader in clinical nutrition for Mount Saint Joseph. "We find it allows them to meet other people who are diabetic and then get together outside the centre. They form their own little support groups."

The program, which educates about 200 people a year, is a joint effort with the Vancouver/Richmond Health Board, the Chinese support organization S.U.C.C.E.S.S. and the Chinese Canadian Medical Society.

"We started out with nothing and gradually built it up over the years," Fraser says. "It's been a good experience to work together with all these community groups."

To register, call 684-1628. There is a six-month wait for the program.

That's the motto of Mount Saint Joseph Hospital's Lifeline, a community outreach service designed to help seniors and people with a host of medical conditions — from heart problems to AIDS — maintain their independence.

The program provides subscribers with a small waterproof button to wear around their neck or wrist and a Lifeline unit that is attached to their phone line.

If they have a medical emergency, they simply press the button and are immediately connected with Lifeline's monitoring centre, which will send appropriate help.

Program manager Carolyn Darbyshire says that Lifeline, which celebrated its 10th anniversary in December, serves some 2,000 people who would otherwise be at risk or who might need to go into care.

"A lot of our subscribers are very isolated," she says. "Their families are far away and they need this support. We're on call 24-hours-a-day."

This month, a new special needs telephone was unveiled. It lets caregivers, nurses or doctors leave a message to remind subscribers when and how to take their medications.

Mount Saint Joseph's Lifeline is a non-profit service supported by Telus, the Royal Canadian Legion and the Department of Veterans Affairs. For more information call 872-5433.

He followed his nose to find a career. Or perhaps it's more accurate to say Dr. Amin Javer followed the noses of thousands of patients to become one of only two fellowship-trained doctors in advanced sinus surgery in Canada.

Recently hired by St. Paul's, he wants to help make the hospital a world centre for the treatment of sinus disease.

"Many people don't realize how important sinuses are," Dr. Javer says. "But the statistics are mind-boggling." Some 18 to 22 per cent of people are expected to need sinus surgery during their lives.

Dr. Javer, who sees about 30 patients a week, says many of them suffer from severe facial pain, chronic sinus infections and brutal headaches. "Many have been misdiagnosed. They think they have allergies or frequent colds," he says.

When surgery is the answer, he uses an endoscope, a small tube to which a tiny camera is attached. This allows for greater control in an area just below the eyes and just under the brain that's "very high risk."

But for his patients the rewards are, well, breathtaking. "I just had a patient tell me she walked into her mother's kitchen and smelled onions cooking — for the first time in 20 years."

In 1997, a thick pall of smoke hung over much of Southeast Asia as vast expanses of Indonesian forests burned, fueled by El Niño droughts.

To researchers from St. Paul's Hospital, this environmental disaster was a unique opportunity to study the effects of air pollution on human health - a study that has implications for public health policy in Canada.

As the haze covered Singapore from August to November that year, Dr. Jim Hogg and Dr. Stephen Van Eeden of the UBC Pulmonary Research Laboratory at St. Paul's launched a study with researchers at the National University of Singapore.

Blood samples were taken from healthy army volunteers who were working outdoors in the haze. For several weeks the soldiers were exposed to high levels of air pollution that included gases such as ozone and sulfur dioxide as well as particles so fine they could pass through the filters of most air conditioned buildings and penetrate deep into the lungs.

Previous studies linked such air pollution with chronic lung and heart disease and high rates of hospital admissions for pneumonia, lung disease and heart attacks. But what was it exactly that caused this link?

Hogg and Van Eeden believe the air pollution causes bone marrow to release immature white blood cells into the bloodstream. Such cells not only fail to fight off disease — their natural role — but they can actually cause tissue damage.

After the haze finally cleared in Singapore, the researchers took more blood samples from the same soldiers. The results showed a clear association between the amounts of fine particles and sulfur dioxide in the air and increases in immature white blood cells in the soldiers' blood. Other studies have linked this type of response to heart and lung disease.

