Providence Health Care - What's New - Providence Legacy Project, St. Paul's Hospital, Mount Saint Joseph Hospital, St. Vincent's Hospitals, Arbutus, Brock Fahrni Pavilion, Heather, Langara, Holy Family Hospital, Youville Residence

Technology to benefit women of Asian descent and others with hard-to-detect
breast cancer. A digital mammography machine for Mount Saint Joseph Hospital -- which may prove effective in detecting breast cancer for the high proportion of Asian women treated there -- tops the wish list for this year’s Angel Campaign.

“Asian women have high density breast tissue which makes early detection of breast cancer difficult,” said Dr. Richard Lee, a radiologist at Mount Saint Joseph Hospital. “Researchers from the University of North Carolina have found that digital mammography is effective in detecting cancer in women with high density breast tissue.”

Approximately 70 per cent of the diagnostic mammography exams at Mount Saint Joseph Hospital are performed on Asian women.

Digital mammography may have a substantial impact on early detection of breast cancer and other breast abnormalities in these cases because it allows the radiologist to carefully
review images of the breast from various perspectives, including tomography or “slice imaging” to provide clearer images of cancer in early stages of development.

“This year’s Angel Campaign will be devoted to a number of initiatives, including raising $750,000 to purchase the much-needed digital mammography machine for Mount Saint Joseph Hospital. This technology will set new standards of care for early detection and diagnosis of breast cancer for Asian and other women receiving services at Mount Saint Joseph,” said Ann Corrigan, CEO of Tapestry Foundation for Health Care.

Digital mammography means faster service and less discomfort and radiation exposure for Asian and other women who undergo diagnostic mammograms at Mount Saint Joseph Hospital. This ultimately leads to more effective diagnosis and shorter wait times for the diagnostic procedure.

Every year, more than 7,500 screening mammograms and 5,000 diagnostic mammograms are conducted at Mount Saint Joseph Hospital.

The Tapestry Foundation launches the Angel Campaign this Thursday to raise money for specialized medical equipment, programs and eldercare research at Brock Fahrni Pavilion, Holy Family Hospital, Marion Hospice, Mount Saint Joseph Hospital, St. Vincent’s Campus of Care, St. Vincent’s Hospital Langara, and Youville Residence. Tapestry Foundation was established last spring from the legacy of three fundraising organizations – St. Vincent’s Hospital, Holy Family and Mount Saint Joseph’s Hospital Foundations.

Funds raised by this year’s Angel Campaign will also support the following initiatives:

• Renovations to kitchen spaces at Brock Fahrni Pavilion and Holy Family Hospital, allowing the 192 residents personalized meal planning and opportunities for sharing;
• Wheelchairs urgently needed at Marion Hospice to transfer patients within and outside of the facility, offering them independence as well as opportunities for private moments with loved ones;
• Special lifts at St. Vincent’s Hospital Langara and Youville Residence to provide mobility and independence to the 90 per cent of residents who depend on them;
• Home entertainment and sound systems to bring enjoyment to future residents of St. Vincent’s Campus of Care, opening in 2008.

Tapestry Foundation for Health Care supports patient and resident care at seven of eight Providence Health Care facilities including: Brock Fahrni Pavilion; Holy Family Hospital; Marion Hospice; Mount Saint Joseph Hospital; St. Vincent’s Campus of Care; St. Vincent’s Hospital Langara; and Youville Residence. These sites offer seniors’ care, hospital and hospice care, and physical rehabilitation services within the Vancouver community. The Foundation supports these sites by raising funds for medical equipment, programs, services and research in the field of elder care.

h 2007 ary 2007Experts from St. Paul’s Offer Drop-in Sessions on Heart Failure

Inaugural Director Appointed for Innovative New Institute

at St. Paul’s Hospital

The fight to detect, prevent and care for heart and lung diseases has taken a significant leap forward with the appointment of internationally renowned heart and lung researcher Dr. Bruce McManus as the inaugural Director of the Providence Heart + Lung Institute at St. Paul’s Hospital.
Launched in June 2007, the Providence Heart + Lung Institute at St. Paul's Hospital merges and integrates all of Providence’s heart and lung research, education and care programs under one umbrella. It is the only such institute of its kind in Canada.

“Dr. McManus provides a level of expertise, leadership and passion for heart and lung research that is unrivalled in the country,” said Dianne Doyle, President & CEO, Providence Health Care. “In his six-year appointment (2000-2006) as Scientific Director of the CIHR Institute of Circulatory and Respiratory Health, he led the development and implementation of a bold and widely-praised strategic research plan for Canada to address outstanding questions related to cardiac, respiratory, vascular, brain (stroke), blood, critical care, and sleep disorders and diseases.

“His leadership to the new Providence Heart + Lung Institute at St Paul’s Hospital will transform cardiovascular and pulmonary research and care, moving new solutions from the laboratory to the clinics and communities for improved care of British Columbians.”

Heart disease is the biggest killer of Canadians – an illness that 74,000 die from each year. About eight out of every 10 Canadians are at risk of developing some form of cardiovascular disease in their lifetimes.
Chronic or infectious lung and respiratory diseases are also on the rise, impacting one in every five Canadians. The burden of heart and lung ailments on the health care system in costs and patient numbers dwarfs all other human health problems.
“Dr. McManus’ leadership and established national and international linkages with heart and lung researchers, clinicians and institutions will further give BC an edge in attracting the best and brightest minds in research, prevention and care,” said Dr. Yvonne Lefebvre, President, Providence Health Care Research Institute.

“They and their breakthrough work, in turn, will on one hand, optimize the use of resources for care, and on the other, attract more funding from all sectors -– government, industry, private donors, competitive awards, and foundational sources – investments that will lead to new knowledge, new disease-prevention methods, and better treatments for heart and lung illnesses.”

St. Paul's Hospital has been providing cardiovascular care since 1950. Its cardiac program – now at home in the Heart Centre within the Heart + Lung Institute – provides a broad spectrum of cardiovascular care including many leading provincial programs in areas of need like healthy heart programs, adult congenital heart disease care, heart failure, heart transplantation, heart valve replacement without the need for surgery, and several others. Research and care are closely linked and will be further developed together in the Heart + Lung Institute.

Similarly, the Hospital's respiratory care programs span an impressive continuum – providing key clinical services for such lung conditions as asthma, cystic fibrosis, chronic obstructive pulmonary disorders such as bronchitis and emphysema, and pulmonary fibrosis. The tradition of international leadership in respiratory research started by Dr. James Hogg extends now for 30 years and reaches from the basic laboratory into all clinical domains.

The risk factors, causes, mechanisms and outcomes for disorders of the heart, lungs, and blood vessels are often in common. Such is the case in regards to dramatic heart and lung consequences of tobacco smoke and air pollution.

“Together, heart and lung failure constitute an enormous burden of illness in Canada,” said Dr. McManus. “They are responsible for the most admissions through emergency departments, most admissions to ICUs, most hospital costs in general, the most drug costs, the most professional costs, and the most suffering.

“Through the Providence Heart and Lung Institute – and in a spirit of collaboration and cooperation with like-minded professionals and the public at large across British Columbia – we will build on the successes of past pioneers, present research and clinical leaders and health partners to solve the remaining mysteries of heart and lung health and disease and diminish the suffering of heart and lung patients and their families for generations to come. The Heart + Lung Institute as a vehicle for innovation and impact will change the landscape here and across the country.”

About Providence Health Care
With 6,000 staff, 1,000 physicians and 1,400 volunteers, Providence Health Care is the largest faith-based health care organization in Canada, operating seven sites in Vancouver, BC, including St. Paul’s Hospital, Mount Saint Joseph Hospital, Holy Family Hospital, Marion Hospice, and complex care/residential services at Langara, Brock Fahrni, and Youville sites. Providence is renowned for its research in more than 30 clinical specialties. Its teaching and research programs are affiliated with the University of British Columbia.

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h 2007 ary 2007Experts from St. Paul’s Offer Drop-in Sessions on Heart Failure

St. Paul’s Hospital Foundation’s Lights of Hope Campaign

The 2007 Lights of Hope display will light up for the first time Friday, November 16 at 6:50 pm. The lighting will heralded by fireworks and the cheers of more than 400 guests expected to gather across the road from St. Paul’s Hospital at Helmcken and Burrard.

