Angels on the rooftops of Providence Health Care sites are heralding the start of Christmas and the annual Angel Campaign at St. Vincent’s & Holy Family Health Care Foundation.

For more than 17 years, angels have inspired thousands of donations in support of seniors’ health care at St. Vincent’s and Holy Family Hospitals, part of Providence Health Care. In the past two years, the Foundation has expanded to take two additional Providence Health Care sites under its wings - Marion Hospice and most recently, Mount Saint Joseph Hospital.

“We’re proud to be raising funds for patient care at Mount Saint Joseph Hospital through the Angel Campaign,” explains foundation chair Colleen Tracy. “The Foundation has always risen to the challenge of meeting patient and resident care needs within Providence Health Care, and we’ll continue ensuring they receive the greatest care and comfort possible.”

Angel donations support purchases of medical equipment at St. Vincent’s Hospital Langara, Brock Fahrni Pavilion, Youville Residence, Holy Family Hospital, Marion Hospice and Mount Saint Joseph Hospital, as well as quality-of-life programs and services and research in the field of elder care. The Foundation is also raising funds for the new St. Vincent’s Campus of Care. Phase I of construction, a 68-unit assisted living facility, is currently under construction at 33rd and Heather Street.

The Angel Campaign runs through December and includes official lighting of the rooftop angels and distribution of thousands of paper angels to donors through a direct mail program. Angels are returned, along with donations, and displayed on Angel trees at each of the sites. A series of Angel Teas at the sites are also being hosted in conjunction with the Campaign, to celebrate the season with patients, residents and their families.

For more information, or to make an Angel donation, call 604.877.3193.

St. Vincent’s & Holy Family Health Care Foundation raises funds for specialized equipment, programs, services and other capital expenditures for seven Providence Health Care sites.

St. Vincent’s Hospitals are residential care facilities that include St. Vincent’s Hospital Langara, Brock Fahrni Pavilion and Youville Residence. Holy Family Hospital includes residential care as well as physical rehabilitation services for older adults who have experienced strokes, hip and knee replacements, amputations and crippling arthritis conditions. Marion Hospice offers end-of-life hospice care for patients with less than three months to live. Mount Saint Joseph Hospital is a community hospital offering a multicultural approach to service delivery and clinical programs. Phase one of construction of the St. Vincent’s Campus of Care is currently underway with construction of 60 subsidized assisted living units, and eight independent apartments for young disabled adults.

For more information, contact:
Marianne J. Dupré, Communications
St. Vincent’s & Holy Family Health Care Foundation
Tel: 604.322.2604 Fax: 604.321.2696

Fireworks to herald the lighting of St. Paul's Lights of Hope Thursday

at 6:55 pm

(November 23, 2006)

Wintry Burrard Street will get a welcome burst of light tonight at 6:55 pm when the fireworks go off and the Lights of Hope display outside St. Paul's Hospital is illuminated for the first time this season. About 300 guests are expected to gather at Burrard and Helmcken for the lighting ceremony.

Each year, more than 100 volunteers gather in early November to build the display using donated products. As a result, donors' financial support for the Lights of Hope campaign helps St. Paul's Hospital Foundation purchase equipment, support research and enhance patient care at Vancouver's downtown teaching hospital.

Thanks to the support of our volunteers and donors, the Lights of Hope campaign has raised more than $6 million over the years. Foundation Executive Director Jane Adams explains that this year's goal is $1.8 million: "The light display is a tribute to the community's appreciation for the work that happens year round at St. Paul's," she said. "A big thank you to everyone who has made a donation so far and thank you in advance to the many generous people who do so when they see the beautiful lights go on for another season."

This year's campaign will help to buy equipment and information technology for the hospital's busy Emergency department and create a new Advanced Cardiac Imaging Operating Room in the Heart Centre. To find out more about Lights of Hope or to make a donation, call 604-662-HOPE or visit www.helpstpauls.com.

The display will be illuminated until January 5.

Seniors and Young Adults Benefit from Assisted Living

(November 1, 2006)

A new $20-million assisted living development for Vancouver seniors and young adults with disabilities was celebrated today with a groundbreaking attended by federal, provincial and municipal government representatives.

The new assisted living development, previously St. Vincent’s Hospital, is located at 33rd Avenue and Heather Street. The development, operated by Providence Health Care, will provide affordable housing and care for seniors and young adults who require some support services but wish to maintain their independence. The units are funded under Independent Living BC (ILBC), a partnership between the federal and provincial governments, local health authorities, non-profit groups and the private sector.

“Canada’s New Government is working closely with our partners to support the Vancouver area and its many community projects,” said the Honourable David Emerson, Minister of International Trade and Minister for the Pacific Gateway and the Vancouver-Whistler Olympics, on behalf of the Honourable Diane Finley, Minister of Human Resources and Social Development. “This development will enable seniors and young adults with disabilities to continue to live close to their family and friends and enjoy a high quality of life.”

Lorne Mayencourt, MLA for Vancouver-Burrard, said these units are part of the provincial
government’s commitment to provide 5,000 residential care beds, assisted living units and supportive housing units with home support by the end of 2008.

“This assisted living development is unique in that it will house both seniors and young adults with disabilities together,” said Mayencourt. “The Province is committed to finding innovative ways to provide housing and care options to our most vulnerable citizens and this is a way for us to do just that, while in addition enabling multiple generations to live together on one site. I think a lot of good can come from that.”

The assisted living units will be self-contained apartments with a 24-hour response system.
Residents will receive personal care services, such as recreational opportunities and assistance with medications, housekeeping, meals, and laundry services.

Vancouver Coastal Health will be subsidizing the residents’ personal care and hospitality services. The units for people with physical disabilities, while co-located at the site will operate as a separate housing option.

“There was significant input from the disabled community to ensure the units will be fully
accessible to meet residents’ needs,” said Linda Thomas, director of housing for Vancouver Coastal Health. “We are excited to be a part of this development, as it supports our vision of creating a full range of options for seniors, and offers young people with disabilities housing that allows them to maintain a high level of independence.”

Vancouver Mayor Sam Sullivan added that the development of the assisted living building, which included the demolition of St. Vincent’s Hospital, was done with an eye towards sustainability.

“I would like to congratulate Providence for being so creative in their approach to the development of this first phase of housing on the old hospital site,” said Sullivan. “In addition to providing much-needed housing for seniors and youth with disabilities, this project is a model of sustainability due to the fact that many of the previous structures were recycled into the new development.”

“To help meet the Ministry of Health’s and VCH’s goals, Providence’s long-term vision for this
site is to develop a campus of care – facilities that provide a broad range of elder-care services, enabling seniors to age in place rather than have to move as their care needs increase,” said Dianne Doyle, president and CEO of Providence Health Care. “Providence voluntarily closed St. Vincent’s Hospital so we could innovatively redevelop the site and renew the mission of the Sisters of Charity who founded the hospital.”

The Government of Canada and the Province of British Columbia, through the ILBC program, are committed to providing 4,000 affordable assisted living apartments across the province. To date, more than 3,500 ILBC units have been allocated in communities across B.C.

Today’s announcement reflects the B.C. government’s goal of providing the best system of support in Canada for seniors.

Two PHC Physicians Win National 'Who's Who in Healthcare' Awards
(October 25, 2006)

Canadian Healthcare Manager handed out its Who's Who in Healthcare Awards in Toronto on October 20, 2006. Among the winners were PHC’s Dr. Kirk Hollohan and Dr. Eric Grafstein. These awards are given annually to nine extraordinary individuals who have demonstrated leadership and innovation in their respective field of healthcare.

The Vigilant Healer - Dr. Kirk Hollohan

In his bloody battle to end sepsis infection—which kills tens of thousands of Canadians each year—Dr. Kirk Hollohan has realized a triumph. Dr. Kirk Hollohan is determined to beat sepsis with an organizational onslaught against the often fatal infection. Two years ago, the battle took on a personal turn.

Dr. Kirk Hollohan hails from Newfoundland but he now calls B.C. home since he moved to Vancouver in 1996 to work in one of Canada’s most progressive emergency departments.Today, as physician leader for quality and utilization management at St. Paul’s Hospital, he is focused on an intense battle against one of healthcare’s greatest scourges—sepsis.

Sepsis is a systemic infection in tissues or the blood stream caused by bacteria or other infectious organisms. If left unchecked, it can lead to septic shock and ultimately organ failure and death. It kills tens of thousands of Canadians each year. “Time is tissue when it comes to sepsis,” says Dr. Hollohan. “Treating sepsis is more about quality improvement rather than finding a new treatment. Our work is not about a new wonder drug that is going to change the outcomes. The key is early diagnosis and removing all delays to treatment.”