Although the study took place overseas, Hogg says these results give a clear warning to Canadians about the risks posed by second-hand cigarette smoke, motor vehicle exhaust and other forms of air pollution that, on occasion, reach similar levels in our country.

For most of us, visiting the family doctor is an easy, unremarkable event.

But for new immigrants and refugees, figuring out how to use the Canadian health system can be both frightening and intimidating.

"A lot of these people don't know anything about the health system," says Stella Tsang, who is the leader, community partnership development for Providence Health Care. "They have language barriers and special cultural needs."

That's where the Bridge Community Health Clinic steps in. Based at Mount Saint Joseph Hospital, the clinic provides routine physicals and communicable disease screening — in the language of the immigrants and refugees.

"Interpretation services are really important," Tsang says, noting the clinic will support any language, even getting immediate translation services through AT&T if necessary. (The current three most requested languages are Spanish, Albanian and Burmese.)

But translation is only one aspect of the clinic. Many of the refugees may have survived trauma in their homeland — and have psychological scars as well as physical ones. "Staff have been trained and have the sensitivity to treat people with respect," Tsang says. "They understand their trials and tribulations."

The clinic is meant to be a bridge in every sense of the word. Staff encourage patients to integrate into the health care system and to find their own family doctors. And statistics show that goal is being met: After one year, 50 per cent have left Bridge and found their own GP.

This unique clinic, which handled about 5,000 visits last year, is the result of a partnership with the Vancouver/Richmond Health Board, the Immigrant Services Society, the B.C. Multicultural Health Services Society, and Mount Saint Joseph Hospital.

The health care system has always used technology - from the elegantly simple wheelchair to the highly complex CT scanner. But today, the range of technological options is dizzying — and expensive.

Providence Health Care estimates it has a capital equipment inventory valued at $109 million, with an average annual replacement need of $15.6 million. Most of this equipment relies on computer technology to operate.

But in addition to high-tech, life-saving equipment, advances in information technology offer a glimpse of a whole new future for patients and staff.

If you"ve been a patient in hospital, you may have wondered why nurses, doctors and other care providers repeatedly asked you the same questions. The answer is paper — Providence Health Care generates 6.8 million documents a year and patient charts average 150 pages. Technology can streamline this information online, ensuring timely and accurate data is available across departments and sites. And it can be done with checks and balances to ensure privacy. But we"re not there yet.

Online records do more than simplify patient information. Systems can actually improve patient care. For example, in the US, more than 65 per cent of hospitalized patients experience an adverse drug event, which can be prevented by using electronic clinical decision support.

There are also systems that improve efficiency, which is critical in an era of staff shortages. These include systems to improve communication between hospitals, manage data, streamline administrative functions and facilitate patient care, research and education.

The good news is technology will help us re-invent the way we deliver health services. The bad news is it comes at a substantial price. Providence Health Care estimates it needs to invest $5 million a year for the next five years to put these and other systems in place. Without the up-front investment, re-inventing health care delivery will be difficult, if not impossible.

In the past year, the growing shortage of nurses has made headline news. Now the trend that started in nursing is emerging in other health care professions, including physiotherapy, occupational therapy, medicine and lab technology.

We"re starting to see the same signs as we did at the beginning of the nursing shortage. It"s harder to find qualified applicants and it"s particularly challenging to replace staff away on vacation or sick leave.

On the physician front, the forecast is not good. According to a recent report on CBC radio, about 6,000 full time doctors in Canada are over the age of 65 and more than a third of those are in their 70s. "We have issues in a number of areas, including general surgery, hematology, general internal medicine and medical oncology," says Dr. Brian Warriner, vice president of medicine. And, as with nurses, we are not training enough young doctors to replace those retiring.

Providence is actively working to recruit and retain qualified staff. "Our strategies include offering specialty training to our current staff, off-shore recruiting, advertising in journals in Canada, the US and Australia, attending job fairs here and in the US, and paying relocation expenses," says Lynette Best, professional practice leader for nursing. "We"re also developing strategies to ensure the staff who work at Providence want to stay with us."