This year is the 10th anniversary of St. Paul’s Hospital Foundation’s Lights of Hope Fundraising Campaign and the goal is $2.1 million. In honour of this milestone, a larger firework display is planned as well as some special elements for the display, including a 10-year banner made of lights and the introduction of lights in every colour of the spectrum. If stretched end-to-end, the countless lights that make up the display would reach all the way around the Stanley Park Seawall.

This year’s display contains more than 400 stars recognizing the company and family names of donors who have contributed to the Lights of Hope fundraising campaign. Over the years, the Lights of Hope Campaign has helped to raise more than $8 million for equipment, research and patient care at St. Paul’s Hospital. Lovingly created by volunteers using donated products, the display itself has more than tripled in size since its inception in 1998.

There’s still time to make your own donation to the Lights of Hope campaign by calling 604-662-HOPE or by visiting www.helpstpauls.com

Major Contributors
The platinum sponsors for the Lights of Hope 2007 fundraising campaign are: Aly B. Mawji & Family; Scotiabank and Teck Cominco. The display itself would not be possible without the dedication of the following people and companies who donate their expertise or products to build it each year. Many have been involved with this important campaign for nine years or more. They are:
St. Paul’s Hospital Foundation’s Volunteer Lights of Hope Logistics Committee
Stuart Olson Construction
Sasco Systems Ltd.
The Electrical Contractors Association of BC
The International Brotherhood of Electrical Workers local 213 & 258
Stantec Architecture Ltd.
BL Innovative Lighting
BC Hydro Power Smart
Bogdonov Lerer Engineering Inc.
Westburne Electric Supply BC
Production Equipment Rentals and Sales
The BCIT Electrical Trades Students
Dave McIndoe and the electrical staff of St. Paul’s Hospital

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B.C. Centres Receive $1.2 million To Study Heart Disease and HIV

Two B.C.-based health research centres are embarking on a $1.2 million national study to examine how to reduce the risk of heart attack and stroke in people living with HIV. The B.C. Centre for Excellence in HIV/AIDS (CfE) and the Providence Heart and Lung Institute, both housed at St. Paul’s Hospital in Vancouver, part of Providence Health Care, will be investigating how the cholesterol-lowering drug rosuvastatin (Crestor) interacts with essential anti-HIV medications and whether or not it successfully prevents hardening of the arteries. This is the first known study of its kind.

"As a result of the success of HIV treatments in preventing AIDS-related disease and death, HIV-infected persons have longer life expectancies, but they are beginning to see an increase in cardiovascular diseases such as heart attacks and strokes," says Dr. Greg Bondy, the study’s principal investigator and a researcher with the CfE. "This is not only an important study for HIV disease – it could also have much broader implications in the general population, particularly for those with metabolic disorders."

While it is not completely understood why people with HIV are at a higher risk for cardiovascular disease, a number of factors can be pointed to as the most likely causes. Antiretroviral drugs have been found to cause cholesterol levels to rise and researchers believe that HIV disease itself may put individuals at an increased risk. In addition, a high prevalence of smoking among this specific population is of particular concern.

"New strategies need to be developed to deal with this emerging health issue," says Dr. Julio Montaner, director of the CfE and president-elect of the International AIDS Society.

"Providence is ideally positioned to contribute given its established excellence in both HIV and cardiopulmonary research and care.

While smaller studies have looked at the arteries of people living with HIV, no study has examined a possible intervention to preventing heart disease among the population. AstraZeneca, maker of rosuvastatin, has donated the $1.2 million to research the efficacy of the drug among this particular group.

"We are proud to support first-class research in the province of British Columbia," says Mark Jones, president & CEO, AstraZeneca Canada Inc. "This announcement is the latest in a number of investments that AstraZeneca Canada has made in this province. We are committed to funding novel and important research that will help contribute to the overall health of Canadians."

The study will be conducted with the support of the Canadian HIV Trials Network (CTN). HIV-positive individuals who do not have established heart disease and are not currently on cholesterol lowering medication will be eligible to take part.

"Cardiovascular disease is a major health concern for people living with HIV," says José Sousa, chair of the Canadian HIV Trials Network (CTN) community advisory committee that reviewed the study proposal and provided important community feedback to the investigators. "We are pleased to see industry stepping up to support investigator-driven research that is in the community’s interest."

Study details:

• Two-year duration

• 250 participants at sites in B.C., Ontario and Quebec

• Recruitment set first for B.C. in October 2007

• Participants to be treated monthly with either rosuvastatin or placebo

• Participants’ arteries to be examined using carotid artery ultrasound technology, which will indicate any hardening or change in composition of the arteries

For further information on the study and enrolment, visit http://www.hivnet.ubc.ca/.

For interview requests or further information, please contact Bernadette Amiscaray, media relations, 604-561-4640 (c) , bernadette.amiscaray@karyo-edelman.com

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 seven care facilities operated by Providence Health Care, Canada’s largest faith-based health care organization.

About the Providence Heart and Lung Institute at St. Paul’s Hospital

Launched in June 2007, the Providence Heart and Lung Institute at St. Paul's Hospital merges and integrates all of Providence’s heart and lung research, education and care programs under one umbrella. Its mandate is to transform cardiovascular and pulmonary research and care—transferring new care solutions from the laboratory to the clinics and communities to improve the lives of British Columbians.

About AstraZeneca

AstraZeneca is a leading global pharmaceutical company with an extensive product portfolio spanning six major therapeutic areas: gastrointestinal, cardiovascular, infection, neuroscience, oncology, and respiratory. AstraZeneca's Canadian headquarters and packaging facilities are located in Mississauga, Ontario, and its state-of-the-art drug discovery centre is based in Montreal, Quebec. For more information, please visit the company's website at www.astrazeneca.ca.

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PHC is Going Smoke Free – Inside and Outside

On May 31, 2008, Providence Health Care is going completely smoke-free. Smoking will not be permitted on all PHC property, including all buildings, grounds and parking lots.

We recognize that there are some especially vulnerable patient and resident populations, such as seniors, mental health, addictions and palliative care patients who will be most impacted by this change. The policy will be phased in for many of these groups and we will ensure that these changes take place in a compassionate way sensitive to their needs.

As a health care provider, Providence Health Care has an obligation to promote good health practices and a duty to protect people from the hazards of second hand smoke. We are committed to ensuring a safe, healthy and clean environment for our patients, residents, staff, volunteers, and the general public.

There is no safe level of exposure to second-hand smoke. Second-hand smoke is a serious health hazard that can lead to disease and premature death not only in smokers, but in children and non-smokers too. Second-hand smoke is a carcinogen and contains more than 50 cancer-causing chemicals. Even brief exposure to second-hand smoke has immediate adverse effects and increases risk for heart disease and lung cancer.

We recognize that this policy is a big change for some people so we encourage you to find out more by clicking on the link below. If you have a question that is not answered in the FAQ, or have a comment to share, please e-mail communications@providencehealth.bc.ca

Frequently Asked Questions

What is the smoke-free premises policy?
As of May 31, 2008, PHC will be completely smoke free. Smoking will not be permitted on PHC property, including all buildings, grounds and parking lots. There will be some special considerations in timing for the policy for residential care, mental health/addictions and palliative care facilities.

Why is PHC implementing this policy?
We want to make sure that people who work, visit, or receive services at PHC are not harmed by second-hand smoke. Second hand smoke can cause many major diseases for smoker and non-smokers. As a health provider, we have an obligation to promote healthy choices and provide a supportive environment for everyone while on PHC property.

Are the other health authorities going smoke-free too?
By October 2008, it’s expected that all health authorities will be smoke-free.

Are patients, residents, and staff expected to quit smoking?
No, the policy is not about forcing people to quit; rather, it’s asking people not to smoke on PHC property.

Does the policy apply to everyone?
The policy applies to all PHC staff, physicians, contractors, volunteers, patients and visitors.
Culturally-related ceremonial use of tobacco will be permitted. PHC funded and contracted facilities will be strongly encouraged to develop similar smoke-free premise policies.

Will residents in long-term care facilities be allowed to smoke outdoors?
Most facilities will become smoke-free inside and outside on May 31, 2008. Some special considerations in timing will be given by PHC’s senior leadership team, recognizing that this is a person’s home and thus a few mental health and long term care facilities will not be completely smoke-free.

