Healthier You
1q9UNXu
1q9UNXu
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
<strong>Healthier</strong> <strong>You</strong><br />
2016<br />
Spring<br />
easy<br />
camping<br />
recipes!<br />
Page 30<br />
Divisions<br />
of Family<br />
Practice<br />
Grassroots healthcare<br />
change in<br />
your community<br />
Surgical<br />
initiative<br />
Puts patients at the<br />
centre of their care<br />
paving<br />
the way<br />
Telehealth clinics<br />
for post-transplant<br />
follow-up<br />
Page 26<br />
Better information, better care: Aboriginal Self Identification – p. 10
Volume 2, Issue 1<br />
coverstory<br />
paving<br />
the way<br />
Spring<br />
2016<br />
Telehealth clinics for<br />
post-transplant follow-up<br />
p.26<br />
Technology is helping patients in rural<br />
communities who otherwise must travel<br />
long distances to attend appointments.<br />
p.30<br />
Spring is here and many families are anxious<br />
to go camping. Here are some healthy, easyprep<br />
meal ideas for your next trip.<br />
inside<br />
Divisions of Family Practice Page 6<br />
Formed to encourage doctors to work in family practice,<br />
this grassroots approach has spread to 230<br />
B.C. communities.<br />
Quick and nutritious recipes Page 8<br />
Healthy recipes from Interior Health Registered Dietitian<br />
Laura Kalina and Cheryl Christian.<br />
Teamwork ACTs to help those<br />
at riskPage 14<br />
Assertive Community Treatment teams in Kelowna<br />
and Kamloops reach out to help people with significant<br />
mental health and substance use issues.<br />
Early Recovery After SurgerYPage 22<br />
Surgical initiative puts patients at the centre of their<br />
care – where they belong.<br />
Right care keeps seniors homePage 24<br />
A project in Kamloops this winter helped frail seniors<br />
recover at home instead of in hospital.<br />
Better information, better carePage 10<br />
Aboriginal Self Identification helps Interior Health meet<br />
human resources needs while supporting the health-care<br />
needs of our communities.<br />
spring 2016 <strong>Healthier</strong> <strong>You</strong> 3
WELCOMEmessage<br />
Chris Mazurkewich,<br />
President & CEO Interior Health<br />
Welcome from<br />
Interior Health<br />
I love spring. As things green up all<br />
around us and the days lengthen and<br />
brighten, I am excited to get my bicycle<br />
back on the road. Fellow cyclists will<br />
understand the clarity of thought that<br />
comes through a long ride.<br />
At Interior Health, we greet this<br />
spring with a clear focus. An aging<br />
population, growing rates of chronic<br />
disease, new treatments and technology,<br />
and competing demands for healthcare<br />
dollars make it important we<br />
allocate our time, resources, and energy<br />
strategically.<br />
There are five strategies that will be our top priority, guiding much of our<br />
work for the next three years:<br />
1. Enhance access to appropriate primary<br />
health care.<br />
2. Improve primary and community care<br />
outcomes and delivery for frail seniors<br />
living with complex chronic conditions.<br />
3. Improve primary and community<br />
care outcomes for mental health<br />
and substance use clients.<br />
4. Improve timely access to elective<br />
surgery.<br />
5. Implement a renewed system of care<br />
to improve access and service quality<br />
across rural and remote communities,<br />
including continuing to build relationships<br />
with Aboriginal partners to ensure health care<br />
RURAL AND<br />
ABORIGINAL<br />
HEALTH<br />
PRIMARY<br />
HEALTH CARE<br />
SURGICAL ACCESS<br />
SENIORS CARE<br />
MENTAL<br />
HEALTH AND<br />
SUBSTANCE<br />
USE<br />
is provided in a culturally safe and sensitive way.<br />
Our goal over the next three years is to reduce the growth in demand at<br />
hospitals and emergency departments, to free up the facilities to care for the<br />