That knowledge led him and his team at St. Paul’s to develop a new approach for assessing and treating patients presenting at Emergency with signs of sepsis. It starts with a checklist that is used as a screening tool at triage. If certain items are checked off, a physician is paged immediately so the patient is seen as quickly as possible. The physician can then order tests and the results are fast-tracked by the lab.

“Another key is early goal-directed therapy,” he adds. Once the tests are completed and the physician has made a diagnosis, IV antibiotics are available in Emergency so there’s no wait for the pharmacy to fill and deliver the prescription.“The major hurdle was not paying attention to Dr. Hollohan. “We need to guarantee timely, best-practice care to each patient every single time.”

The improvement methods used by his team were developed based on research conducted by the Bostonbased Institute for Healthcare Improvement. “There’s a movement in healthcare to bring industry standards to the delivery of patient care,” he adds. “We need to guarantee a high level of care within our system.”

The St. Paul’s team has proven that changing the system can save lives. After eradicating time barriers in identifying and treating sepsis, patient mortality from severe sepsis and septic shock decreased by 50%, and surviving patients spent 38% less time in the ICU.

“Our results are earning national recognition, but more importantly, they are saving patients’ lives,” he concludes. Unfortunately, these standards weren’t in place at the hospital where Dr. Hollohan’s father was rushed to when he became ill more than two years ago. His sepsis was under-treated and under-managed. He died, unable to benefit from his son’s discovery. -Pamela Clarke

The Accelerator - Dr. Eric Graftstein

Encouraging emergency room doctors to electronically report patient conditions is one small step for Dr. Eric Grafstein on the way to bigger leaps in improved patient care. Dr. Eric Grafstein says that one of the best ways to improve our public healthcare system is for emergency departments to focus on customer service.

While growing up in a family of retail store owners, Dr. Grafstein learned that to survive and thrive in a competitive market, you had to excel at taking care of your customers. Decades later, he brings that same commitment to customer service in his role as associate research director of emergency informatics at St. Paul’s Hospital in Vancouver.

“Patients are customers even in a not-for-profit system. This is especially true in the emergency department as it is one of the key faces of healthcare for the public,” says Dr. Grafstein. “Many people don’t know how to access healthcare so they go to Emergency. This creates difficulties in providing timely patient care.”

He started his career as a clinician/researcher at St. Paul’s, quickly discovering that although the hospital had records of the number of patients who had cataract surgery, for example, there was no data on patients who presented to the Emergency department with chest pains. “The data was missing,” recalls Dr. Grafstein. “There were serious data quality and data quantity issues.”

Determined to find an efficient and inexpensive means of gathering the data, he and his team devised other ways of collecting information: “We were one of the first hospitals to implement [computerized] physician order entry. I became more and more interested in how technology could result in greater efficiency, greater gains," explains Dr. Grafstein. The key was that “information should only be entered once and it needs to be a byproduct of healthcare workers doing their job.”

Keenly aware of the fact that it’s difficult for people to change, he made it as easy as possible for the physicians. The first step involved minimal change: doctors enter their diagnoses, then follow the prompts until a final report—a discharge summary—is made.

The end results were fewer errors and better patient care. People left the Emergency with a hard copy of their diagnosis, a list of the procedures performed, a prescription, information sheets, and follow-up steps. This information is also electronically faxed to their primary care physician.

Another outcome was that the hospital ended up with data that can easily be developed into report cards on access, utilization, quality, and efficiency of care. Linking with other databases also allowed researchers to help answer questions such as “Do women get different care when they present to the emergency department with chest pain?”

“Validated and complete data allows us to do research that otherwise has been inaccessible in our healthcare system,” says Dr. Grafstein.

Eventually he would like to see data from emergency departments across the country made available to the public, much like the Maclean’s rankings for universities. “It should be a meritocracy,” he concludes. “The public deserves to know which emergency departments are the best.” —Pamela Clarke

Providence Health Care Appoints New President & CEO

(October 12, 2006)

Dianne Doyle has been appointed the new President and Chief Executive Officer of Providence Health Care. Doyle, who was PHC's Vice President of Medicine & Ambulatory, Surgery & Acute Services Programs, succeeds Carl Roy, who completed his five-year tenure as President & CEO of Providence Health Care on September 22, 2006.

In making the announcement, Providence’s Board of Directors said Doyle’s strong leadership, strategic thinking and comprehensive health-care knowledge will ensure Providence continues to be an essential provincial resource and pursues its vision for improved and more compassionate delivery of health care.

“Dianne is a well respected, highly experienced health-care leader with over 20 years of senior executive experience in health care and over 25 years directly at Providence Health Care,” said Kip Woodward, Chair of Providence’s Board of Directors. “She is ideally suited to transform our programs, services and facilities to meet the patient needs and our ever-increasing challenges”.

Doyle began her career as a staff nurse at Royal Jubilee Hospital in Victoria, BC, but since then has worked exclusively in PHC facilities. She was a Head Nurse and Medical Instructor at St. Paul's Hospital and then moved to Mount Saint Joseph Hospital as Vice President Patient Care Services. She became the Chief Operating Officer and Vice President, Patient Care and Support Services for Mount Saint Joseph in 1995/96 and was then named Acting President and Chief Executive Officer, CHARA Health Care Society.

She is recognized as a champion of Catholic health care provincially and nationally. Currently, she is the Vice Chair of the Catholic Health Association of Canada, a Board member of the BC Health Care Leaders Association, and Vice Chair of both the Catholic Health Association of B.C and the Denominational Health Care Association.

Doyle’s service to the community includes supporting many non-profit groups with her time and expertise. In 2005 she climbed Mt. Kilimanjaro in support of the Alzheimer Society of BC.

Doyle has a BSN from the University of Ottawa and an MSN from the University of British Columbia. In 1990 she received a CHA Health Services Management and CHE Certification from the Canadian Council Health Services Executives. In 2002 she received her Fellowship in the Canadian Council Health Services Executives.

Dr. Bruce McManus to Lead Scientific Programs for the iCAPTURE Centre
and the Heart Centre at St. Paul’s Hospital

(October 3, 2006)

Dr. Bruce McManus has been appointed Director of the James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research and Scientific Director of the Heart Centre at Providence Health Care, effective September 1, 2006.

Dr. McManus, who recently received the BC Innovation Council’s Lieutenant Governor’s Technology Innovation Award for his leading-edge contributions to research in BC and around the world, is a Professor in the Department of Pathology and Laboratory Medicine at the University of British Columbia. He previously served for six years as Co-Director of the iCAPTURE Centre and Director of the Cardiovascular Research Laboratory within the Centre.

The iCAPTURE Centre, a UBC-affiliated research centre based in St. Paul’s Hospital, focuses on the complex genetic and environmental influences that determine susceptibility to diseases of the heart, lung and vascular systems, particularly those involving inflammation or infection.

“I am delighted that I will have the opportunity in this next stage of iCAPTURE’s development to work with Bruce, one of Canada’s truly visionary scientists, in building an even stronger and more vibrant research capacity in heart and lung disease at Providence Health Care,” said Yvonne Lefebvre, Vice President, Research and Academic Affairs and President of the Providence Health Care Research Institute.

As Scientific Director for the Heart Centre, Dr. McManus will work with Heart Centre leaders and their colleagues to bring new synergies between the cardiovascular and pulmonary clinicians and scientists in the iCAPTURE Centre, the goal being to identify better ways to prevent, treat, and manage the patients who suffer from these common problems.

“The appointment of Dr McManus as Scientific Director of the Heart Centre is a tremendous step forward in the continued development of our program, said Dr. Ron Carere, Physician Director of the Heart Centre at St. Paul’s Hospital. “It aligns with our strategic direction to strengthen the Heart Centre’s delivery of clinical care and role as a premier program in research, investigation and the introduction of innovative treatments and technologies. We look forward to Dr McManus’ scientific leadership.”

Dr. McManus recently completed a five-year term as the inaugural Scientific Director of the Institute of Circulatory and Respiratory Health, Canadian Institutes of Health Research. In this capacity, he led the development and implementation of a strategic research plan for Canada to address pressing questions related to heart, lung, blood, brain (stroke), sleep, and critical care ailments.