How will I know where smoking is prohibited?
Signage will indicate where smoking is prohibited. As well, each PHC site has unique property lines. The easiest way to identify where PHC property ends is where the property meets city sidewalks that are adjacent to city streets.

How will the policy be enforced?
Like all smoking bans, the policy will be largely self-enforcing. Anyone smoking on the property will be asked to extinguish his or her cigarette or asked to move off the grounds in respect of PHC’s policy.

Have a question or concern that hasn’t been addressed here?

E-mail us at communications@providencehealth.bc.ca

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PHC Announces $7.5 Million in New Research Funding

A total of $7.5 million in new research funding for Providence Health Care and its partners was announced today. Of that total, $4.25 million is being contributed by Pfizer Canada.

The first investment is for targeted research at the BC Centre for Excellence in HIV/AIDS and the second is to establish the first Canadian research chair in cardiovascular disease prevention. Both research initiatives are to be housed in St. Paul’s Hospital, part of Providence Health Care.

The development in Canada of an important tropism virus strain test for HIV/AIDS with the BC Centre for Excellence in HIV/AIDS will receive support with a $3 million investment by Pfizer. Currently available only in the United States, this blood-screening test would be one of the solutions available to deal with HIV/AIDS drug resistance in Canada because it enables identification of the tropism of the virus. This would then allow physicians to prescribe the appropriate treatment regimen.

Pfizer Canada also contributed $1.25 million for the creation of the first Canadian research chair in cardiovascular prevention research. This new, innovative Simon Fraser University chair will be named the Pfizer/Heart and Stroke Foundation Chair in Cardiovascular Prevention Research at St. Paul’s Hospital. Other contributions to this chair include $1.5 million from Simon Fraser University, $1 million from an anonymous donor to St. Paul’s Hospital Foundation and $750,000 from the Heart and Stroke Foundation of BC & Yukon, for a total of $4.5 million, making it one of the largest in the country.

"Our support of these two B.C.-led initiatives demonstrates Pfizer Canada’s commitment to excellence in healthcare research in the province Pfizer Canada is also announcing the contribution of $1.25 million and for the benefit of all Canadians,” says Paul Lévesque, President and CEO of Pfizer Canada. "We are extremely pleased to participate in bringing to Canada a novel test – called a tropism test –- which will benefit all HIV/AIDS patients experiencing resistance to their current treatment and allow their physician to better target the appropriate treatment regimen.”

"The second investment is a unique academic partnership to create the first Canadian chair in cardiovascular prevention research, and Pfizer Canada is proud to bring this vision to reality. This Chair is of paramount importance because much of what we know about cardiovascular disease is preventable,” adds Mr. Lévesque.

"We thank Pfizer for making this significant investment in both the BC Centre for Excellence in HIV/AIDS and the Providence Heart and Lung Institute at St. Paul’s Hospital,” said Dianne Doyle President & CEO of Providence Health Care. "These initiatives will further our research agenda in two important areas of emphasis – HIV/AIDS and cardiac – and help the patients that we serve.”

Tropism test beneficial to all HIV/AIDS patients in Canada

"Dr. Richard Harrigan and his team at the BC Centre for Excellence in HIV/AIDS will initiate a large scale program to develop and validate a rapid and novel laboratory blood test as a means of predicting HIV tropism. The tropism test allows identification of patients who respond to certain targeted HIV medications,” explains Dr. Julio Montaner, Director of the BC Centre for Excellence in HIV/AIDS. "The HIV patient being tested can have his specific type of tropic strain identified (either CCR5-tropic or CXCR4-tropic).”

Chair in cardiovascular prevention research – a first in Canada

"The chair’s research program aims at better understanding cardiovascular diseases and prevention strategies. This is a must as cardiovascular disease can be prevented in many cases, yet it is still the leading cause of death in Canada. This new chair will leverage the public health research strength of Simon Fraser University’s new and rapidly growing Faculty of Health Sciences and build on the clinical and academic programs at St. Paul’s Hospital,” says Dr. Michael Stevenson, President and Vice Chancellor of Simon Fraser University.

"This initiative fills an important gap provincially, nationally and internationally. The Heart and Stroke Foundation is pleased to be part of this important endeavour, supporting the advancement of life-saving research that will make a difference to the heart health of British Columbians. In BC alone, the Heart and Stroke Foundation has contributed over $100 million since the 1950s to support world-class research at BC universities and hospitals,” adds Bobbe Wood, President & CEO of the Heart and Stroke Foundation of BC & Yukon.

"This new endowed chair is not only the first of its kind in Canada, but it is also an opportunity to recruit a world-renowned scientist focused on cardiovascular disease prevention to British Columbia,” said Dr. Andrew Ignaszewski, Division Head of Cardiology at St. Paul’s Hospital/Providence Health Care. "I would like to thank all of our partners for coming together to support this initiative – one of the largest endowments in cardiovascular care in the history of Canadian medicine and research. Our team is looking forward to raising funds to establish more endowed chairs in support of world-class research within Providence’s new Heart and Lung Institute at St. Paul’s Hospital.”

Backgrounders on the tropism test, the BC Centre for Excellence in HIV/AIDS, and the "Pfizer/Heart and Stroke Foundation Chair in Cardiovascular Prevention Research at St. Paul’s Hospital” are available upon request.

For more information:

Sylvie Tessier, Pfizer Canada tel. (514)247-9467

Stephen Burega, BC Centre for Excellence in HIV-AIDS tel. (604)506-3734

Anne McLaughlin, St. Paul’s Hospital Foundation tel. (604)806-8917

Erica Branda, Simon Fraser University tel. (778)782-3353

Gavin Wilson, Providence Health Care tel. (604)806-8583

Tom Gies, Heart and Stroke Foundation of BC & Yukon tel. (604)671-4042

Chair in Cardiovascular Prevention Research - Backgrounder

Thanks to donor support, Simon Fraser University, St. Paul’s Hospital/Providence Health Care and the Heart and Stroke Foundation of BC & Yukon are about to launch an international search for Western Canada’s first Chair in Cardiovascular Prevention Research. Based at the Heart Centre, part of the Providence Heart + Lung Institute at St. Paul’s Hospital, the Chair will hold a full time tenure appointment in SFU’s new Faculty of Health Sciences.

The Pfizer/Heart and Stroke Foundation of BC & Yukon Chair in Cardiovascular Prevention Research – located at St. Paul’s Hospital and a member of the Faculty of Health Sciences at SFU - will be the catalyst for an expanded cardiovascular research program aimed at a better understanding of cardiovascular disease and new prevention strategies. Although preventable in many cases, cardiovascular disease – including heart and blood vessel disease and stroke - is still the leading cause of death for British Columbians.

The key contributors to this $4.5 million endowed chair are: Pfizer Canada Inc. ($1.25 million), the Heart and Stroke Foundation of BC & Yukon ($750,000) an anonymous $1 million dollar donor to St. Paul’s Hospital Foundation and Simon Fraser University ($1.5 million).

The chair will leverage the public health research strength of Simon Fraser University’s rapidly growing Faculty of Health Sciences and build on the strengths of the clinical and academic programs at St. Paul’s/Providence Health Care.

Established in 2004, the Faculty of Health Sciences’ mission is to understand the many factors that shape health experiences over the life course from a population perspective, and to apply this knowledge to develop policy. The Faculty of Health Sciences (FHS) promotes a population and public health approach that recognizes the interactions and relationships among multiple determinants of health. FHS represents a consortium of disciplines, straddling molecular and cellular processes, field-based investigation, intervention and evaluation, as well as policy processes, that together address issues relating to the health of communities through education, research, and service.

The Heart Centre at St. Paul’s is home to B.C.’s largest and most comprehensive referral centre for patients with heart disease. It is a major teaching facility for cardiac professionals and a leader in the investigation and treatment of heart disease. Launched in June 2007, the Providence Heart + Lung Institute at St. Paul's Hospital merges and integrates all of Providence’s heart and lung research, education and care programs under one umbrella. Its mandate is to transform cardiovascular and pulmonary research and care—transferring new care solutions from the laboratory to the clinics and communities to improve the lives of British Columbians.