acutely ill while people recovering from illness, coping with chronic medical<br />
conditions, or at the end of life, are primarily supported through communitybased<br />
programs.<br />
These strategies are demonstrated throughout our latest issue of <strong>Healthier</strong><br />
<strong>You</strong>. Stories highlight our efforts to build relationships with our physician<br />
partners around primary care; help mental health and substance use clients<br />
get out of hospital and into new homes; enhance surgical services; increase<br />
the number of Aboriginal staff in our work-force; and leverage technology<br />
to support patients in rural communities. Watch for icons that represent our<br />
strategic areas in the stories throughout the magazine.<br />
Enjoy the read, and whether you are on a bike, a hiking path, or out in the<br />
garden, I hope you have an opportunity to celebrate the arrival of spring and<br />
reflect on how you can further support your own healthy living.<br />
<strong>Healthier</strong> <strong>You</strong><br />
Volume 2, Issue 1 – Spring 2016<br />
Interior Health<br />
Published by:<br />
PUBLISHED BY interior HEALTH & GLACIER MEDIA<br />
Copyright ©2016. All rights reserved. Reproduction<br />
of articles permitted with credit.<br />
Contributors MENTAL / <strong>Healthier</strong> <strong>You</strong> is produced<br />
HEALTH<br />
HEALTH AND<br />
by the SUBSTANCE Interior Health communications team<br />
USE<br />
with contributions from public health staff, in<br />
partnership with Glacier Media.<br />
SENIORS<br />
CARE<br />
SURGICAL<br />
ACCESS<br />
Glacier Media Group<br />
PRIMARY<br />
Sales & Marketing<br />
HEALTH CARE<br />
Kevin Dergez<br />
Director RURAL AND<br />
ABORIGINAL<br />
of<br />
HEALTH<br />
Special Projects<br />
kdergez@glaciermedia.ca<br />
SURGICAL ACCESS<br />
Ellyn Schriber<br />
Newsmedia MENTAL HEALTH Features Manager BC<br />
AND SUBSTANCE USE<br />
eschriber@glaciermedia.ca<br />
Keshav Sharma<br />
Manager Specialty Publications<br />
ksharma@glaciermedia.ca<br />
Advertising Sales<br />
The Daily Courier – Kelowna<br />
Kamloops This Week<br />
Creative Director / Eric Pinfold<br />
eric@phitted.com | www.phitted.com<br />
www.glaciermedia.ca<br />
SENIORS CARE<br />
RURAL AND<br />
ABORIGINAL<br />
PRIMARY<br />
HEALTH<br />
CARE<br />
Advertisements in this magazine are coordinated by Glacier Media.<br />
Interior Health does not endorse products or services. Any errors,<br />
omissions or opinions found in this magazine should not be attributed<br />
to the publisher. The authors, the publisher and the collaborating<br />
organizations will not assume any responsibility for commercial loss<br />
due to business decisions made based on the information contained<br />
in this magazine. Speak with your doctor before acting on any health<br />
information contained in this magazine. No part of this publication<br />
may be reproduced or transmitted without crediting Interior Health<br />
and Glacier Media. Printed in Canada. Please recycle.<br />
4 <strong>Healthier</strong> <strong>You</strong> spring 2016
Flaman is First<br />
in Physio<br />
Bikes<br />
For the Best In Physio<br />
Equipment See Us First<br />
Foam<br />
Rollers<br />
Stability<br />
Balls<br />
Exercise<br />
Mats<br />
Tread<br />
Climbers<br />
Resistance<br />
Bands<br />
Pilates<br />
Balls<br />
MAGIC<br />
MIKE
SUBSTANCE<br />
USE<br />
SURGICAL<br />
ACCESS<br />
HEALTH<br />
CARE<br />
RURAL CARE<br />
MENTAL<br />
HEALTH AND<br />
SUBSTANCE<br />
USE<br />
PRIMARY<br />
HEALTH CARE<br />
SENIORS CARE<br />
SURGICAL ACCESS<br />
MENTAL HEALTH<br />
AND SUBSTANCE USE<br />
SURGICAL ACCESS<br />
RURAL CARE<br />
Divisions<br />
of Family<br />
Practice:<br />
Grassroots<br />
health-care<br />
change in your<br />
community<br />
Family doctors across B.C. are<br />
working with community and<br />
health-care partners—including<br />
health authorities—to enhance<br />