Background

The iCAPTURE Centre

Built on a 25-year history of research excellence, the iCAPTURE Centre was created in 2000 with the infusion of $21 million of technological infrastructure funding from the Canada Foundation for Innovation and its partners. In addition to its St. Paul’s facility, iCAPTURE co-investigators are located at Vancouver General Hospital, UBC’s Point Grey campus and the Centre for Molecular Medicine and Therapeutics.

iCAPTURE is dedicated to relieving the massive socioeconomic burden on our society caused by heart attacks, heart failure, COPD, asthma and critical care. More than 270 personnel in the iCAPTURE Centre, including 125 trainees and students, are using the best available technologies and tools to image and measure changes in molecules, cells, tissues, organs and whole organisms, including patients, to understand the link between our genetics and environments in causing heart, lung, and blood vessel diseases. For example, iCAPTURE Centre investigators are trying to understand how common injurious factors like air pollution, cigarette smoke, unhealthy diet, lack of blood flow, unhealthy aging, viral infections, and immune attack compromise the integrity of the heart muscle, vessels, and valves, and the lung airways and air sacs.

The iCAPTURE Centre was founded on the work of Dr. James Hogg, and in 2003 the Centre was re-named in recognition of his immeasurable contributions to its success. An Officer of the Order of Canada, Dr. Hogg continues, with the immediate past Centre Director, Peter Paré, to make major contributions in solving the unknowns in lung disease and to bring discovery to bear on the health of British Columbians.

The Heart Centre at St. Paul’s Hospital

The Heart Centre at St. Paul’s has developed an international reputation for its work in the prevention of heart disease and for the care, treatment and support of people living with heart conditions. Health professionals of the Heart Centre provides primary through quaternary care for patients with hardening of the arteries, valve diseases, congenital cardiac malformations, rhythm disturbances and other disorders. As a University of British Columbia teaching hospital, St. Paul’s serves as a training facility for cardiac professionals and is a leader in heart disease research, both in the laboratory and in the clinic. Innovators in clinical care are engaged in applied research throughout the Heart Centre. Recent examples include the development of a wireless implantable defibrillator.

Dr. Bruce McManus

Dr. McManus’ own investigative program is focused on enteroviral infections of the heart muscle and the biology of heart allograft rejection. He co-leads a transdisciplinary team of researchers seeking proteomic, metabolomic, and genomic biomarkers of acute and chronic rejection. He has co-authored over 300 peer-reviewed articles and chapters, and edited three books.

Dr. McManus has also served as Councillor for the International Society for Heart Research and for the American Society for Investigative Pathology. He is past-president of the Society for Cardiovascular Pathology. Dr. McManus was a recipient of an NIH John F. Fogarty Senior International Fellowship and co-recipient of the Max Planck Research Award. He has been elected as a Fellow of the Royal Society of Canada in the Academy of Sciences. Recently, and he was elected as an inaugural Fellow of the Canadian Academy of Health Sciences. He has received the UBC Killam Research Prize in the Senior Scientist Category and was elected as Fellow of the International Academy of Cardiovascular Sciences.

For more information, visit www.icapture.ca and www.heartcentre.ca

PHC's 2005-2006 Annual Report is Now Available

(September 29, 2006)

Providence Health Care

An Essential Provincial Resource

http://www.providencehealthcare.org/documents/PHC_Annual_Report.pdf

What exactly is an essential provincial resource? Take 5,300 dedicated staff, 1,200 committed physicians and researchers, 1,400 generous volunteers, seven top notch care facilities, six populations of emphasis; then add a strong values-based culture. Together, you get Providence Health Care — an essential provincial resource.

Working in partnership with Vancouver Coastal Health, the Provincial Health Services Authority and the University of British Columbia, Providence Health Care provides vital health-care services to patients and residents from the Lower Mainland and the rest of British Columbia. Close to 35 per cent of our patients are from outside of Vancouver.

Providence’s care providers had one of their most fulfilling years — treating more patients than ever before, making more medical breakthroughs, and continuing to improve the lives of British Columbians.

Providence addressed our growing healthcare pressures head on. Challenges such as coping with emergency department congestion, addressing infection control issues, reducing waitlists, improving patient safety, and continually enhancing access to programs and services were an everyday reality. Our staff, physicians and leaders rose to the challenge and found numerous creative solutions.

Providing programs, research and expertise that are provincial in scope — including renal care, cardio-pulmonary, elder care, HIV/AIDS, etc. — requires strategic vision that clearly defines our opportunities and outcomes.

This past year, Providence developed longterm strategic priorities that chart our path for the next three years. Our priorities are to 1) provide excellent care and service, 2) create an environment that attracts and retains the best people, 3) support research and new knowledge integration, 4) achieve strategic growth, and 5)live our Catholic Mission everyday.

A cornerstone of our priorities is the renewal of our acute and residential sites. The past year included intensive work on the renewal planning for St. Paul’s Hospital and continued work on the St. Vincent’s Hospital, Heather site Campus of Care. These renewal plans are crucial to meeting the increasing needs of British Columbians for the 21st century.

The mere presence of a strategic vision, however, does not define an organization’s success — its people do. This annual report provides a glimpse into some of our activities and achievements, made possible by our care
providers’ commitment, wealth of knowledge and by the continued support of patients, residents, families and communities.

Providence is proud to be sharing our programs and knowledge with other parts of the province as well as actively importing expertise and attracting researchers from around the world. We are also proud to provide services and programs unique in British Columbia. We know British Columbians rely on us and we work everyday to meet their health-care needs.

Sandra Heath
Board Chair

Carl Roy
President & CEO

Providence Health Care Appoints New Board Chair
(August 21, 2006)

Kip Woodward has been appointed the new Board Chair for Providence Health Care effective immediately for a two-year term. Woodward, who served as Vice-Chair of the board last year, replaces Sandra Heath, PHC's Board Chair for the past four years.

“As Vice-Chair and an integral member of our Board, Kip already has a proven track record in helping guide Providence toward fulfilling our mission and achieving our strategic priorities. I look forward to working with Kip and the Board in my ongoing capacity as Past Chair," said Heath.

Since 1998, Woodward has been the President of Woodcorp Investments Ltd., which pursues venture capital investments. Before that, he was the President of Douglas Lake Investments and served in various management and executive positions for Canada’s Woodward stores.

Over the years, Woodward has represented many organizations as Board Chair including Brentwood College School, The Nature Trust of British Columbia, Hot House Growers Inc. and the Keg Royalty Trust Fund. He is also a member and/or director of many
not-for-profit organizations including Canada’s Top 40 Under 40, the Provincial Judicial Council and the P.A. Woodward Medical Foundation.

In addition to Woodward’s appointment, other changes to Providence Health Care’s Board of Directors include the addition of Delores Holmes, Bashir Jaffer and John Kitchen. Stepping down from the board this year are Janet Brown, Richard Wong, Sister Mary Lei Gordon, Tom Murphy and Keith Purchase.

New Procedure Offers Hope for Tendon Injuries

(July 14, 2006)

St. Paul’s Hospital radiologist Dr. Tony Wong has developed a successful new technique for the treatment of those with chronic tendon injuries known as tendonoses.

Chronic tendonoses patients have abnormal tendons caused by repeated injury, from over-use. As a result, the tendons thicken and often have clefts or tears, causing constant pain and preventing patients from doing normal activities, such as walking.

Dr. Wong’s new technique to treat tendonoses involves the injection of a substance called hyperosmolar dextrose directly into the tendon under ultrasound guidance.

The procedure, which takes less than half an hour per injection, has a success rate of more than 80 per cent for treating Achilles tendons and 70 per cent for infrapatella tendons located below the knee.

“I have been performing this procedure for just under three years and a high percentage of chronically disabled patients have been able to return to their normal pre-injury activities,” said Dr. Wong.

The majority of Dr. Wong’s patients were referred through the UBC Sports Medicine Clinic, and range from marathon runners to average people who all suffer from disabling chronic tendon pain.

All had previously failed conservative treatments. Many also had unsuccessful steroid injections, which are widely used but are not helpful as the condition is not due to inflammation, but is due to damaged tendons. The hyperosmolar dextrose injections were performed as a last resort before surgery.

The procedure also offers hope for people suffering from other tendon-related injuries.

“I have since expanded the treatment to include tendonopathy of the elbow (tennis elbow) and plantar fasciitis (damage to the ligament connecting the heel and toes) and several other sites. It may have value in treating some shoulder tendon injuries but further studies are needed,” said Dr. Wong.

Injections of hyperosmolar dextrose have been used to strengthen tendons and ligaments (Prolotherapy) for many years but these injections were not under the guidance of ultrasound or directly into the body of the tendons.