The Heart and Stroke Foundation, a volunteer-based health charity, leads in eliminating heart disease and stroke and reducing their impact through the advancement of research and its application, the promotion of healthy living, and advocacy. Across Canada, more than $1.1 billion has been invested by the Foundation into research support since the 1950s.

The BC Centre for Excellence in HIV/AIDS - Backgrounder

The BC Centre for Excellence in HIV/AIDS is embarking on the development of a novel screening method for HIV patients to identify if their strain of HIV is either CCR5 or CXCR4 tropic. This distinction identifies patients who will respond to treatment by certain targeted HIV medications and will also significantly personalize HIV treatment.

CCR5 and CXCR4 are chemokine receptors in the human body. HIV is able to use either CCR5 or CXCR4 as co-receptors to gain entry into T cells, which help coordinate the human immune system.

Pfizer Canada has earmarked $3M for the development of this Canadian screening method, which is a second generation tropism assay. More specifically, this screening assay will help determine if the patient’s strain is CCR5-tropic and likely to respond to a CCR5 antagonist, or CXCR4-tropic and unlikely to respond to a CCR5 antagonist. CELSENTRI (maraviroc), recently approved by Health Canada and marketed by Pfizer, is one such CCR5 antagonist for which the test will be used.

The Centre aims to develop a screening method that is simpler, more cost-effective and more widely available than the current testing process. This particular investment from Pfizer allows the Centre to utilize cutting edge laboratory equipment and research methods.

The study’s primary investigator will be Dr. Richard Harrigan. Harrigan is the director of the Centre’s research laboratories. His research has focused primarily on HIV drug efficacy and resistance and the genetic basis of HIV drug resistance.

About the Centre

Founded in 1992 by St. Paul’s Hospital and the provincial Ministry of Health, the BC 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. The Centre manages and monitors the health of all HIV patients receiving treatment in British Columbia. St. Paul’s Hospital is one of seven care facilities operated by Providence Health Care, Canada’s largest faith-based health care organization.

Dr. Julio Montaner is the director of the BC Centre for Excellence in HIV/AIDS and the president-elect of the International AIDS Society (www.IASociety.org). The International AIDS Society is the world’s leading independent association of HIV/AIDS professionals with more than 11,000 members.

Dr. Montaner has more than 20 years experience in HIV/AIDS research and developing and conducting HIV-related clinical trials. He has published extensively with regard to respiratory complications of HIV and the use of antiretroviral therapies. He has also played a central role in the evaluation of alternative therapeutic approaches and has pioneered multiple drug rescue therapy. Dr. Montaner contributes significantly nationally and internationally in the transfer of research advances into clinical practice and the development of the HIV/AIDS Therapeutic Guidelines.

Tropism Backgrounder

What is tropism?
Tropism is the route that the HIV virus uses to enter the CD4+ T-cell (also known as immune cells that protect body from infection). HIV can either use a CCR5 co-receptor or a CXCR4 co-receptor to enter the CD4+ cell. In the case of HIV, the virus is mostly CCR5-tropic meaning it will only use the CCR5 co-receptor to enter the cell. As the disease progresses the amount of CXCR4-tropic virus increases and it will use the CXCR4 co-receptor to enter the cell. The following are the various categories of HIV viruses:
• CCR5-tropic HIV use only the CCR5 receptor
• CXCR4-tropic HIV use only the CXCR4 receptor
• Dual-tropic HIV can use either the CCR5 or CXCR4 receptor
• Mixed-tropic HIV reflects that a single individual can have a mixed population of HIV (i.e., CCR5-, CXCR4- and/or dual-tropic HIV).

What are CCR5 and CXCR4?
• CCR5 and CXCR4 are proteins (medically known as chemokine receptors) on the surface of CD4+ cells in the human body. These receptors signal other cells involved in immune function to move to or remain in an area of inflammation.
• About 1 percent of Caucasians of European ancestry has no CCR5 co- receptors on the surface of their cells; however, they appear to have normal immune function suggesting that blocking the CCR5 co-receptor may not affect normal immune function.

What percent of people infected with HIV/AIDS likely have CCR5-tropic HIV?
• Studies have shown that approximately 80 percent of people newly diagnosed with HIV or who are untreated, only have the CCR5-tropic virus.
• In the natural progression of the disease, this drops to 50-60 percent in patients being treated with anti-retroviral medicines

What is a tropism test?
Tropism tests are tests used to determine which co-receptor (CCR5 or CXCR4) each patient’s strain of HIV uses to enter the cell.

How is the test performed?
A blood sample is drawn from the patient and it is shipped to a laboratory at Monogram Biosciences (San Francisco, CA) where a test, is performed to determine the tropism.

How long will it take to get results?
Because the diagnostic process is multi-step and labor intensive, results may take anywhere from 3 to 5 weeks.

How much will the required tropism test cost?
The cost of the tropism test will be assumed by Pfizer Canada Inc. for the immediate future.

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Fast Track Unit Opens for St. Paul's ER

A redesigned and refurbished emergency “fast track” unit at St. Paul’s Hospital will reduce wait times and improve around-the-clock patient care, Health Minister George Abbott said today at the facility’s official opening.

“As one of the province’s busiest emergency rooms, St. Paul’s is at the forefront of treating some of the most complex cases, as well those that are non-life threatening,” said Abbott. “The redesigned, innovative fast track unit allows patients with less serious needs to be seen, assessed, and treated faster and released in a timely manner. Fast tracking frees the main emergency room staff to focus on the most urgent cases, and it improves patients’ access to emergency services overall.”

The fast track is a separate area from the main St. Paul’s emergency room and allows for the rapid assessment and treatment of less serious injuries and illnesses. The fast track unit cost $1.2 million to develop and is the latest improvement as part of a $12.2-million plan to revitalize St. Paul’s Hospital’s Emergency Department.

The new fast track’s improvements in design, staffing, equipment and patient admission procedures are expected to reduce emergency room wait times for less urgent cases, allowing more of these patients to be assessed and treated in less than two hours.

“Right now at St. Paul’s Hospital, staff and physicians are treating over 60,000 emergency patients a year,” said Dr. Lawrence Cheng, physician operations leader at St. Paul’s emergency. “Reducing wait times allows us to see more patients. For example, if we free up an additional 30 minutes per patient, that would allow us to see another 10,000 patients a year in emergency, leading to improved access and care throughout the system.”

With six stretcher bays, the new fast track will include increased treatment space for IV antibiotics, dedicated rooms for ophthalmology, ear, nose and throat, a new room for treating infants and children, as well as gynecology rooms for specialized examinations and treatments.

“Through the $10-million funding from the provincial government and Vancouver Coastal Health – along with $2.2 million from the St. Paul’s Hospital Foundation, we’ve made design and care improvements that have already resulted in a 22 per cent reduction in overall emergency wait times at St. Paul’s,” said Dianne Doyle, president & CEO of Providence Health Care. “Along with prevention, healthy living, and recruitment and retention of health care professionals, innovative solutions such as this redesign will be key to addressing our growing patient care challenges.”

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h 2007 ary 2007Experts from St. Paul’s Offer Drop-in Sessions on Heart Failure

Cardiac Specialists at St. Paul’s Hospital are First in North America to Implant New-Technology Heart Pumps

Cardiac specialists from the Heart Centre, part of the Providence Heart + Lung Institute at St. Paul’s Hospital, are the first in North America to successfully perform two breakthrough heart-pump implants in patients with failing hearts using new-generation ventricular assist devices (VADs).

The small but powerful heart pumps, no larger than a few grams, are intended as short-term relief for hearts with declining function or following surgery. They reduce the heart’s workload while providing blood to body organs.

The two procedures were performed about a week apart in mid-August, marking the first time outside of Europe the devices have been used and saving the lives of both patients, whose heart function had reached critically low levels.

Dr. Anson Cheung, Surgical Director of Cardiac Transplant and Mechanical Circulatory Assist Device of BC, performed the procedures, assisted in the first case by cardiologists Drs. Ron Carere and Eve Aymong.

The first patient, Carl Smith, a 41-year-old father of four from Cloverdale, was admitted to St. Paul’s with a seriously weakened heart. He had a left ventricular pump weighing just eight grams inserted via a catheter in the groin area and then threaded through an artery to the heart. After five days he was successfully weaned off the device, having regained sufficient heart function to be safely discharged home.