local patient care, achieve<br />
common health-care goals, and<br />
improve professional satisfaction<br />
for doctors. This work is being<br />
done by community-based groups<br />
of family doctors called divisions<br />
of family practice.<br />
above: South Okanagan Similkameen<br />
Division of Family Practice Executive<br />
Director Terrie Crawford with Board Chair<br />
Dr. Tim Phillips.<br />
Divisions of family practice were formed as part of an<br />
effort to encourage doctors to work in family practice.<br />
In 2002, many medical students were opting out of<br />
family medicine. So Doctors of BC and the provincial<br />
government began looking for new ways of empowering<br />
doctors to build relationships in their communities,<br />
promote leadership, and inspire health-care change. A<br />
grassroots approach was needed to kickstart this change,<br />
and the Divisions of Family Practice initiative, funded by<br />
Doctors of BC and the provincial government, provided<br />
this. The initiative began in 2009 with three local divisions,<br />
and there are now 35 divisions of family practice serving<br />
more than 230 B.C. communities. More than 4,700 family<br />
doctors are members of their local division. Today, health<br />
authorities play a critical role in partnering with Divisions<br />
of Family Practice at the local level.<br />
6 <strong>Healthier</strong> <strong>You</strong> spring 2016
There are seven divisions of family practice<br />
within Interior Health:<br />
1 Central Interior Rural, covering the towns of 100<br />
Mile House, Williams Lake, and Tatla Lake<br />
2 Central Okanagan, covering Kelowna, Westbank,<br />
Lake Country, and Peachland<br />
3 East Kootenay, covering Cranbrook, Creston,<br />
Fernie, Golden, Invermere, and Kimberley<br />
4 Kootenay Boundary, covering Castlegar, Christina<br />
Lake, Fruitvale, Grand Forks, Greenwood, Kaslo,<br />
Midway, Nakusp, Nelson, New Denver, Rock<br />
Creek, Rossland, Salmo, and Trail<br />
5 South Okanagan Similkameen, covering<br />
Keremeos, Oliver, Osoyoos, Penticton, Naramata,<br />
Summerland, and Princeton<br />
6 Shuswap North Okanagan, covering Armstrong,<br />
Enderby, Lumby, Salmon Arm, Sicamous,<br />
Sorrento, and Vernon<br />
7 Thompson Region, covering the Kamloops area<br />
Family doctors in local divisions meet with<br />
community partners and health-care stakeholders<br />
through committees called Collaborative Services<br />
Committees (CSCs). CSCs include representatives<br />
from the division, the local health authority, Doctors<br />
of BC, and the Ministry of Health. These partners<br />
work with other health-care stakeholders (e.g.,<br />
representatives from municipalities, other nonprofits,<br />
local First Nations, and patients) to identify and address<br />
local health-care challenges. “The CSC structure<br />
enables family doctors and their partners to identify<br />
shared goals and determine where and how to focus<br />
collective efforts to meet local health-care needs,” says<br />
Andrew Earnshaw, Executive Director of the Kootenay<br />
Boundary Division. “In Kootenay Boundary, the CSC<br />
includes Interior Health’s local leadership from all<br />
portfolios: Community, Mental Health and Substance<br />
Use, Acute, Residential Care and Allied Health.”<br />
One goal of divisions is to increase access to<br />
primary care for local residents. This is done in a<br />
number of different ways, including recruiting new<br />
doctors to communities; creating health-care teams<br />
by incorporating allied health care providers such<br />
as nurse practitioners, dietitians, and social workers<br />
into group practices; supporting doctors to practice<br />
more efficiently so they can take on more patients;<br />
and providing access to telehealth technology in rural<br />
communities to connect patients with follow-up care.<br />
One example of how divisions are working to improve<br />