Dr. Wong developed the idea for the treatment after receiving an article sent to him by Dr. Jack Taunton at the UBC Sports Medicine Clinic. The article was by a Swedish doctor who used injections to destroy nerves supplying painful Achilles tendons. This took away the pain but did not address the damage in the injured tendons. Dr Wong decided that to try to repair the damage in the tendons was more rational. The use of dextrose was on the advice of Dr Jean Gilles who uses it in her practice of Prolotherapy. The ultrasound is used to localize the damaged areas in the tendon and to guide the injections.

St. Paul's Hospital performs Canada's first implant of wireless cardiac device

(June 30, 2006)

A patient in the Heart Centre at St. Paul’s Hospital today became the first in Canada to receive an implantable cardiac defibrillator (ICD) that uses wireless technology.

Conventional ICDs have been used for many years in patients with abnormal heart rhythms who are at risk for cardiac arrest—the abrupt loss of heart function. ICDs are sophisticated devices implanted under the skin that are connected with leads positioned inside the heart or on its surface. ICDs have electronics that automatically monitor and treat abnormal heart rhythms recognized as life threatening, and, if necessary, shock the heart back into a normal rhythm.

The new wireless technology offers many advantages over the previous generation of implantable defibrillators, from efficiencies in the operating room to new ways to monitor patient health and disease progression.

Today’s procedure, in which cardiologist Dr. Stanley Tung and his team implanted a wireless ICD into a 62-year-old male patient from Pemberton, BC, follows Health Canada’s June 20 approval of a family of wireless cardiac devices manufactured by Medtronic Inc., a global leader in medical technology. Medtronic is the only manufacturer of wireless ICDs.

“We are extremely pleased that the Heart Centre at St. Paul’s was selected as the site of the first wireless ICD implant,” said Dr. Tung. “This is an exciting new era for implantable cardiac devices. Wireless capability brings the potential for many more applications down the road; this is just the beginning.”

The wireless technology makes the implantation process simpler and less cumbersome. Instead of being connected by wires to hospital computer equipment, all testing and programming of the ICD can be done from a distance. The programming physician and computer equipment do not even need to be in the same room as the patient.

When patients attend the hospital clinic for check-ups, their ICDs’ wireless capability will be activated. The devices will immediately begin communicating with hospital equipment, downloading information crucial to the patients’ health and reprogramming the ICD if needed. These tasks can be accomplished simultaneously with multiple ICDs, a major advantage for a busy clinic like St. Paul’s, which can see up to 30 patients a day. As a result, physicians can spend more time talking with patients.

Another benefit for patients is the ease with which their ongoing health can be monitored. Patients from out-of-town with wireless ICDs will not have to return to St. Paul’s in person every six months for follow-up appointments. That’s because the devices can transmit information, including a patient’s heart failure status, over a regular phone line. An ICD can be coupled with a monitor in the patient’s home that sends data streaming to their physician’s computer with updates on how well the ICD is functioning and if the patient’s heart rhythms have been normal.

The wireless ICDs use a radio frequency band specifically designated for medical implants, which protects them from interference caused by cellular or cordless phones and other common electronic devices. This provides a level of protection not offered by systems that use other frequencies.

The Medtronic wireless ICDs also help track and manage heart failure symptoms using another exclusive technology that monitors a common symptom of heart failure—the build-up of fluid in patients’ lungs. The device measures fluid levels in the lungs many times a day to provide physicians with important clinical information about a patient’s heart failure status. Physicians then have the opportunity to adjust the patient’s heart failure treatment before their symptoms worsen, potentially avoiding hospitalization.

St. Paul’s is the only hospital on the BC Mainland that implants ICDs, providing the service to patients from throughout the Lower Mainland, the Interior and the North.

Initially, ICDs were only implanted in patients who had survived a previous cardiac arrest, to prevent a recurrence. However, in recent years research has shown that, for some patients who are diagnosed with heart disease and poor heart function, ICDs can be used prophylactically to prevent a first cardiac arrest.

St. Paul’s now implants more than 350 ICDs a year, nearly double the numberimplanted at the hospital just two years earlier.

Background

About the Heart Centre at St. Paul’s Hospital

The Heart Centre at St. Paul’s is known around the world for its work in the prevention of heart disease and for the care, treatment and support of people living with heart conditions. As a University of British Columbia teaching hospital, St. Paul’s serves as a training facility for cardiac professionals and is a leader in heart disease research, both in the laboratory and in the clinic. In addition to treating patients with heart disease, the Heart Centre also focuses on prevention, helping patients stay well and out of hospital. St. Paul’s is part of Providence Health Care, Canada’s largest Catholic health-care organization.

About Medtronic, Inc.

Medtronic, Inc. (www.medtronic.com), headquartered in Minneapolis, is the global leader in medical technology – alleviating pain, restoring health, and extending life for millions of people around the world. Medtronic of Canada Ltd. is a member of MEDEC (Canada’s Medical Device Technology Companies), which is the national industry association representing over 120 medical devices and diagnostic companies. Member companies are dedicated to serving the healthcare community through the provision of high quality medical products and services that benefit Canadians.

Providence Health Care wins national award for innovation with life-saving sepsis protocol

(June 14, 2006)

For the third time in as many years, a team of caregivers at Providence Health Care has won a prestigious national award for innovation in health care—the 3M Health Care Quality Team Award.

Awarded annually by the Canadian College of Health Service Executives (CCHSE), this prominent health-care accolade acknowledges successful, sustainable quality improvement projects that demonstrate high levels of innovation and outstanding teamwork. Providence Health Care has now won a 3M award an unprecedented three years in a row.

This year’s 3M Health Care Quality Team Award in the acute care category has been won by a multidisciplinary team from the Emergency Department and Intensive Care Unit (ICU) at St. Paul’s Hospital, who applied practices that improved patient care and reduced deaths from sepsis by nearly 50 per cent. The award was presented yesterday at the annual National Healthcare Leadership Conference in Victoria.

“Congratulations to the St Paul’s Intensive Care Unit and Emergency Department team for their great work and on receiving this prestigious award. This remarkable life-saving innovation dramatically lessens risk for recovering patients,” said Health Minister George Abbott. “This is another example of how B.C.’s medical professionals are leading improvements in healthcare through teamwork and ingenuity.”

“The award acknowledges the excellent work being done at Providence to improve access and care for patients,” said Carl Roy, President and CEO of Providence Health Care. “This initiative is an outstanding example of how innovation, quality and teamwork can help save lives. It also provides an invaluable model of best clinical practices that can be emulated across Canada.”

Sepsis is a systemic infection in tissues or the blood stream caused by bacteria or other infectious organisms. It can originate anywhere in the body and, if left unchecked, leads to septic shock and ultimately organ failure and death. Those at greatest risk are all critically ill patients, the elderly and those with chronic disease or compromised immune systems. One of healthcare’s greatest challenges, sepsis is a major cause of illness and death worldwide and takes the lives of tens of thousands of Canadians each year.

Providence Health Care is part of a Canada-wide initiative designed to use ICU expertise to improve patient care and help prevent deaths from sepsis. The team adopted the best practice standards established by the national ICU collaborative and developed a streamlined process for the early identification and treatment of septic patients.

When this process was implemented, the results were dramatic. There was nearly a 50 per cent decrease in patient deaths from sepsis, exceeding the team’s original goal of reducing patient mortality by 20 per cent. And, because septic patients were being identified and treated earlier, they spent less time in the ICU.

“We created a new process that removed delays and barriers to care for sepsis patients, allowing for early identification and faster treatment. This not only reduces their risk of death, but also potentially reduces the number of admissions to the ICU,” said Bonita Elliott, ICU Operations Leader. “This provides greater access to the ICU for other patients who require that level of care.”

The team has shared their data and learning with the national collaborative and are also presenting at both local and national conferences.

“Our results are earning national recognition, but more importantly they are saving patients’ lives. We hope that our results will inspire other hospitals to implement similar initiatives,” said Dr. Kirk Hollohan, Physician Leader, Quality and Utilization Management.

Some of the process changes instituted in the award-winning sepsis protocol include educating staff about early warning signs of sepsis, standardizing testing and medication orders and having a medication kit in the ER that contained all possible antibiotic combinations for sepsis patients, which prevented delays in obtaining the appropriate antibiotics from the pharmacy. As well, monitoring technology was brought into the ER to give staff the ability to measure precisely the extent of septic infection and what treatment was needed.

The winning team included representatives from the ICU, ER, Pharmacy, Information Management/Information Systems and Performance Improvement.

Providence Health Care first received a 3M award in 2004 when the Foot and Ankle Clinic won for a clinical pathway that reduced patient length of stay by 50 per cent and greatly increased patient satisfaction. PHC’s Laboratory Services won a 3M Award in 2005 with an initiative that dramatically decreased turnaround times of patient test results and reduced operating costs by $500,000 a year.