The second patient, a 59-year-old Mission man, received a different version of the same device, a 17-gram right ventricular pump, which was implanted through the chest. The patient had just received a heart transplant but required the device for six days to allow his new heart to regain strength. The patient has since been discharged.

The devices, known by the trade name Impella and manufactured by ABIOMED, Inc., can pump as much as five and a half litres of blood per minute, the equivalent of a healthy heart. They can sustain patients from a few hours to 10 days, until their heart has recovered or is strong enough to be transferred to another means of support.

The Impella pumps are now a standard of care within the St. Paul’s Heart Centre Advanced Heart Failure Program. The devices replace the earlier generation of short-term cardiac support, called extracorporeal membrane oxygenation (ECMO). Similar to a heart-lung machine, an ECMO device continuously pumps blood from the patient into a machine that removes carbon dioxide and adds oxygen, then returns the oxygenated blood to the patient.

ECMO machines are large and unwieldy, requiring 24-hour supervision by a perfusionist, immobilizing patients and putting them at increased risk of stroke, bleeding and restriction of blood flow to the extremities.

The new Impella devices are tiny by comparison, relatively easy to implant, do not require a perfusionist, have fewer complications and allow the patient to be transported easily within the hospital and to and from other hospitals.

The devices do not replace the much larger, long-term VADs, which use technology both inside and outside the body to maintain blood circulation and enable patients to go home with the device for up to a year or more.

The St. Paul’s Advanced Heart Failure Program, which serves all of BC, is funded by the Provincial Health Services Authority and Providence Health Care.

As part of the Providence Heart + Lung Institute at St. Paul’s Hospital, the Heart Centre is BC's most comprehensive referral centre for patients with heart disease, a major teaching facility for cardiac professionals, and a leader in investigating heart disease causes and treatments.

Launched in June 2007, the Providence Heart + Lung Institute at St. Paul's Hospital merges and integrates all of Providence’s heart and lung research, education and care programs under one umbrella. Its mandate is to transform cardiovascular and pulmonary research and care—transferring new care solutions from the laboratory to the clinics and communities to improve the lives of British Columbians.

Providence Health Care is the largest faith-based health care organization in Canada, operating seven sites in Vancouver, BC, including St. Paul’s Hospital, Mount Saint Joseph Hospital, Holy Family Hospital, Marion Hospice, and complex care/residential services at Langara, Brock Fahrni, and Youville sites. Providence provides care in partnership with Vancouver Coastal Health.

h 2007 ary 2007Experts from St. Paul’s Offer Drop-in Sessions on Heart Failure

New Ward for Patients Without a Family Doctor at

Mount Saint Joseph Hospital

This summer, a new ward opened up at Mount Saint Joseph Hospital, where patients who either do not have a family physician or do not have a physician who actually visits hospitals, could be cared for by family doctors. Initiated by the Department of Family and Community Medicine, the team wanted to create a family practice model in the hospital that would be sustainable from a quality of care, economic and scheduling point of view, in response to a growing trend of family physicians leaving hospital care.
For patients, the benefits are the continuity and patient-centeredness inherent in a family practice model. Family doctors are trained to balance medical needs with respect for patient goals and cultural backgrounds.

This becomes particularly important when "end of life" situations arise. Family doctors are also familiar with community services and resources, so that discharge planning and follow-up may be easier. Although not every patient will be cared for by his or her "own" family doctor, there will be good communications to ensure that care is appropriate and discharge plans are clear.

The team from the Department of Family and Community Medicine worked closely with Mary Donlevy, Director of the Greater Vancouver Family Practice Residency Program Site, to develop a model with a strong educational component that would make it attractive for both practicing family physicians and medical residents in training.

Residents benefit from the learning and mentorship of experienced physicians while practicing family physicians enjoy the exposure to new ideas and concepts that residents pick up in their training.

Up to eight patients can be accommodated in this model. A family practice resident serves as "attending physician" for a one-month period. Family doctors work in a teaching capacity for one-week periods.

Generally, they visit patients with the medical resident in the mornings, and are available to come back or to consult by phone as necessary. The weekly schedule allows family physicians to schedule their time and plan their week accordingly so they can do hospital care and still carry on their office.

"Where the added travel from the office to the hospital for one patient visit alone became uneconomical from a financial and time management point of view, having a weekly schedule and the right number of patients will hopefully make this program economically sustainable for physicians," says Dr. Garey Mazowita, Chair of the Department of Family and Community Medicine.

"It is a great opportunity for family physicians to deliver a high quality of hospital care to our patients while building a stimulating educational environment with residents."

The team is also planning to enhance educational activities for residents. Internal Medicine, ICU and Emergency have offered additional teaching opportunities, to enrich the medical residents’ education.

Now in its fourth month, the program has received very positive feedback from patients, residents, nurses and physicians. The Department of Family and Community Medicine a long-term vision for the new service at MSJ:

"We want to develop a core group of family physicians who can commit to coming in three to four times a year so that they are familiar with the model of care, become skilled at interacting with residents and enhance their own clinical skills.

"At the same time it is important that we keep open slots for members who want to participate less frequently or just try it. As well as providing an alternate model of patient care, it is a sustainability strategy for our members in that it provides manageable and enjoyable practice and teaching opportunities."

So far, three residents have gone through the program. Residents are committed for the entire academic year, and the family doctor preceptor schedule has only a few open weeks left.

h 2007 ary 2007Experts from St. Paul’s Offer Drop-in Sessions on Heart Failure

There's More to Learn About Healthy Aging!
Healthy Aging Seminars for Fall 2007

The focus is on seniors this autumn at the Fall 2007 Healthy Aging Seminar Series, presented by the new TAPESTRY FOUNDATION FOR HEALTH CARE.

Since 1999, the Healthy Aging Seminar Series has offered comprehensive information on important issues facing today's seniors. Held twice a year in spring and fall, the series addresses a range of issues that includes physical and mental health, fitness and nutrition, as well as financial management and tax and estate planning.

"With the boomer generation now reaching retirement, people are searching for information on how to care for their health, their finances, and the care of aging parents," explains Foundation CEO, Ann Corrigan. "Our Foundation recognized an important need for ongoing education in this area and responded by offering timely and informative seminars through local community health and financial experts."

Seminars offered this fall include:

- Reduce Your Risk of Heart Disease
- The Healthy Brain – What You Need to Know
- Navigating the Long Term Care System* (*Presented in Cantonese only.)
- Breaking the Habit of Breaking Bones

Seminar attendees should note that due to the current civic strike, seminars previously scheduled at Van Dusen Gardens have been relocated to HOLY NAME CHURCH at 4925 Cambie Street in Vancouver until further notice.

Admission is free. Seating is limited.

To reserve a seat in advance, call 604.838.5585.

The Fall 2007 Healthy Aging Seminar Topics:

Reduce Your Risk for Heart Disease
Wednesday, September 12, 2007 (1pm - 2:30 pm)
Lifestyle choices are the cornerstone of prevention strategies for heart disease. While you can't control some risk factors (age, family history, gender or ethnicity), you can control others such as smoking, stress, high blood pressure, excessive alcohol consumption, physical inactivity and being overweight. Join Bonnie McNaughton, a registered nurse from St. Paul's Hospital, as she discusses ways to prevent and manage heart disease.

Navigating the Long-Term Care System*
Wednesday, September 19, 2007 (1pm - 2:30 pm)
(*This session will be presented in Cantonese only.)
Are you eligible for greater health care support in your community? Emily Mak, a social worker with Providence Health Care guides you through the system to help get the care you need - community home support, assisted living or residential care when you can no longer live independently.

The Healthy Brain - What You Need to Know!
Wednesday, September 26, 2007 (1pm - 2:30 pm)
The latest research tells us we are never too young or too old to take action in defense of our own brain health. Judy Bourne and Betty Sinclair of the Alzheimer Society of B.C. presents information about known risk factors and Alzheimer's disease, and health measures we can integrate into our daily life to reduce the risk of Alzheimer's or a related dementia.