A national public opinion survey shows that Canadians feel the health care system is facing a funding crisis and the quality of health care is eroding. The survey, done by the Angus Reid Group, was released early in May at a national forum on health care called "Medicare — Sustainability and Accountability in the 21st Century." The two-day forum featured a wide range of political and policy experts including Saskatchewan Premier Roy Romanow, CD Howe Institute president Jack Mintz, and Alex Preker, lead health economist with the World Bank Group in New York. The forum sponsors, who commissioned the research, included the British Columbia Medical Association (BCMA), the Registered Nurses Association of British Columbia (RNABC), the Health Association of British Columbia (HABC), and the Canadian Medical Association (CMA)

Angus Reid used a telephone survey in the last week of April to canvass the opinions of 1,500 Canadians across the country. Key results include: 75% of Canadians think the Canadian health care system is currently facing a major funding crisis. 60% feel that hospital and medical services should be sufficiently funded to treat diseases, illnesses and injuries even if it means spending less on health promotion. 66% agree that many Canadians misuse the healthcare system leading to increased costs. 37% think it's a good idea to allow privately-owned healthcare facilities, paid by government with tax dollars, to provide some health services that are currently provided in hospitals while 33% oppose the idea and 29% are neutral on the idea. 64% of Canadians think that the quality of health care in their province has become worse over the past five years. 83% of Canadians think health care professionals like doctors and nurses should have a major role in shaping any necessary reforms to the healthcare system while 76% say their provincial government should play a major role and 42% think academics should play a major role. 87% of Canadians agree there should be public consultations to discuss any proposed changes to the way healthcare is funded, managed and delivered in their province. (Reprinted in part from CNWire May 11, 2000.)

The recruitment and retention of nurses remain a top priority at Providence. Based on the demographics of our nurses and PHC's average nurse turnover rate per year, it's estimated that in the next five years we will need approximately 1,200 RNs/LPNs to continue delivering care to current day levels.

Between October 1999 to March 2000, there were 134 new nursing hires at St. Paul's, Mount Saint Joseph, Heather and Holy Family, and 105 'terminations' (the term used to cover people leaving, whatever the reason). The most common reasons for termination were: unavailable for work, moving away from the area or taking other positions. The largest vacancies are in the following programs: Heart Centre, Surgical Suite, Specialized Medicine, ICU, Surgery and Community Health. On average, we've had 100 nursing vacancies per month over the last eight months, although that average appears to be on the rise.

Educational Opportunities Maximized
Since the Fall of 1998, Providence has invested significantly in continuing, specialty education for nurses. RNs were fully funded for courses in the following areas:

Overcrowding at St. Paul's Emergency has been all too common in recent months, with long waits to see a doctor, and patients needing admission unable to get beds "upstairs" on the units. New Stat Medicine Clinics opened recently to ease this burden by taking referrals from emergency for patients needing to see an internal medicine specialist.

Previously, these patients either had to be admitted or, if they were well enough to go home, received a referral to a specialist, which could mean a wait of several months. With the new clinics, the patient can see a specialist within three days. It is hoped this will ease some of the pressure on hospital beds, shorten emergency waits and prevent return visits to emergency.

When it comes to looking after your damaged knee or your worn-out hip, it's all in the family at Providence Heath Care.

First, the highly trained surgeons at St. Paul's use their surgical skills to repair your damaged parts; then, the special expertise of the rehab team at Holy Family Hospital swings into action to help get you back on your feet again.

Holy Family works with patients from all across the province, but as a member of Providence Health Care, it makes an especially effective team with St. Paul's. "Our fast-track orthopaedic program works very well," says Jenise Brouse, patient care leader for rehabilitative services.

For many people, visits to an outpatient clinic are enough. But for patients who are over 55 (and meet the necessary criteria) there are eight beds offering the opportunity for intensive rehabilitation therapy. As part of their therapy, patients are expected to participate in the normal activities of daily living, such as getting dressed and eating in the dining room and doing as much for themselves as possible.