access to primary care is the Martin Street Outreach<br />
Centre in Penticton, a partnership of the South<br />
Okanagan Similkameen Division of Family Practice and<br />
Interior Health. The centre opened in May 2015, and is<br />
now providing primary care to 350 patients with mental<br />
health and substance use issues. Care for these patients is<br />
provided by a team that includes doctors, Interior Health<br />
Mental Health and Substance Use counsellors, a social<br />
worker, and a STOP HIV nurse.<br />
Team-based care projects in East Kootenay, Kootenay<br />
Boundary, and Thompson regions are also underway,<br />
to help patients access the care and social supports<br />
they need. These projects focus on the integration<br />
of registered nurses, social workers, and life skills<br />
workers into practices. “The broad health authority<br />
representation on the Kootenay Boundary CSC is<br />
particularly important as we expand team-based care<br />
in our region,” says Earnshaw. “With perspectives from<br />
across the spectrum of care, family doctors and their<br />
health-care partners are well positioned to identify<br />
approaches to best suit the health-care needs of their<br />
communities.”<br />
Divisions are also working in communities around<br />
the province to improve care for seniors living in<br />
residential care facilities, through the Residential Care<br />
initiative. Changes implemented by the initiative<br />
will ensure that facility residents are provided with<br />
24/7 access to a doctor, proactive doctor visits, and<br />
medication reviews to identify harmful interactions and<br />
eliminate unnecessary medications.<br />
To learn more about projects being worked on by the<br />
division of family practice in your community, visit<br />
www.divisionsbc.ca.<br />
right: Division representatives regularly meet with<br />
Interior Health staff and others involved in local<br />
health-care planning.<br />
spring 2016 <strong>Healthier</strong> <strong>You</strong> 7
Quick and nutritious<br />
recipes to make<br />
healthy eating a breeze<br />
These recipes are from the Low-Glycemic Meals in Minutes cookbook,<br />
co-authored by Interior Health Registered Dietitian Laura Kalina and<br />
Cheryl Christian. Learn more at www.lowgimeals.com.<br />
For more information about healthy eating, visit www.healthyfamiliesbc.ca<br />
or call HealthLink BC at 8-1-1 (toll-free). Registered dietitians are available<br />
Monday to Friday from 9 a.m. to 5 p.m. to answer your nutrition questions.<br />
Homemade Sweet<br />
Potato Fries<br />
This recipe makes six servings.<br />
• 3 medium sweet potatoes<br />
or yams<br />
• 2 tbsp (30 mL) olive oil<br />
• 1 tbsp (15 mL) paprika<br />
• Seasonings of choice (for<br />
example, oregano and basil)<br />
• Salt and pepper to taste<br />
Directions<br />
1) Preheat the oven to 400 F.<br />
2) Wash and peel sweet potato (or<br />
leave skin on if desired).<br />
3) Cut each sweet potato into oneinch<br />
strips or wedges, and put<br />
into a large bowl.<br />
4) Add the olive oil, paprika and<br />
spices to the bowl and toss<br />
sweet potato to coat.<br />
5) Place sweet potato strips on a<br />
foil covered baking sheet.<br />
6) Bake for 15 minutes on one side<br />
and turn them over. Bake 15<br />
minutes on the other side. If you<br />
want to crisp further, put under<br />
broiler for two to three minutes.<br />
Calories 112; carbs 16g; protein 1g;<br />
fat 5g; fibre 2g<br />
Amazing Quiche<br />
Makes four to six servings.<br />
• 4 large eggs<br />
• 1 ½ cups 1% milk<br />
• ¼ cup whole wheat flour<br />
• 3 tbsp cornmeal<br />
• 3 green onions, chopped<br />
• ½ red bell pepper, finely chopped<br />
• 1 cup low-fat cheddar cheese, grated<br />
• ½ tsp salt<br />
• ½ tsp pepper<br />
Directions<br />
1. Preheat oven to 400 F. Spray a 9-inch<br />
pie plate with vegetable oil.<br />
2. In a blender or food processor, combine<br />