Breaking the Habit of Breaking Bones
Wednesday, October 3, 2007 (12:30 - 2 pm)
Join Dr. Larry Dian, Head of Geriatric Medicine at Vancouver General Hospital, as he explores the latest developments in the management of osteoporosis. Learn more about risk factors and preventive measures, diagnosis and treatment, and managing a healthy lifestyle with osteoporosis.

h 2007 ary 2007Experts from St. Paul’s Offer Drop-in Sessions on Heart Failure

PHC's 2006-2007 Annual Report is Now Available:
Transforming Care through New Knowledge

Courage, compassion & innovation drive positive change at Providence Health Care

http://www.providencehealthcare.org/documents/PHC-Annual-Report-2007.pdf

How many of us have heard about a research breakthrough on the evening news only to discover at your next hospital visit that the procedure remains unchanged.
It's frustrating, but care providers face many barriers to implementing newly confirmed research. Reducing the lag time between new discoveries and their translation into care remains a key priority for Providence Health Care (PHC). As one of our five strategic priorities, "supporting research and new knowledge integration," this concept remains fundamental to our ultimate goal of caring for British Columbians. Our plans to accelerate new knowledge into care include novel training methods, hiring key personnel to implement change quickly, and more thoroughly integrating our research and care teams.

People power and leadership are the two keys to making this happen. We are blessed by the people who choose to work and volunteer at Providence sites. They are courageous, they are compassionate and they are innovative. This annual report offers examples of how our people exhibited these traits over the past year.

We think it is not surprising that these characteristics - courage, compassion and innovation - are some of the very traits exhibited by the Catholic Sisters who
founded our hospitals and residences. The Sisters relied on similar traits, and a great deal of faith, to overcome the obstacles they faced. Obstacles like time, money, prejudice, and indifference. They overcame all of this to ensure that anyone in need received care.

Our history, tradition and values continually guide us to improve patient and resident care - not just to overcome current challenges, but to meet the demands and needs of the future. We have an exciting vision for renewing our aging facilities and for ensuring we have the right solutions in place for generations to come. One of Providence's major areas of focus is the renewal of St. Paul's Hospital. It's been delivering care for over 100 years and, as one of two provincial teaching hospitals, helps form the backbone of BC's health care system. Our vision includes building a brand new state-of-the-art hospital and research facility in Vancouver's False Creek Flats, while maintaining an important care presence in Vancouver's West End. Our commitment is to continue engaging the public and communities to share our
vision and to receive important feedback on how best to transform this knowledge into meeting all our patients' future care needs.

Dianne Doyle
President and CEO

Kip Woodward
PHC Board Chair

h 2007 ary 2007Experts from St. Paul’s Offer Drop-in Sessions on Heart Failure

Mercury Thermometer Exchange at Mount Saint Joseph Hospital’s Community Recycling Day

Mercury Thermometer Exchange at Mount Saint Joseph Hospital’s Community Recycling Day.

Members of the public are invited to exchange their old mercury-filled thermometers for a free digital thermometer at Mount Saint Joseph Hospital on Saturday, August 25 from 9 am - 2 pm.

The mercury used in old thermometers is toxic and can pose a health hazard, especially to children. Disposal in household garbage is not advised as the mercury will end up in landfills, contaminating surrounding soil and water.

The public can bring in their old mercury-filled fever thermometers and receive a free digital thermometer, provided by BD, one of the hospital’s medical suppliers. Digital thermometers are electronic and provide a safe and reliable way to take a person’s temperature if they become ill. Quantities are limited, and the offer is valid only on August 25.

The public is also welcome to bring other household items that contain mercury, including batteries and florescent light bulbs. These will be sent to a hazardous waste service provider for appropriate disposal. The community is also invited to bring old, expired medications for safe disposal.

“At Providence Health Care, we believe that we share accountability for the well-being of our community, above and beyond providing basic health care needs. By adopting green practices, we can contribute to a healthier, sustainable future for our staff, patients and residents, the community and the environment,” said Mary Campling, Vice President of Finance and leader of PHC’s Green Team.

The exchange is part of the 18th annual Mount Saint Joseph Hospital Go Green Summer Health Fair. Everyone is welcome to attend this fun community event that features a flea market, farmers’ market with local produce, home baking and health testing including blood pressure, cholesterol, and bone density.

The thermometer exchange and Health Fair take place at the Kingsway entrance of Mount Saint Joseph Hospital, 400-block Kingsway, two blocks southeast of 12th Ave. Mount Saint Joseph Hospital is part of Providence Health Care, Canada’s largest faith-based health care provider

Call 604.806.8131 for more information.

2007 ary 2007Experts from St. Paul’s Offer Drop-in Sessions on Heart Failure

PHC Earns Fourth Consecutive 3M Award with Medication

Safety Project for Seniors

A team of caregivers from Providence Health Care (PHC) has once again won a 3M Health Care Quality Team Award from the Canadian College of Health Service Executives (CCHSE). This marks the fourth consecutive year that PHC has won this national honour that recognizes innovation, quality and teamwork in health care. This year, the award for innovation in health care goes to the Residential Medication Reconciliation team, who reduced medication discrepancies and improved medication documentation in admission orders for PHC elder care residents by 75 percent.

The award was presented June 12 at the annual National Healthcare Leadership Conference in Toronto. Each year CCHSE presents one 3M Award in each of two categories, hospital environment and non-hospital environment. This is first time that PHC has won in the non-hospital environment category.

"Some of the greatest health-care challenges can be addressed with ingenuity and teamwork," said Health Minister George Abbott. "I would like to congratulate the Residential Medication Reconciliation team at Providence for their great work in improving medication safety for care home residents and on receiving this prestigious award. Patients and residents in British Columbia—and nationally—are benefiting from the innovation being developed by B.C.’s health professionals."

"I’m proud of the fact that this year, it is a residential care team from Providence that has won the 3M award," said Dianne Doyle, PHC’s President and CEO. "This is a part of our sector that continually does great work but doesn't always get the deserved recognition."

Pharmacists and nurses in residential care have long been concerned about the number of discrepancies that occur when residents are moved into care homes from acute care or the community—discrepancies that could potentially result in medication errors. Chart audits show that over half of all medication errors occur at admission, transfer or discharge.

The frail elderly have an increased risk of errors due to the relatively large number of medications they take and because sometimes they do not advocate on their own behalf. Residents and their families are rarely able to provide an accurate and complete list of medications when moving into a residential facility.

To help prevent this type of scenario, the team introduced medication reconciliation, a structured review process that has been shown to be a powerful strategy in preventing errors at these transition points. This included computer-generated orders known as Moving In Medication Orders (MIMOs), which they started using in the residence at Holy Family Hospital, which is part of Providence Health Care, in January 2006.

"Because of this initiative the risk of residents being prescribed an incorrect medication has been greatly reduced," said team leader Pam Kelly, Pharmacy Section Head for PHC Residential Care. "And if it becomes more widely used, we could potentially bring the rate to near zero."

The MIMO, which is remotely printed to the receiving facility, is generated for residents moving in or returning from a PHC acute care site, which account for about 40 per cent of all those moving into PHC residences. It lists all the medications that the resident was receiving on discharge.

Residential RNs compare this list with any other information they have about the resident’s medications to determine if there are any discrepancies. The complete list is then faxed to the resident’s physician. The RN calls the physician’s office 30 minutes later to review the list, makes changes as required and signs the bottom of the form as a verbal order.

The form is designed to minimize transcription errors—RNs previously copied medication orders by hand—while reducing the risk that medications are overlooked. The MIMO is then faxed to Pharmacy for processing and the original is filed in the resident’s record.

The result has been a 75 percent reduction in discrepancies contained in admission orders for residents. The discrepancy rate per resident is now one-quarter of the national average.

The MIMO system has since been implemented in most of Providence Health Care’s other residential care homes, including St. Vincent’s Langara, Mount Saint Joseph and Brock Fahrni.

Providence Health Care, Canada’s largest faith-based health care organization, owns and operates five residential care homes in the City of Vancouver, in which about 700 elders live. PHC also operates St. Paul’s Hospital and acute care services at Mount Saint Joseph Hospital and Holy Family Hospital.

h 2007 ary 2007Experts from St. Paul’s Offer Drop-in Sessions on Heart Failure

St. Paul’s Hospital is the Only Clinic in BC to Specialize in the

Treatment of Scleroderma

St. Paul’s Hospital is home to the only clinic in BC that specializes in the treatment of scleroderma, a disease that has a low public profile yet affects more Canadians than either cystic fibrosis or muscular dystrophy. The St. Paul’s Scleroderma Clinic, which was established in 2003, coordinates the care of scleroderma patients from throughout the province, giving them access to the latest drugs and treatments.