A unique part of Holy Family's resources is "Easy Street," where patients can practice real life situations, such as boarding the bus, getting into and out of a car, grocery shopping and using a banking machine.

Stella Brown, a Vancouver senior who recently needed her left hip replaced, is one of the satisfied customers. "The therapists are very caring," she says. "It's just been great — even the food," she adds with a laugh.

If you're a patient, you expect to have your pulse taken. But sometimes hospitals need to take their pulse too — and that's what's happening now as Providence Health Care gets the results of its first ever standardized surveys of resident and patient satisfaction.

"We care what our residents, patients and their families think," says Lena Cuthbertson, who is leader of quality management for Providence. "We want to continually improve the quality of our care and services and this tool will give us information we need to do that."

Results of the first survey, which looked at individuals in residential care, are preliminary, but show that 72 per cent of Providence residents give the overall care and services received in their facility an excellent to good rating, while 28 per cent rate it as fair to terrible. An impressive 60 per cent said they would describe their site as "a wonderful place."

Cuthbertson says she's pleased with the results but certainly not complacent. "It shows we're doing a lot of really good things, but it also shows we have opportunities for improvement," she says. For example, residents said they wanted more participation in their care, more leeway in choosing roommates and increased opportunities to use their minds.

Although Providence hospitals have regularly collected satisfaction information in some form, this is the first time standardized surveys are being used. "Standardized" means the same survey is used at other Canadian residential facilities or other acute care hospitals — allowing Providence to compare how it's doing with other similar organizations.

Conducting the surveys has been no small effort. Providence spent two days training 43 volunteers to do in-person interviews of its 795 residents — including a number of interviews in Cantonese and Punjabi. But that's not the end of it. Last month a second standardized survey was started — this time a mail-in one focusing on patients who have used Providence Health Care acute services at St. Vincent's Hospitals, Mount Saint Joseph Hospital and St. Paul's Hospital.

In 1998, Brock Fahrni Pavilion held a dubious distinction. Home to 150 residents, many of them war veterans, the facility had the highest number of reported aggression-related incidents from patients/residents per staff population of any of the eight facilities that comprise Providence Health Care.

• number of incidents of aggression are down by 33%
• staff time lost due to injury from aggressive incidents is down 33%
• Workers' Compensation Board costs from aggressive incidents are down 25%

There are some risk factors caregivers can't control, like a history of violence, dementia and the frustration of impaired ability that accompanies Parkinson's Disease or stroke. Visual and hearing impairment can increase confusion, causing restlessness and impatience. "But, there are triggers staff probably can control," says Bullock, "including noise, pain, hunger, appearing disrespectful. When staff are aware of the risk factors and the things that could trigger an event, they are better able to avoid a confrontation that results in aggression or violence."

Violence in the Workplace1 Occupational groups at greatest risk from workplace violence:
Healthcare employees
Correctional officers
Social services employees
Teachers
Municipal housing inspectors
Public works employees

Suddenly, you can't read the small print on your bank statements. Your joints are getting creaky. And if you stay out late at a dinner party, the next day you need a nap.

The signs of aging are unmistakable. But what's unique today is that so many baby boomers are facing them at the same time. And with these signs come increases in heart disease, diabetes, cancer and Alzheimer's Disease.

That's why Providence Health Care is excited to be part of a new Centre for Excellence in Aging and Health. Launched a year ago, with partners Simon Fraser University and the Vancouver/Richmond Health Board, the centre will help the aging population stay as healthy and well as possible.

"It's really huge," says Dr. Akber Mithani, who is vice-president of medicine for Providence Health Care. "We'll be doing research, developing programs for improved health and evaluating how well these programs do in helping people maintain health and independence as they age."