eggs, milk, flour, and cornmeal. Blend<br />
for 30 seconds, until well blended.<br />
3. In the prepared pie plate, gently toss green onions, red pepper, grated<br />
cheese, salt and pepper. Pour the milk and egg mixture over the cheese<br />
mixture.<br />
4. Bake 30 minutes, or until a knife inserted in the centre comes out clean.<br />
Calories 168; carbs 14g; protein 14g; fat 6g; fibre 2g<br />
Nutrition tip: Adequate intake of both calcium and vitamin D can<br />
reduce the risk of developing osteoporosis. Both children and adults need<br />
1,000 to 1,500 mg of calcium daily, depending on age. In terms of food, that<br />
means consuming at least three servings of milk products every day. One<br />
serving includes one cup of milk or enriched soy milk, ¾ cup of yogurt, or<br />
1 ½ oz of cheese. Most people can’t get enough calcium and vitamin D in<br />
their diets, so we recommend a pharmaceutical grade calcium supplement<br />
containing magnesium and vitamin D. From the Low-Glycemic Meals in<br />
Minutes cookbook.<br />
8 <strong>Healthier</strong> <strong>You</strong> spring 2016
2169PANDOSY.COM<br />
HOME • OFFICE • BUSINESS • INVEST<br />
Maximise your lifestyle and optimise your health<br />
and well being with the latest in innovative<br />
technology and design. Located in the heart of<br />
Kelowna’s hospital district, 2169 Pandosy is just<br />
steps away from where you want to be.<br />
LOVE WHERE YOU LIVE<br />
LOVE WHERE YOU LEASE<br />
2169pandosy.com | 1-877-773-7071 | Collett Manor 2169 Pandosy Street, Kelowna BC<br />
Kamloops’<br />
Only Running<br />
& Walking<br />
Specialty Shop!<br />
Amazing range of widths and sizes<br />
to look & feel good!<br />
• Kids Footwear<br />
• Sandals/Orthotic Adaptable<br />
• Crosstrainers<br />
• Dress/Casual • Trail<br />
• Court/Basketball<br />
• Track Spikes • Light Hikers<br />
“PUTTING FEET FIRST”<br />
250.377.4055 • www.runnerssole.com<br />
#74 - 1395 Hillside Drive, Kamloops, B.C. V2E 2R7<br />
PERSONAL<br />
CARE<br />
HOME<br />
MAKING<br />
COMPANION<br />
SERVICES<br />
NURSING<br />
LIVE-IN<br />
CARE<br />
Helping you. Live your life. <br />
Get the support your loved ones need and the peace<br />
of mind you need. Services include Personal Care,<br />
Home Making, Companion Services, Nursing,<br />
Accompanied Visits, Caregiver Relief, Help<br />
With Meds. We’re specially trained to help with<br />
Alzheimer’s and dementia, diabetes, acquired brain<br />
injury and end of life care. We’ve been helping<br />
families just like yours since 1984.<br />
CAREGIVER<br />
RELIEF<br />
ACCOMPANIED<br />
VISITS<br />
We Care Kelowna<br />
#240-1715 Dickson Ave. Kelowna, BC<br />
250.861.8315 • www.wecare.ca
CARE<br />
ACCESS<br />
CARE<br />
PRIMARY<br />
HEALTH CARE<br />
SENIORS CARE<br />
PRIMARY<br />
HEALTH CARE<br />
SENIORS CARE<br />
RURAL AND<br />
ABORIGINAL<br />
HEALTH<br />
MENTAL<br />
HEALTH AND<br />
SUBSTANCE<br />
USE<br />
RURAL AND<br />
ABORIGINAL HEALTH<br />
SURGICAL ACCESS<br />
MENTAL HEALTH<br />
AND SUBSTANCE USE<br />
SURGICAL ACCESS<br />
Better<br />
information,<br />
better care:<br />
Aboriginal Self Identification<br />
Growing up in the Nuxalk<br />
Nation on B.C.’s remote<br />
north coast, Kirsten Tallio<br />
was always taught to<br />
honour her elders.<br />
“In our culture you give high regard to<br />
the elderly,” she says. “I was raised by my<br />
grandparents and was taught that from a very<br />
young age.”<br />
Now, in her work as an LPN with Home Health<br />
in Kamloops, the teachings of her grandparents<br />
are at the forefront as Kirsten provides care and<br />
support for frail elders in their homes.<br />
Kirsten is one of more than 700 employees who<br />
have self-identified as Aboriginal since June<br />
2011 when Interior Health’s Aboriginal Self<br />
Identification initiative was launched for staff.<br />
continued on page 12 <br />
