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Enhancing patient care

A letter from the Winnipeg Health Region

BY ARLENE WILGOSH
Winnipeg Health Region President & CEO
Wave, March / April 2013

Arlene Wilgosh

The Winnipeg Health Region strives to provide a very high level of care to people across Winnipeg and Manitoba. And we know that providing this care, and finding ways to provide better care, require a strong commitment to research and innovation.

That simple truth was brought home to me yet again as I reviewed a few of the stories you'll find in this issue of Wave.

Take, for example, the cover story on Dr. Ryan Zarychanski.

As this article explains, Dr. Zarychanski is a key player at the George and Fay Yee Centre for Healthcare Innovation (CHI), which was created a few years ago through a partnership between the Winnipeg Health Region and the University of Manitoba.

As the name implies, the CHI's mandate is to look for new ways to improve the delivery of care in Manitoba. And, as the story suggests, it is having a significant impact on how we go about our business.

Dr. Zarychanski's work illustrates the point. Born and raised in Winnipeg, he is an expert in a field of research known as knowledge synthesis. In lay terms, he might best be described as a kind of medical detective. He specializes in investigating how things work, or, perhaps more accurately, if they work the way they are supposed to.

A prime example of his research involves a study he led into the use of hydroxyethyl starch. For years, this drug was widely used to increase the blood volume of patients in need of a transfusion. That is, until Dr. Zarychanski took a closer look.

By carefully reviewing studies on the drug from around the world, Dr. Zarychanski and his research team were able to determine it was actually harmful to patients in many cases. As a result of his work, we at the Region have asked doctors not to use this drug as a blood expander. In addition, health-care jurisdictions around the world are also examining protocols governing the use of this drug.

As our story notes, Dr. Zarychanski has a number of other projects on the go, all of which will ultimately lead to improvements in the delivery of health care.

Clearly, we can expect the Centre for Healthcare Innovation to play an important role in enhancing the care patients receive in our hospitals as we go forward.

But ideas for improving care can and do come from all areas of the system. A relatively new initiative underway at the Pan Am Clinic that is helping to reduce wait times for patients in need of total shoulder replacement is a case in point.

For those who may not know, the Pan Am Clinic was founded 33 years ago as a private facility to treat people suffering from sports-related injuries. In 2001, the clinic became part of the Winnipeg Health Region and started to serve a broader cross-section of the public. By 2003, it was determined that the clinic should play a role in meeting the increasing demand for orthopedic services. That led to a major investment in expanding its facilities, including the establishment of two operating suites for its day-surgery program.

Today, the Pan Am Clinic, led by founder and Chief Operating Officer Dr. Wayne Hildahl, is a leader in bone and joint medicine, providing care to thousands of Manitobans suffering a vast array of sport and non-sport injuries ranging from broken ankles to torn ligaments.

Given its history and mandate, the clinic is well-positioned to look for new ways to enhance the delivery of orthopedic care. The shoulder surgery initiative developed by orthopedic surgeon Dr. Jamie Dubberley is a good example.

As you will discover upon reading this story, shoulder replacement surgery is a complicated procedure that has traditionally been done in a hospital.

That can take some time to arrange, of course, because hospital operating rooms are in high demand. Patients who have the operation also tend to stay in hospital for a day or two after surgery.

Enter Dr. Dubberley. He took a look at the problem of wait times and wondered whether something could be done to expedite procedures for patients. In researching the issue, he discovered a project in Ontario where shoulder replacement surgery was being done on an out-patient basis, meaning patients could have the operation and go home the same day. That led him to explore whether the same thing could be done at the Pan Am Clinic. As our story explains, Dr. Dubberley eventually approached some colleagues and developed a proposal to perform shoulder replacement operations as part of the clinic's out-patient program. Once everyone was on board, the clinic started accepting patients for shoulder replacement surgeries on an out-patient basis.

The benefits here are clear. Wait times for patients have been cut by as much as 50 per cent. Moreover, patients are able to go home right after surgery. That generally suits patients just fine as they rarely want to spend more time in a hospital than they have to, and, of course, it frees up the hospital bed to be used for other patients.

As frequent readers of this column will know, I firmly believe research and innovation are critical elements in building an efficient and effective health-care system, especially during times of rising demands for services and tight budgets.

These two stories illustrate the point quite nicely. In both cases, patients have benefitted from the efforts of individuals who are dedicated to a very simple proposition: As good as our health-care system is, we can always make it better.

Wave: March / April 2013

About Wave

Wave is published six times a year by the Winnipeg Health Region in cooperation with the Winnipeg Free Press. It is available at newsstands, hospitals and clinics throughout Winnipeg, as well as McNally Robinson Books.

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