The only visible sign of this autoimmune disease is shiny, hardened skin caused by the body’s production of excess collagen, a fibrous type of protein that makes up the body’s connective tissues, including skin. Underneath the skin, however, an even more damaging process is at work. The body’s immune system, for unknown reasons, is attacking itself and hardening the connective tissues of blood vessels, which can affect major organs such as the heart, lungs, kidney and gastrointestinal tract.

There is no known cause or cure. Severity of the disease varies—some patients are crippled by it and the disease can even be fatal. But under the care of specialist physicians such as those at St. Paul’s, patients are able to control and manage their symptoms for many years.

The St. Paul’s Scleroderma Clinic provides huge benefits for patients, especially those who live outside Vancouver. Scleroderma patients need a rheumatologist as their primary caregiver, but there are many areas of the province where there is a shortage of these specialists. The clinic also reaches people whose family doctor does not know how to properly care for them.

Dr. James Dunne, Director of the St. Paul’s Scleroderma Clinic, says that one of the benefits of having a scleroderma clinic in a major hospital is the opportunity to collaborate with specialists from other disciplines to provide the best possible care for patients.

Patients benefit from health care providers who have expertise in many different disciplines such as cardiology, respirology, nephrology and rheumatology. For example, Dunne partners with St. Paul’s respirologist (lung specialist) Dr. Pierce Wilcox to conduct a combined clinic for patients who have lung problems related to their scleroderma.

Research is also a focus of the clinic. Dr. Dunne, who is a member of the Canadian Scleroderma Research Group, is developing a national database that will track and monitor patients nationwide. The first of its kind in Canada, it will allow physicians to share expertise and develop “best practice” procedures. The clinic intends to carry out more research on vascular physiology (how blood vessels function), which Dr. Dunne believes will benefit more than just scleroderma patients.

“Because of the nature of scleroderma, some of the work we do will not only help people with the disease but could benefit patients with conditions such as pulmonary hypertension (high blood pressure in arteries that supply the lungs) and atherosclerosis (hardening of the arteries),” he says.

Being a relatively rare disease, scleroderma receives less attention from medical science and the pharmaceutical industry.

“There are many challenges ahead of us, but primarily we have to grow the clinic and get more research funds to build on the knowledge we already have at St. Paul’s,” says Dr. Dunne.

Scleroderma Facts

In a population of 100,000, scleroderma will affect roughly 10 people. There are an estimated 500 sufferers in B.C. and up to 40,000 in Canada.

Four times as many women as men suffer from the condition, which often strikes patients in their 40s.

It affects all races, but has a higher prevalence among people of Italian and Japanese descent.

Scleroderma is not contagious or infectious.

Research has yet to pinpoint any particular genetic link or environmental trigger.

There are two main types of the disease: localized and systematic. Systematic scleroderma (sometimes known as systemic sclerosis) can be fatal.

Raynaud’s phenomenon is commonly associated with scleroderma. Triggered by cold weather, Raynaud’s can affect blood flow to the fingers, toes, ears and nose.

The Scleroderma Society of B.C. is a major supporter of the St. Paul’s Scleroderma Clinic.

2007 ary 2007Experts from St. Paul’s Offer Drop-in Sessions on Heart Failure

PHC’s Home Hemodialysis Program Enables Kidney Patient

to Compete in Triathlons

Of all the athletes at the University of British Columbia triathlon this March, few would have needed as much determination to get there as 23-year-old Giovanni Lam. He was admitted to St. Paul’s Hospital with kidney failure as a teenager and has been a chronic dialysis patient ever since.

Despite facing lengthy in-hospital dialysis sessions three or four times weekly to filter out waste products from his bloodstream, the lifelong athlete was determined to stay active. Several years later, when he was finally able to join a home hemodialysis program, Lam found that opportunity.

Most patients are eligible for home dialysis as long as they have good judgment and are in a stable medical condition. They also need to learn to program the machine and understand how to problem-solve typical complications.

Patients who are eligible for home dialysis take about six weeks of training, three times a week, at a community dialysis clinic. When they finish, patients take the machine home and are responsible for managing their own care, including setting up the machine, inserting needles into themselves, monitoring their blood pressure and changing water filters.

St. Paul’s has trained 39 out of BC’s 100 home-dialysis patients since the independent hemodialysis program began in September 2004. The hospital hosts the largest hemodialysis unit in the province and also operates six community dialysis units in Vancouver, North Vancouver, Richmond, Squamish, Powell River and Sechelt.

"Home hemodialysis is the best decision I’ve ever made related to improving my health," says Lam. "It gives me the free time I need during the day to attend school, because I do nocturnal hemodialysis where I basically am able to sleep through the night as I receive dialysis."

Research shows that independent hemodialysis can provide many health and lifestyle benefits. Home-based dialysis can be done more often and for longer periods of time than conventional hemodialysis, which is usually done 3-4 times per week for four hours. In comparison, with nocturnal hemodialysis patients can dialyze 6-10 hours per night on most days of the week.

This longer treatment time more closely resembles the natural function of the kidneys. As a result, patients need fewer medications, enjoy a more liberal diet and an improved quality of life.

Lam is busy studying Human Kinetics at UBC with an eye to becoming a high-school gym teacher. Having a more flexible schedule and fewer days in the hospital also allowed him to train six days a week in preparation for the UBC triathlon short course—a 400-metre swim, an 11-kilometre bike ride and a five-kilometre run.

"All of this wouldn’t have happened without the help of Dr. Anthony Chiu from St. Paul’s Nephrology Department," says Lam, who notes that the St. Paul’s doctor is always encouraging patients to improve their quality of life through regular exercise.

Research has shown that besides improving mood and self-confidence, exercise also increases cardiac circulation, which can help improve dialysis treatments.

Most important for Lam, Dr. Chiu helped American Shad Ireland—the first chronic dialysis patient to complete an Ironman triathlon—introduce the Shad Ireland Foundation to Canada.

Ireland established the foundation to inspire and encourage other dialysis patients to incorporate physical activity into their daily lives. Lam, who attended one of Ireland’s talks, says, "He basically inspired me right then and there."

The result? Lam applied for and became the first Canadian to receive the Peg Smythe Fitness Grant, made possible by the Shad Ireland Foundation and biotech company Genzyme Canada. Along with that initial dose of inspiration came the bike, bike shoes, helmet and wetsuit that Lam needed to participate in the UBC event.

And participate he does. Lam ran the Vancouver Sun Run on April 15 and will travel to Minnesota in July to take part in a triathlon as part of Team Ireland 2007.

SPH Celebrates 100th Anniversary of its School of Nursing

Alumni of the St. Paul's Hospital School of Nursing will reunite this month to celebrate "A Legacy of Caring" on the 100th year anniversary of the school's opening. By the time the last class graduated in 1974, the school had left an important legacy, training nearly 4,000 nurses.

Led by the Sisters of Providence, the school's rich history mirrored the sweeping social changes that transformed Canada in the 20th century. Although the School closed more than 30 years ago, there is a strong bond among former students and a close affiliation with the hospital. More than 450 graduates are expected to gather at the St. Paul's Conference Centre on Sunday, May 27, to mark both the 100th year anniversary and the half century milestone of the class that graduated in 1957.

"We mark this milestone because the School played such a vital role in making this hospital a strong, vibrant contributor to the health care system of Vancouver and British Columbia," said Dianne Doyle, PHC's President & CEO, who will address the group.

Please note, this event is only open to nursing alumni and is by invitation only.

To learn more about the history of the school, please click here.

To watch Global TV's coverage of this important milestone, please click here.

Sisters of Providence Earn AccolAIDS Award

The religious order of women who founded St. Paul’s Hospital were honoured for their long commitment to patients with HIV at an awards ceremony April 22.

The Sisters of Providence were presented with an AccolAIDS awards in the unsung heroes category. The annual awards gala honours outstanding achievements by individuals and organizations working in the BC HIV community and raises funds for the BC Persons With AIDS Society.

Also receiving an AccolAIDS Award were project coordinator Caitlin Johnston and the staff of Vancouver Injection Drug User Study, winners in the science, research and technology category. The study is part of the St. Paul’s-based BC Centre for Excellence in HIV/AIDS.