above: Home Health Team Leader Kirsten<br />
Tallio is one of more than 700 Interior<br />
Health employees to self-identify as<br />
Aboriginal so far under the Aboriginal Self<br />
Identification initiative.<br />
10 <strong>Healthier</strong> <strong>You</strong> spring 2016
Welcome<br />
Home!<br />
Providing Independent<br />
Living, Assisted Living and<br />
Residential Care:<br />
Village at Mill Creek<br />
1450 Sutherland Ave.<br />
Sun Pointe Village<br />
700 Rutland Rd.<br />
Village at Smith Creek<br />
2425 Orlin Rd. (Westside)<br />
Call for a tour<br />
250.215.1500<br />
baptisthousing.org<br />
OPEN<br />
SATURDAYS<br />
Proof 1<br />
Baptist Housing – <strong>Healthier</strong> <strong>You</strong><br />
Prepared October 2015<br />
1/8 Page: 3.667” w x 2.417” h, colour<br />
All Requisitions Accepted • No Appointment Necessary • FREE Covered Parking • Open During Lunch Hour • Two X-Ray Machines • Minimal Wait Time<br />
Rob Covaceuszach | 250.470.0785 | robc@ok.bc.ca<br />
Located in the Lower Level l of f the Lansdowne Village Mall (London Drugs)<br />
250-377-0773 • #107-450 Lansdowne Street • Open Monday to Saturday, 9am - 5pm<br />
juSt arriVed<br />
Come visit Surg-Med<br />
Kamloops/Vernon for<br />
your consultation and<br />
expert installation.<br />
www.pgsurgmed.com<br />
XPRESSO<br />
TRILLIUM<br />
SERIES<br />
Features:<br />
• Seat 1.5” quilted and padded<br />
seat cushion for extra comfort /<br />
removable seat cushion<br />
• Brake System Cable-free /<br />
Easy to adjust and maintain<br />
• Collapsible Basket Foldable<br />
& removable<br />
• Lightweight 14 lbs<br />
Centre fold<br />
• Wide Back Strap Pad Extra<br />
wide for added comfort<br />
I am pleased to announce the arrival of Evolution’s newest and<br />
lightest center folding walker: the Trillium! The 14 lbs Trillium<br />
Series is the most comfortable walker on the market today. With<br />
the new quilted padded seat cushion and extra wide double back<br />
strap pad, users can sit in comfort and walk in style. The Trillium<br />
comes with an all-new cable-free braking system, allowing for<br />
effortless handle height adjustment and easy maintenance.<br />
Unit #9-111 Oriole Rd, Kamloops, BC<br />
PH: 236-425-1235<br />
FAX: 236-425-1238<br />
TF: 1-844-259-8576<br />
4206 – 25th Avenue Vernon, BC<br />
PH: 250-549-7288<br />
FAX: 250-549-7281<br />
TF: 1-866-942-7288<br />
Visit the<br />
Kamloops<br />
store and<br />
our friendly<br />
expert staff!<br />
Don’t miss a Moment... Call us today!<br />
Hearing can affect every aspect of your life from<br />
your social well being to your health and safety, but<br />
it is often the subtle sounds that you miss the most.<br />
Our Services Include:<br />
• Hearing Testing<br />
• Digital Hearing Aid<br />
Sales<br />
• Hearing Aid Batteries<br />
• Hearing Aid Repairs<br />
• Custom Noise<br />
Protection<br />
• Hearing Aid Accessories<br />
www.canadianhearingcare.com<br />
Registered Under the Health Professions Act<br />
Kelowna<br />
Orchard Plaza<br />
1876 Cooper Road<br />
Call Deb at<br />
1-888-793-2294<br />
Ashcroft<br />
310B Railway Avenue<br />
Call toll-free<br />
1-888-927-0682<br />
Sorrento<br />
1257 Trans Canada Highway<br />
Call Anna-Marie or Theresa at<br />
1-888-786-0410<br />
Penticton<br />
2210 Main Street<br />
Call Brenda at<br />
1-888-532-0916<br />
Revelstoke<br />
305 1st Street West<br />
Call Jill or Linda at<br />
1-888-904-4632<br />
Kamloops<br />
Downtown<br />
208-321 Nicola Street<br />
Call toll-free<br />
1-888-856-8437<br />
• DVA TAPS Cards<br />
Accepted<br />
• First Canadian Health<br />
Provider<br />
• Part of the WorkSafeBC<br />
Hearing Aid Provider<br />
Network<br />
Vernon<br />
3100 35th Street<br />
Call Val at<br />
1-888-879-9421<br />
Salmon Arm<br />
Lakeshore Village<br />
251 Trans Canada Highway<br />
Call Anna-Marie or Theresa at<br />
1-888-784-1067<br />
Kamloops<br />
Northills Centre<br />