Background

3M Health Care Quality Team Award

About the award

Offered through The Canadian College of Health Service Executives, The 3M Health Care Quality Team Award recognizes team members who apply a quality management process to create measurable benefits in their network of services and programs. The award encourages institutions and health care providers to embrace quality management by developing innovative approaches that bring about sustainable improvement in programs and services. The 3M Health Care Quality Team Award is the only award of its kind that recognizes innovation, quality and teamwork.

About 3M Health Care

3M is a diversified, international company with a health care business consisting of more than 10,000 medical, surgical, consumer, home health care, dental and pharmaceutical products. 3M uses six sigma processes within its own organization and has helped hundreds of its customers to integrate quality management processes into their operations.

About CCHSE

Founded in 1970, the Canadian College of Health Service Executives (CCHSE) is a national, non-profit, professional association dedicated to developing, promoting, advancing and recognizing excellence in health leadership. Our 3,000 individual and 70 corporate members work in all health sectors across the country. We offer a wide range of services including a competency-based certification program, a forum for the exchange of information and best practices, a career network, and an extensive national program of professional development resources and opportunities. We also publish the only peer-reviewed journal that covers issues related to advances in health services management, theory and practice in a Canadian context. Our contribution to the health system and, ultimately to the health of Canadians, is through the leadership excellence of our members.

Unique Program Lets Caregivers Experience the Effects of Dementia
(June 2006)

Providence Health Care has partnered with the Alzheimer Society of B.C. to participate in the Alzheimer Society’s new, leading edge program Making the Connection – The Dementia Experience – the first and only one of its kind in BC – that offers a simulated dementia experience where the senses are artificially altered through various techniques.

Making the Connection – The Dementia Experience offers professional caregivers a chance to walk in the shoes of a person who has dementia, and helps participants understand what a person with dementia feels, hears and sees. The program is completed with a debriefing and an education workshop.

“We are providing education for residential care staff to gain insight into what people with dementia endure in their day-to-day lives. PHC is one of the first health organizations in BC to offer this type of innovative training to staff. This also ties in well with the Eden Alternative – the guiding philosophy at PHC’s residences, which aims to eliminate loneliness, helplessness and boredom,” says Dr. Elizabeth Drance Physician Program Director in Elder Care at Providence Health Care.

“When you work with people who have dementia, you may understand what’s going on at an intellectual level, but what has often been lacking is training that creates a deeper human understanding,” says Betty Sinclair, Director of Support and Education for the Alzheimer Society of B.C. “We think it’s exciting that an organization like Providence saw the value in this program, and were the first to come on board.”

The Alzheimer Society developed the two-part course to give professional caregivers insight and skills to help inspire change in the way they provide care to people with dementia. About 600 people, including 525 staff from Providence, have completed Making the Connection – The Dementia Experience since its launch. For more information about Making the Connection – The Dementia Experience, call 604-681-6530 or e-mail adevries@alzheimerbc.org.

Providence Nurses Recognized for Excellence
(May 2006)

Lynette Best – Award of Distinction in Nursing

Lynette Best, Providence Health Care’s Chief of Professional Practice and Nursing has been awarded one of nursing’s top honours – the College of Registered Nurses of British Columbia (CRNBC)’s Award of Distinction in Nursing.

This award recognizes Lynette for her outstanding contributions to the nursing profession and for demonstrating excellence in relation to the Standards for Registered Nursing Practice in British Columbia.

With her extensive background in both health care management and leadership of professional nursing practice, Lynette brings a very specialized body of knowledge and expertise to Providence and the nursing profession. This has been invaluable for PHC in

the creation and administration of service delivery models, coordinating change and creating a total quality management environment focused on the needs of patients, residents and staff.

“In our complex health care environment, Lynette has been extremely successful in balancing the often-competing demands of care delivery (e.g. access to care), efficiency (e.g. cost) and effectiveness (including the safety and quality of care),” noted Carl Roy, PHC’s President and CEO. “She never loses sight that the patient is the focal point of all we do in health care.”

Sandra Whytock – Award of Excellence in Nursing Practice

Sandra Whytock, PHC’s Clinical Nurse Specialist for Geriatric Medicine and Rehabilitation, has been selected for the CRNBC’s Award of Excellence in Nursing Practice.

Sandra is a nursing expert in the specialized field of Gerontological Nursing. Her practice includes consultation, education, research and direct clinical care. She is frequently sought out to participate in working groups where a reasoned and knowledgeable voice is needed.

Her expertise has contributed to the development and implementation of care standards that include dysphagia management, elder care bowel protocol, diabetes care, and management of unsettled behaviours.

Sandra is also a Nurse Continence Advisor and has established continence clinics at St. Paul’s Hospital and Holy Family Hospital.

In addition, she is a major contributor to the work of professional practice groups that include the Acute Care Geriatric Nurse Network, the Rehabilitation Nurses Professional Group, Canadian Nurse Continence Advisor Association and the UBC School of Nursing.

Everyone that knows Sandra has witnessed her passion, integrity and commitment to advancing the care of seniors and their families. Sandra, indeed, is a worthy recipient of the CRNBC award.

New techniques allow St. Paul’s kidney transplant program to
increase the number of compatible donors and save lives
(May 10, 2006)

As St. Paul’s Hospital celebrates the 20th anniversary of its first kidney transplant, patients are benefiting from innovative new procedures that can help overcome incompatibility between organ donors and recipients and reduce the risk of rejection.

The story of New Westminster resident Aran Lewis provides a dramatic example of how the new treatments can increase the pool of potential donors and save lives.

Lewis, 26, was born with a congenital kidney defect that required corrective surgery and kidney transplants. But his second transplanted kidney had failed and after four years of dialysis his health was deteriorating. His only hope was another transplant. His mother was willing to donate her kidney, but although she and Aran had the same blood type, they were otherwise incompatible. No other matches could be found.

When Aran’s situation became desperate, the St. Paul’s kidney transplant team agreed to perform the surgery using promising new protocols, including “pre-treatments” that prepare the recipient for transplant.

“We had never performed a kidney transplant with this degree of incompatibility before,” recalled Dr. David Landsberg, Physician Program Director, Renal Program and Head, Division of Nephrology, of the surgery that took place in June 2005. “It was very high-risk, with many possible complications as well as the risk of failure.”

While Aran’s recovery wasn’t without complications, there have been no signs of rejection. He has fully recovered, was married last September and has begun to resume an active lifestyle that includes swimming and learning to play golf.

“St. Paul’s program, which is operated in partnership with the BC Transplant Society, is on North America’s leading edge of these new pre-treatment regimes,” says Dr. Landsberg. “Now, just because a possible kidney donor and recipient are incompatible, it does not necessary mean that performing the living donor transplant is out of the question. Never before have we had such a complete set of tools to address these issues.”

New tools available to the transplant team include a better ability to characterize and monitor harmful antibodies, advances in renal biopsy and pre-treatment medications that prevent bone marrow from producing antibodies. Such immunosuppressant drugs were first developed as cancer treatments

A key technique the transplant team used pre- and post-treatment is called a plasma exchange. This was accomplished by withdrawing Aran’s blood with dialysis-like equipment that separated the plasma, which carries the antibodies, from the red blood cells.

Antibodies are an essential part of the immune system and normally act to protect the body. But this is a liability in the case of organ transplants, as the antibodies identify the organ as foreign tissue and attack it. The plasma exchange technique replaces the plasma with albumen.

Plasma exchanges can allow an expansion of the pool of potential donors, which comes at an opportune time. End-stage kidney disease is rapidly increasing, especially among those over 65, primarily due to complications from high blood pressure and diabetes.

“The number of people in BC with end-stage kidney disease requiring dialysis is growing at a rate of eight to 10 per cent per year,” says Dr. Landsberg.

Kidneys for transplantation are in short supply. Patients who do not have a living donor can wait five to seven years to receive a kidney from a deceased donor. The gift of a new kidney has a tremendous impact on quality of life, renewing health and liberating recipients from frequent dialysis treatments.

The St. Paul’s kidney transplant program has evolved over the past 20 years into BC’s largest and one of Canada’s finest. It operates in partnership with the BC Transplant Society, which is responsible for all aspects of organ donation and transplantation in the province.

The program’s achievements include performing Canada’s first living anonymous donor transplant, Canada’s first HIV-positive kidney transplant and BC’s first minimally invasive laparoscopic surgery to remove a kidney from a living donor. More than 1,300 kidney transplants have been performed at the hospital since 1986.