The 11th annual Pacific Spirit Run, a Vancouver tradition, is a 10km run/5km walk along natural trails, rimmed by spectacular forest scenery. This year, the run takes place on Sunday, May 14th, 2000 (Mother's Day) in Vancouver's Pacific Spirit Regional Park at UBC. The event helps support the work of the Osteoporosis Falls and Fractures Prevention Program at St. Vincent's Hospital, Heather and the Healthy Heart Program at St. Paul's Hospital. The run also promotes the benefits of healthy, active living and the importance of preventing these diseases. Registration is $25/participant (less for children, families and school teams) before April 28. Entry fee includes a long sleeved t-shirt and barbecue lunch. For more information, call the Pacific Spirit Run Hotline at (604) 877-3340 or visit us at www.pacificspiritrun.com.

Your genetic makeup can make you more vulnerable to the viral infections and allergens that lead to chronic lung disease.

A researcher at St. Paul's Hospital, Peter Parè, MD, is seeking to discover why that is, which will add to our understanding of asthma, emphysema and chronic bronchitis.

Parè is one of five St. Paul's medical researchers who recently received nearly half a million dollars in funding from the Medical Research Council of Canada (MRC) to conduct basic health research in critical care and heart and lung diseases.

The MRC is the major federal agency responsible for funding biomedical health research in Canada.

Patients with kidney disease are better served thanks to an ongoing expansion of the Renal Program at St. Paul's Hospital.

Kidney failure is increasing by 15 per cent each year in BC, largely as a result of diabetes and high blood pressure. When disease prevents the kidneys from doing their job — filtering waste products and excess fluid from the blood — patients must make regular visits to clinics where dialysis machines perform this function for them.

Eight new hemodialysis stations have been added to the 29 existing at St. Paul's Hospital, and when renovations are complete there will be 43. This will help fill an urgent need for more hemodialysis services in the Vancouver area. As well, existing space has been converted into a peritoneal dialysis centre, and supply and equipment rooms have been expanded.

St. Paul's has the largest renal program in the province, providing treatment from dialysis to kidney transplants, and is home to the Provincial Renal Agency, which oversees renal care services in BC.

Looking for a change in your life? Working more and enjoying it less? Too tired to do a job search or read this year's version of "What Colour is My Parachute?" You can check out Providence Health Care's job opportunities during an Ally McBeal commercial break or while relaxing with a cup of tea. Go to providencehealthcare.org and click on "Career Opportunities." If you like what you see, surf the site to get a feel for the organization. Still liking it? Send your application electronically, and then we'll call you. You gotta like that!

In March, Holy Family unveiled its new and improved pool. With full wheelchair access, increased water depth, expanded change room facilities and new bathrooms on deck, up to 50% more patients will enjoy the healing effects of water. The therapeutic properties of water have long been recognized by health care providers. At Holy Family Hospital, hydrotherapy benefits a broad variety of rehabilitation patients — from those recovering from hip or knee surgery to those suffering from arthritis, back pain or neurological problems. Water exercise decreases swelling and improves balance, strength, range of motion and circulation.

Two recent changes in provincial legislation are affecting Providence Health Care and its patients and residents.

• Amendments to the Human Tissue Gift Act require all in-hospital deaths of persons up to age 75 to be reported to a central agency. Physicians and nurses at Providence are responsible for doing this, so that all families of potential donors have the chance to donate organs and eyes that will help others.
• New Adult Guardianship Legislation means that adults can now choose, in advance, someone they trust to represent them and make decisions on their behalf at a time when they become incapable of doing so. The legislation also coordinates assistance for abused and neglected adults.

A mini baby boom is keeping everyone hopping at St. Paul's Hospital. Deliveries for the year ending March 31 are up 18 per cent - that's about 150 babies more than last year. Why the increase? Wendy Panton, who is patient care leader for the women and infants health program, says the credit goes to the care team. "Our patient satisfaction forms are giving us tons of accolades for the wonderful care," Panton says. "We have a wonderful team of care givers who work extremely well together." The switch to single room maternity care — where patients deliver their baby and are then cared for in the same room — is also a big part of the appeal, she says.