BCPWA Society Chairman Paul Lewand praised recipients and nominees as “individuals who, in so many different ways, have improved the lives and circumstances of HIV-positive British Columbians through tireless dedication, commitment, and care.”

The Sisters of Providnce were nominated with their award because they urged St. Paul’s staff and physicians to care for those with AIDS in the early days of the disease, when other hospitals were refusing to treat these patients.

In the decades that followed, St. Paul’s remained at forefront of treatment, research and support of people with HIV/AIDS. The hospital established the first integrated, palliative-care unit for patients with AIDS and cancer, became home to the Centre for Excellence in HIV/AIDS and the Canadian HIV Trials Network and provided space for the original Dr. Peter Centre.

“People said that it must have taken courage to admit AIDS patients into care or that it must have been a difficult decision. But as far as we were concerned, the decision was a simple one. Do these people need our help? If they do, then we will care for them,” said Sister Gloria Keylor, Provincial Superior of the Sisters of Providence, in accepting the award.

PHC President and CEO Dianne Doyle presented the awards to the Sisters.

“I’m proud to say the hospital has never lost sight of the Sisters’ original vision of being responsive and relevant to the community, of caring for the disenfranchised and of providing the best possible care,” she said. “I speak for everyone at Providence Health Care when I say I am proud to be carrying on the Sisters’ legacy of compassionate care for those who need it most.”

AccolAIDS Awards were presented in eight categories. Winners in the science and research category, the Vancouver Injection Drug User Study (VIDUS) is a project that provides a means of tracking HIV incidence and prevalence among injection drug users over time.

According to Dr. Julio Montaner, the Director of the BC Centre for Excellence in HIV/AIDS, “The output from VIDUS is of utmost importance to those working with at-risk populations. This research has been the basis for many groundbreaking endeavours in Vancouver.”

Also nominated for AccolAIDS awards from Providence Health Care and the Centre for Excellence in HIV/AIDS were:

· Irene Goldstone, RN (with three nominations)
· IDC Research Nurses Monica Valyi, RN and Gerene Larsen, RN (with two nominations)
· Dr. Julio Montaner
· Drug treatment staff at the BC Centre for Excellence
· Social workers Mary Petty and Wallace Robinson (with two nominations)
· The John Ruedy Immunodeficiency Clinic

The Sisters of Providence were also nominated in the social, political, community action category.

The AccolAIDS wards gala raised a record-setting $90,000 that will be used to support BCPWA Society’s programs and services for people living with HIV/AIDS.

Chelation Therapy Study Offers Hope to MDS Sufferers

(March 22, 2007)

A recent research study at St. Paul’s could bring new hope to people with myelodysplastic syndromes, or MDS, a group of blood disorders that primarily affect seniors.

MDS can cause severe anemia and increased susceptibility to infection. In some patients, MDS can also result in acute myelogenous leukemia, the most common form of leukemia among adults. In fact, MDS was formerly known as “pre-leukemia.”

Patients with MDS who have severe anemia usually need multiple blood transfusions as part of their treatment. A common side effect is that the body builds up abnormal iron levels that can cause permanent damage to organs such as the liver.

The treatment for reducing iron levels in the blood is iron chelation therapy, which until recently meant that patients must endure having a drug infused beneath the skin for 12 hours a day, five days a week.

As this therapy is difficult for patients, a team of St. Paul’s hematologists (blood specialists) led by Dr. Heather Leitch conducted a research study – the first of its kind – to assess the effectiveness of chelation therapy in reducing the toxic effect of iron on the organs as well as reducing the level of iron in the blood.

Researchers looked at patient records to compare the progress of people who received chelation with that of similar patients who did not. (St. Paul’s is home to B.C.’s provincial Iron Chelation Program, led by Dr. Linda Vickars.)

The study, recently presented at a conference to hematologists from around the world, did not find any conclusive results on the benefits of chelation therapy in reducing organ damage.

However, it did show that patients who received chelation therapy lived longer. After four years, 80 per cent of patients who received chelation were alive, compared to only 44 per cent of those who did not receive chelation.

What does this mean? Dr. Leitch explains that while more research is needed on this topic, this study showing the potential of chelation therapy is good news for MDS patients.

“Although we were not able to demonstrate a decrease in organ dysfunction in patients with MDS,” she says, “there was significant improvement in overall survival [with chelation therapy].”

She notes that the results are also timely because a new chelation pill recently approved for use in Canada will make this therapy much easier to take and more tolerable for patients.

If you or a family member has MDS and would like to find out about chelation therapy, ask your family doctor or specialist for more information.

Hospital-supervised chelation therapy to reduce iron in the blood is a medically approved treatment monitored by blood specialists.

Patient Survey Gives St. Paul's Hospital Cancer Care High Marks

(March 14, 2007)

Vancouver, March 14, 2007 – The Ministry of Health today released the results of a patient experience survey that looked at outpatient cancer care services in British Columbia.

The survey included all facilities performing outpatient cancer care in BC and was based on three months of visits from November 2005 to May 2006.

The survey results showed that not only were patients very pleased with the care they received at St. Paul’s, they also ranked our services higher than the regional, provincial and national averages in most areas, including coordination and continuity of care, emotional support, respect for patient preferences, and information, communications and education.

The survey results showed that 100 per cent of St. Paul's patients rated their overall quality of care to be excellent, very good or good. More than 60 per cent described it as excellent, 32 per cent as very good and the remaining seven per cent as good.

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Experts from St. Paul's Offer Drop-in Sessions on Heart Failure

(February 2, 2007)

Heart failure affects people in many different ways and can develop over several years or suddenly as a result of a heart attack. For most people heart failure is a life-long condition.

Join experts from St. Paul’s Hospital’s Heart Function Clinic in free drop-in sessions designed to provide those suffering from heart failure and their families with information on different aspects of heart failure. Take the opportunity to talk one-on-one with a heart-failure specialist while enjoying some “heart-healthy snacks.” Learn how to manage reduced heart function and to stay healthy.

Experts speaking at the event include:

Susanne Burns RN MSN
Dr. Doson Chua PharmD
Catherine Clark RN BSN
Margaret Edmonds RN BSN
Annemarie Kaan RN MCN
Winphia Koo RD
Thuy Le RN BSN
Bonnie McNaughton RN BSN
Dr David Wood MD FRCPC

Presented by Providence Health Care and the Canadian Chronic Heart Failure Clinics Network, this event was made possible through an educational grant from Medtronic.

What: Free Drop-in Sessions “All About Heart Failure”

When: Friday, February 23, 2007 from 9:30 am to 1:30 pm

Where: Holiday Inn Express-Metrotown (4405 Central Blvd, Burnaby Ballroom)

For more information, please call 604-682-2344 local 63811

Media Contact: Gavin Wilson, Providence Health Care. Call 604-806-8583 or email at gwilson@providencehealth.bc.ca

New Heart Centre Website Excellent Source of Information

for Patients & Health Professionals

(January 2007)

The Heart Centre at St. Paul's Hospital is leading the way as an online resource with the launch of its brand-new, comprehensive website. The new website - www.heartcentre.ca - is an extension of the exceptional service provided by the Heart Centre, offering visitors in-depth, up-to-date information in an easy to use, accessible format.

"Our website is one of the most informative and comprehensive heart-health websites in Canada, with a wide range of information for patients, families, health care professionals, and those seeking a career at St. Paul's," said Sandy Barr, program director of the Heart Centre. The Heart Centre website allows patients and families to seek answers to their questions from the privacy of their own home.

Topics covered at www.heartcentre.ca include common heart problems and treatments such as chest pain and heart attacks, heart failure, heart rhythm problems, congenital heart disease, surgery and transplantation, angiograms and related procedures and the Healthy Heart Program.

Patients will find tips on how to prepare and what to expect before, during and after a heart procedure.

The Heart Centre website is also an invaluable resource for health care professionals, with information on how to refer patients to the Heart Centre and lists of procedures, guidelines and educational opportunities. Prospective recruits will find lists of career opportunities for both physicians and other health professionals. St. Paul's Heart Centre has developed an international reputation as a leader in the prevention of heart disease and in 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 thousands of patients each year, the Heart Centre also focuses on prevention - helping patients stay out of the hospital.