When the first transplant took place at St. Paul’s in 1986, the vast majority of patients received a new kidney from a deceased donor. Today, more than 60 per cent of kidney transplants performed at St. Paul’s come from living donors who donate to a family member or friend. BC has the highest proportion of living kidney donors in Canada.

Dialysis can keep end-stage kidney patients alive for a period of time, but transplantation increases their expected lifespan by 10 years on average. For a younger person such as Lewis the benefit of a transplant is even greater, with an average increase in lifespan of 17 years.

Members of the public are reminded that if they have not signed up with the British Columbia Transplant Society’s Organ Donor Registry, they can add their name to the registry by visiting www.transplant.bc.ca or calling 1.800.663.6189.

AIDS: A new leader for the struggle

Dr. Julio Montaner: The St. Paul's Hospital doctor whose groundbreaking work has kept hundreds of thousands of patients alive is taking his fight global.

(May 2006)

Dr. Julio Montaner is like a proud parent as he sits on a bed at St. Paul's
Hospital, chatting to his HIV-positive patient, Rev. Michael Forshaw.

"If you would have seen him in December, he was a ghost of a person," says
Montaner. "Within two months, he gained 30 pounds and his infections
disappeared."

As Montaner talks of the success he's had with a cocktail of two new,
experimental drugs, his mind drifts back to his childhood in Argentina.

That was where he watched his own father doing his rounds in tuberculosis
hospital wards in Buenos Aires.

For Montaner, now recognized as one of the world's leading authorities in
developing HIV and AIDS treatment, got his love of medicine as a
five-year-old.

"I used to go out and see patients with my dad at the weekend when he was
doing house calls," he remembers. "For me, that was the best thing that ever
happened. When I was 10, it would not be unusual to accompany my dad to the
TB hospital to see patients."

The man who has led the battle against a disease that killed 1.5 million
people last year, sees many parallels between the war on HIV/AIDS and the
1950s fight his father, Dr. Luis Montaner, waged on TB.

Montaner is director of the B.C. Centre for Excellence in HIV/AIDS, based
at St. Paul's.

And the 49-year-old medical crusader has recently been named as the
president-elect of the International AIDS Society.

He sees that as an opportunity to take the war from the HIV-and
AIDS-ravaged communities of Vancouver on to the global stage.

For a while, it looked as if Montaner might not follow in his distinguished
father's footsteps.

As a teen at one of Argentina's top high schools, he seemed to falter.

"I didn't do very well," he chuckles, matter-of-factly, his accent still
bearing the Latin lilt of his South American roots. "I went to the best high
school in the country and I was probably one of the underperformers. I was
going through the typical teenage years."

Although he partied his way through high school, he kept his mind focused
on medicine.

"It was the only thing I really cared about and I never understood why I
had to waste so many years of my life going through high school, when I
wanted to be a doctor anyway," he says. "My dad didn't appreciate that part
of my life and, for a while, he had doubts I would make it."

He did just enough to qualify for the city's two medical schools but by
then, his father had been made dean of one of them.

"And the going joke, which was not so funny, was 'You're going to be an
embarrassment,'" says Montaner. "I'm the oldest of seven children and that's
a tough nail in the coffin. My dad became the dean of the private medical
school and I said, 'I'm going to the other one.'"

His life took an immediate, 180-degree turn.

"I just made it into medical school and, once I made it, the party
stopped," he says. "I was a totally different person -- I was doing what I
wanted to do. I became absolutely consumed."

At the end of his first year, after taking his anatomy exam, he went home
to tell his father about it.

"So he looks at me and he says, 'Oh, how did it go?'" says Montaner. "I
said, 'Nine out of 10.' I thought, finally, I was going to turn my dad
around and he said, 'How come you didn't get a 10?'

"His expectations had totally changed -- it was great."

Montaner started spending weekends, spring break and summer working with
his dad who, by then, was president of the Argentina Medical Association.

"I was always looking for trouble where I wasn't supposed to," he chuckles.
"I would ride to the hospital with my dad and I would see things that I
didn't think were being done appropriately. The system was full of holes and
I was very frustrated with all of that."

He got angry and had long discussions with his father about how the system
had to change.

His eventual goal was to "sit to the right of my father" and fix the
problems in Argentina.

When Montaner went into his residency training he became more frustrated,
working in difficult environments and experiencing "horror stories" caused
by a lack of resources.

And while he wanted to work in Argentina eventually, he felt the need to
get out of his father's shadow and make his name on his own.

He shopped himself around to hospitals in France and England.

"A lot of people were friends of my dad and I wanted to get away from my
dad to validate my credentials and be able to come back and say, 'Now I'm
going to work with you and change things,'" says Montaner.

In 1979, he heard a Vancouver-based doctor lecturing at a Uruguay health
conference.

That meeting with Dr. Jim Hogg, from St. Paul's Hospital, changed
Montaner's life and, eventually, the lives of hundreds of thousands of
people suffering with HIV and AIDS.

"He said, 'Why don't you come and work with me in Canada?'" Montaner says.
"One thing that was appealing was that this guy didn't know my dad. Of
course, I didn't know Vancouver was so far away."

In 1981, he came to Vancouver to treat lung disease at St. Paul's.

"I came with a full intention of going back to Argentina and picking up
where I left off," he adds.

He met a Vancouver X-ray technician who "turned out to be very nice" and
they married and have four kids.

After they were married, Dorothee told him she wasn't willing to go with
him to South America.

"She did me a favour by forcing me to look at the reality of what going
back home meant," he says.

By 1984, he was chief resident at the hospital.

"About that time, I started to see cases of pulmonary disease emerging in
young gay men, mostly from the West End," he says. "I was at the front line.
We were receiving patients that were being rejected everywhere else because,
in those days, there was little sympathy for these people."

A woman contracted HIV through a blood transfusion during cancer surgery
and was admitted "with her lungs drowning in her own fluids."

Montaner tried using anti-inflammatory drugs, an unusual treatment for
those with depressed immune systems.

There was a slight, positive response and the method was successfully tried
on other HIV patients.

It resulted in a treatment to prevent the kind of pneumonia that was the
No. 1 killer of AIDS patients.

"By the time we finished, you had no right to have this type of pneumonia
because we could treat it, prevent it and have better antibiotics," says
Montaner. "My dad said, 'What are you going to do now?'"

It was 1985 and Dr. John Ruedy, head the department of medicine at St.
Paul's, told Montaner that two of three people most involved in the HIV
program were taking leaves.

"I said, 'Look at it as an opportunity. Why not revamp the AIDS program
into a research program? If you'll do that, I'll help you,'" says Montaner.

That was on a Friday and on the following Monday, Ruedy came back and
offered Montaner the job.

"It was the shortest job interview I ever had," he chuckles. "I never
looked back. By Monday I became head of the AIDS research program, which was
me, and me . . . and me too."

Ruedy told him he'd been given the new drug, AZT, for clinical trials.

Montaner started with one drug, then two drugs.

And he started emulating the methods used by his father to combat TB using
multiple drugs to form a "mesh" to control the HIV virus.

By the mid-1990s, the trials had grown to combining three drugs, which was
the birth of the drug cocktail known as "highly active anti-retroviral
therapy," or HAART.

"That turned things around," says Montaner. "We had a lot of successes over
the world, but to be here and be part of that development was really
fascinating."

But the battle was far from won.

There were multiples numbers of drugs, pills and doses, making it hard for
people to stick to the regimen.

The disease was also becoming resistant to the drugs as the virus began
mutating. That led Montaner to where he is today, using drugs called TMC 114
and TMC 125 on patients like Forshaw.

The 64-year-old Forshaw -- an openly gay Anglican priest -- was first
diagnosed with HIV in 1991.

"We've had to develop new drugs that work on resistant viruses," says
Montaner. "We've learned from experience, and from the TB experience, that
one active drug at a time doesn't work."

Montaner says HIV hits vulnerable poor, homeless and injection- drug-user
populations.

"It's increasingly affecting those segments of the population, and the same
thing happened with the TB epidemic all over the world," he says.
"Immigrants, aboriginals -- you name it -- are at a disadvantage and HIV
thrives in those environments."

Within a year, Montaner expects to have a triple-drug therapy that will be
a single, once-a-day pill that will be highly effective as a first treatment
for people with HIV.

"We're still seeing people arriving at the emergency room to be diagnosed
with HIV -- which they probably had for a decade -- and they're sick and
nearly dying from it," he adds. "This is not acceptable."

One response is a Downtown Eastside study that will look at 1,500 people
who've slipped through the cracks and bring them to the clinic.

"Treatment is an essential part of controlling the epidemic, both at home
and abroad," says Montaner. "HIV is a curse, and treatment transforms what
used to be a rapidly fatal illness into a chronic and manageable condition."

In a world where 40 million people are infected with HIV and 1.5 million a
year die from it "unnecessarily," Montaner describes government inaction as
"genocide."

He said the former federal Liberal government broke its promise of
additional cash for the United Nations Aids program.

"Our eyes are on the current administration to see that it happens," he
says.

"If it doesn't, we'll be in Toronto in August for the International AIDS
Conference, sponsored by the International Aids Society, and we'll be
reminding the federal government that they haven't met their quota. You can
expect us to be very vocal on that."

So what does Montaner's father -- now aged 76 -- make of his son's
achievements?

"He enjoys the fact that I've done well and, at the same time he says,
'Slow down. You have to take care of yourself," laughs Montaner. "But I'm
still a young man and I have lots left to do."

"Naming & Claiming Spirituality: the invisible ingredient in health & healing"
(May 2-3, 2006)

Providence Health Care invites you and your colleagues to participate in our first bi-annual conference that explores the integral relationship between spirituality, health and healing.

The purpose of this conference is to bring together people of diverse cultural and spiritual traditions in order to create a forum where participants come to discuss issues, share insights and hear from leading experts on this topic. Dr. Daniel Sulmasy, the Chair of Ethics at St. Vincent's Hospital in New York and Dr. Thomas Maddix, Vice President, Mission, Ethics and Spirituality at Providence Health Care are just two of the many speakers who will be presenting.

Open to:
- Physicians and other health care clinicians
- Health care executives and managers; researchers
- Government leaders
- Instructors especially in medicine, nursing and other health disciplines
- Community and social services practitioners
- Primary care and religious leaders
- Educators, patients and families and all those interested in this exciting and thought provoking topic.

Conference Focus:

- Provide a forum for discussion of the place of spirituality and healing within health care

- Share insights and lessons learned from research and/or daily living in the area of spirituality, healing and health

-Understand the relationship between healing and spirituality

- Identify spiritual issues as part of the diagnostic and healing process

- Acknowledge the impact of personal spirituality of health provider, patient and resident upon health outcomes

- Incorporate spirituality into your administrative, clinical, educational and other daily activities

Operative Definitions for the Conference

Spirituality:

The search for the Sacred. A conscious striving to move beyond isolation and self-absorption to a deeper awareness of interconnectedness with the self, other human beings and the transcendent.

(Health Ethics Guide)

Spirituality is the belief system focusing on the intangible elements that impact vitality and meaning to life's events.

(Maughans...The SPIRITual History, Archives of Family Medicine, 5:11-16)

Healing:
Healing is more than curing a disease. Healing takes into account the wholeness of the person, recognizing the interrelationship of body, mind and spirit. It involves the restoration of balance and acknowledges the role spirituality and/or religious belief can play in the healing process.

Conference Venue

The conference will be held at the Coast Plaza Hotel and Suites in the heart of Vancouver's colourful and cosmopolitan West End. On the doorstep is the 400-hectare Stanley Park, with walking and bicycle paths and a pedestrian seawall that takes you to the beaches and the world-famous Vancouver Aquarium. Less than a kilometre away, the city's downtown financial, business, shopping and entertainment centre awaits you.

Conference size is limited, so sign up now!

Click here for a conference program.

Click here for a registration form.

For more information, please contact: Perminder Sihota, Mission, Ethics & Spirituality, PHC, (604)806-8528, psihota@providencehealth.bc.ca

PHC Doctor Named President of International AIDS Organization

(February 22, 2006)

Dr. Julio Montaner, Director of the B.C. Centre for Excellence in HIV/AIDS, has been appointed president-elect of the world's leading independent association of HIV/AIDS professionals.

Montaner will begin his term as president-elect of the International AIDS Society (IAS) at the XVI International AIDS Conference in Toronto, Aug. 13-18. He will assume the presidency at the closing of the XVII International AIDS Conference in Mexico City, in 2008.

Montaner says his election is the direct result of the Centre's growing reputation as a world leader in HIV/AIDS clinical care and research.

"Our ongoing published research continues to push forward understanding of the complexities of the disease - from improving treatment regimens and outcomes to highlighting strategies that may prevent transmission of the virus," says Montaner. "This appointment is really a recognition of the Centre's multi-disciplinary team that is collectively responsible for this important and internationally relevant work."

As president of IAS, Montaner will actively promote the role of the Society as an outstanding worldwide force of committed professionals working together to prevent, control and treat HIV/AIDS. He will focus his efforts on the global expansion of antiretroviral-therapy programs to limit the epidemic's growth.

"We now have very powerful cocktails that are very simple and well tolerated. These regimens not only save lives, but can help decrease transmission-rates of HIV as part of an overall strategy focused on safer-sex practices and other important harm-reduction measures," says Montaner.

Montaner leads clinical activities at the B.C. Centre for Excellence in HIV/AIDS, Canada's largest HIV/AIDS research, treatment and education facility. As well, Montaner is Co-Director of the Canadian HIV Trials Network and Director of the AIDS Research Program and the Immunodeficiency Clinic at St. Paul's Hospital, holding the Endowed Chair in AIDS Research at UBC, the first initiative of its kind in Canada.

IAS is the world's leading independent association of HIV/AIDS professionals, with more than 6,000 individual members from over 130 countries. Toronto is the second Canadian city to host the society's bi-annual conference since Vancouver in 1996. Montaner was part of a small committee of local HIV/AIDS specialists that successfully lobbied for, and organized, the first global HIV/AIDS conference in the country.

About the B.C. Centre for Excellence in HIV/AIDS
Founded in 1992 by St. Paul's Hospital and the provincial Ministry of Health, the B.C. Centre for Excellence in HIV/AIDS is a key provincial resource seeking to improve the health of people with HIV through the development, ongoing monitoring and dissemination of comprehensive investigative and treatment programs for HIV and related diseases. St. Paul's Hospital is one of six health care facilities operated by Providence Health Care, Canada's largest faith-based health care organization. For more information, visit www.cfenet.ubc.ca

About the IAS
IAS is a worldwide force of professionals working together to prevent, control and treat HIV/AIDS. IAS provides critical platforms for presenting new research, sharing best practices and advancing the fight against AIDS. By promoting dialogue, education and networking, IAS helps close gaps in knowledge and expertise at every level of the response. IAS initiatives promote the application of the most current research and best practices in government policy and program development, focusing on resource-challenged settings For more information, visit www.iasociety.org

New Mental Health Beds to Improve Patient Care at St. Paul's Hospital

(January 27, 2006)

St. Paul’s Hospital is opening 15 new mental health beds to improve the
care, treatment and safety of psychiatric patients, while enhancing the wait times and congestion in the hospital’s busy emergency department.

The 15 beds – made possible by Vancouver Coastal Health's funding of $2.5 million for one-time capital costs and $3.7 million in new annual operational costs – form the new Treatment and Evaluation Unit, which had its official opening today at St. Paul’s Hospital.

“Since 2001, the number of psychiatric patients admitted through emergency at St. Paul’s has increased by about 20 per cent,” said Carl Roy, President & Chief Executive Officer, Providence Health Care. “As a result, these patients have been experiencing longer and longer wait times in our emergency department. At the same time, the acuity and severity of illnesses of psychiatric patients have continued to pose new challenges in assessment and treatment.

“With the new Treatment and Evaluation Unit, we will no longer have psychiatric patients, who require highly specialized care environments, waiting long hours in ER beds to be admitted into a hospital bed. They can be admitted straight into the new unit.”

Roy added that, unlike the previous facility, the great benefit of the new unit is it’s specifically designed for mental health patients.

“The Mental Health program at St. Paul’s is a provincial resource, treating patients from throughout British Columbia. When designing the unit, we focused on meeting specific patient needs, ensuring staff safety and having a state-of-the-art facility that allows for a comprehensive approach to psychiatric treatment,” said Roy.

The facility has private and semi-private patient rooms, more seclusion rooms, natural lighting, more space and open areas, video monitoring and numerous specialized safety features.

Dr. Kris Sivertz, Head of Psychiatry, Providence Health Care, said the new facility will also enable physicians and care providers to continue new research and treatment initiatives, focused on emerging complex patient populations.

“We are seeing more and more patients with concurrent disorders – people with psychiatric illnesses coupled with abuse of a variety of drugs and substances,” said Dr. Sivertz. “We’ll be doing some groundbreaking research in this area to help determine the best treatment regimes for these patients.”

The Treatment and Evaluation Unit will start admitting patients within the next two weeks.

Background

Providence Health Care’s Mental Health Program
The Mental Health Program at Providence Health Care provides a range of coordinated emergency, inpatient, ambulatory and provincial services for people with a serious mental illness. St. Paul's Hospital handles 85 per cent of the most severe mental health emergency patients in the Vancouver Coastal Health region. Mental Health includes the Eating Disorders Program, Reproductive Mental Health Program, and the Pain Program.

The St. Paul's Hospital Eating Disorders Program is affiliated with the University of British Columbia and is home to a growing team of researchers.

Reproductive Mental Health is affiliated with BC Women's Hospital and is actively engaged in research.

The Pain Program continues to engage in research and provides interventions available nowhere else in British Columbia.

The Mental Health program has 33 general beds (increased to 48 with the 15 new beds), seven eating disorder beds, and four pain beds.

Providence Health Care’s Metabolic Syndrome Clinic

to be first in Canada

(January 27, 2006)

Specialists from the provincial Heart Centre at St. Paul’s Hospital today announced the creation of Canada’s first Metabolic Syndrome Clinic for British Columbians who have a series of risk factors that make them much more likely to develop diabetes or cardiovascular disease.

Made possible by a $1.6 million donation from AstraZeneca Canada Inc. to St. Paul’s Hospital Foundation, the clinic will focus on helping patients not only understand their risk factors, but also how to take the necessary steps to reduce their chance of developing these chronic, and potentially life-threatening, health conditions.

About one in five British Columbian adults have metabolic syndrome, a medical assessment made based on a patient having three out of five defined risk factors. The most important factor is waist circumference – obesity coupled with an apple-shaped body where most of the excess weight is carried in the mid-section. To be diagnosed with metabolic syndrome, two out of four additional risk factors also need to be present: high blood pressure, raised fasting blood sugar levels, a blood fat abnormality called raised triglycerides and reduced HDL (good) cholesterol levels.

Each risk factor increases cardiovascular risk, but when several risk factors are combined, the patient is twice as likely to die from cardiovascular disease.

“We often see the results of unmanaged metabolic syndrome in our Coronary Care Unit when we treat someone who has already suffered a major heart attack,” said Dr. Andy Ignaszewski, Medical Director, Heart Function Clinic and Healthy Heart Program. “By helping people change their lifestyle or identifying treatable conditions like blood lipid disorders early enough, it’s possible to help people with metabolic syndrome reduce their risk of developing diabetes or cardiovascular disease.”

“We have significant expertise in cardiovascular risk reduction and lipid management within our Healthy Heart Program and it makes sense to use this to begin a new service for British Columbians,” said Dr. Jiri Frohlich, Academic Director, Healthy Heart Lipid Clinic. “As well as patient care and research, the new clinic will focus on developing education and training networks for physicians and health care professionals across the province.”

"AstraZeneca is proud to support St. Paul's Hospital and the Metabolic Syndrome Clinic to help improve the health of British Columbians,” said Mike Cloutier, AstraZeneca's President and CEO. " If we can educate patients about the risks of type II diabetes and cardiovascular disease, we’ll have greater success in preventing these chronic diseases."

“I want to thank AstraZeneca for this very generous donation in support of Canada’s first Metabolic Syndrome Clinic,” said Carl Roy, President and CEO, Providence Health Care. The consequences of unmanaged metabolic syndrome impact hospital and health care resources as well as patients’ lives.”

The first patient will be seen in the Metabolic Syndrome Clinic this summer. A referral from a family doctor is needed.

Background

What exactly is metabolic syndrome?

The International Diabetes Federation’s definition of metabolic syndrome is based on the person having central obesity - waist circumference >94 cm (37 in) for men and >80 cm (31.5 in) for women - plus any two of the following four factors:

raised blood pressure (>135/85) or previous treatment for high blood pressure
raised fasting blood sugar (5.6 mmol/L) or previously diagnosed type 2 diabetes
reduced HDL (good) cholesterol in the blood or specific treatment for this lipid abnormality (< 1.03 mmol/L in men and <1.29 mmol/L in women)
raised triglyceride level in the blood (> 1.7 mmol) or specific treatment for this lipid abnormality.

Ethnic and genetic background increases one’s chance of developing metabolic syndrome. For example, metabolic syndrome is more common in people of First Nations or South Asian background.

For more detailed background information, please click here.

Metabolic Syndrome Clinic

The Metabolic Syndrome Clinic will be part of the Heart Centre’s renowned Healthy Heart Program. The clinic’s multi-disciplinary team will focus on specialized patient care, research, and the development of education and training networks. These networks will enable British Columbia’s physicians and health care professionals to provide the most effective management of patients with metabolic syndrome.

Patients referred to the clinic will be fully investigated to find out more about their risk factors and whether they already have early diabetes or signs of cardiovascular disease. The first line of treatment will be lifestyle therapy focused on healthy eating, exercise and weight loss. However, medical treatment will be initiated when patients do not respond to diet and exercise alone, are found to have risk factors, or pre-existing disease requiring further management.

St. Paul's team is world's first to perform new heart-valve replacement surgery
(January 2006)

A team of specialists at St. Paul's Hospital recently performed the world's first minimally invasive "beating heart" aortic valve replacement surgery.

Cardiac surgeons Drs. Sam Lichtenstein, Anson Cheung and Jian Ye recently worked with interventional cardiologists Drs. John Webb and Ron Carere and echocardiologist Dr. Chris Thompson to replace the aortic valve of a patient who would not have been able to endure open-heart surgery.

"We are very excited to be the first team in the world to perform this new procedure," Lichtenstein said. "Most importantly, we were able to improve the health of a patient who had no other options."

Heart valve replacement surgery usually requires a long incision in the centre of the chest to enable surgeons to expose the heart, which is temporarily stopped while the valve is replaced and sutured in place. A heart-lung bypass machine is used to keep the patient's blood circulating until the heart function is restored.

Instead of this major operation, the team was able to use a special valve that folds to the diameter of a pencil and can be inserted via a small four-inch incision between two ribs. Guided by moving x-ray and echocardiography (heart ultrasound) pictures, the team was able to insert the valve through the base of the patient's heart. When in place, the valve was unfolded, pushing the existing valve tissue aside.

The new procedure is known as trans-apical placement and is one of the therapies available in the evolving field of "closed heart" procedures.

Earlier this year, Webb became the first interventional cardiologist in North America to perform a successful percutaneous aortic valve replacement. In this procedure, the same type of folding valve is threaded up to the patient's heart through the circulatory system using a catheter inserted in the patient's groin. (The valve for both procedures was developed by Edwards Lifesciences Corporation.)

The development of percutaneous valve replacement opens a new door for some patients who could not safely undergo open-heart surgery. However, about 30 per cent of patients over 70 years have blood vessel disease in the major arteries of the lower body that would also preclude them from having the percutaneous procedure. The new surgical technique pioneered by Lichtenstein and the St. Paul's Heart Centre team could one day be an option for these patients.

Will minimally invasive heart valve replacement surgery ultimately be the answer for all patients? Not yet, says Lichtenstein. The team current plans to provide the procedure on compassionate grounds for patients who are too frail to survive open-heart valve replacement surgery. The next step could be offering it to patients for whom open-heart surgery is possible but considered to be high-risk. However, more work needs to be done before this becomes something that would be an alternative for younger, healthier patients.

This world-first at St. Paul's was made possible by the collaborative relationship between surgeons and interventional cardiologists at the hospital's Heart Centre, Lichtenstein said. "We all bring different skills to the table and our willingness to collaborate enabled us to perform this new procedure successfully."

St. Paul's Hospital Welcomes New Year's Baby
(January 2006)

The Lower Mainland's first baby of the New Year was born at St. Paul's Hospital early today.

The New Year's baby, a girl named Natalie Sofia Wan, was born at one minute and 38 seconds after midnight, weighing 8 pounds, 15 ounces. Her parents are Willy and Lena Wan of Vancouver. Natalie is the couple's second child.

Every year, 1,800 women choose to have their babies at St. Paul's, where a comprehensive obstetrical service is available for both low-risk moms-to-be and high-risk women who may require the support of an Intensive Care Unit.

The Maternity Centre takes a family-centred approach, which means that for most families all necessary care will be provided in one room. Fathers or one other significant person can stay 24 hours to support mother and baby. A Special Care Nursery is available for babies who require closer nursing observation and care. St. Paul's is a major teaching facility for obstetric physicians and nurses.