700 Tranquille Road<br />
Call toll-free<br />
1-888-805-1949<br />
MAG-USP-HYOU
continued from page 10<br />
“I really enjoy community care. I feel I can<br />
provide care in a very personal way. I enjoy<br />
getting to know our clients well and spending<br />
that one-on-one time with them.”<br />
“I think it’s really important for our Aboriginal<br />
patients and clients to have Aboriginal people<br />
working here and providing care,” says Kirsten.<br />
“If you look at something like pain level, or<br />
other issues that are bothering them, sometimes<br />
people may not tell the truth. They may view it<br />
as complaining, which is not their custom. But if<br />
I start talking to<br />
them about what<br />
band they are<br />
from, their family<br />
relations and<br />
cultural practices,<br />
they feel more<br />
comfortable and<br />
open up more.”<br />
“The information<br />
helps us develop<br />
and implement<br />
Aboriginal human resource strategies that<br />
encourage Aboriginal people to pursue healthcare<br />
careers,” says Brad Anderson, Director<br />
of Aboriginal Health in Interior Health. “We<br />
know the availability of Aboriginal health-care<br />
professionals is linked to improved health<br />
outcomes for Aboriginal people. There is a great<br />
opportunity to meet the human resource needs<br />
of our organization while also supporting the<br />
health-care needs of our communities.”<br />
“From a staff perspective, I<br />
think it’s important to see other<br />
Aboriginal staff and to hear<br />
their stories.<br />
<br />
The Aboriginal Self Identification initiative<br />
supports various elements of Interior Health’s<br />
Aboriginal Health and Wellness Strategy, as well<br />
as its Aboriginal Human Resources Strategy.<br />
“From a staff perspective, I think it’s important<br />
to see other Aboriginal staff and to hear their<br />
stories. I find it inspiring. I’d love to eventually<br />
become an RN, and knowing others have been<br />
on that journey and accomplished their goals is<br />
inspiring,” says Kirsten.<br />
Another important part of the Aboriginal Self<br />
Identification<br />
program is<br />
patient and client<br />
– Kirsten Tallio<br />
self-identifying.<br />
At registration,<br />
patients and<br />
clients are asked<br />
whether they<br />
self-identify as<br />
Aboriginal or<br />
Métis. Like the<br />
staff program,<br />
participation is voluntary. If they answer<br />
“yes”, there are additional questions, including<br />
whether or not they would like to be put in<br />
touch with unique programs and services<br />
such as Interior Health’s Aboriginal Patient<br />
Navigators.<br />
“It’s important to us that we provide culturally<br />
sensitive care,” says Brad. “Ultimately, the<br />
information helps us develop, implement and<br />
assess services that support those receiving care.”<br />
More info:<br />
Visit Interior Health at www.interiorhealth.ca to learn more<br />
about the Aboriginal Self Identification initiative.<br />
12 <strong>Healthier</strong> <strong>You</strong> spring 2016
Public transit...<br />
It’s good for your health!<br />
Health Connections – Regional Transit Service<br />
Health Connections provides you with accessible transportation options to<br />
non-emergency medical appointments. Although medical appointments have<br />
priority, everyone is eligible to use this service if space is available.<br />
Chase to Kamloops 1·888·376·7525<br />
Creston to Cranbrook 1·877·843·2877<br />
Elk Valley to Cranbrook 1·855·417·4636<br />
Golden to Cranbrook 1·250·344·5237<br />
Kaslo to Nelson/Trail 1·855·993·3100<br />
Kimberley to Cranbrook 250·427·7400<br />
Lillooet/Lytton to Kamloops 1·855·359·3935<br />
Logan Lake to<br />
1·866·376·7525<br />
Kamloops/Kelowna<br />
Merritt to<br />
1·888·376·7525<br />
Kamloops/Kelowna<br />
Nakusp to Nelson/Trail 1·855·993·3100<br />
Nelson/Slocan to Trail 1·855·993·3100<br />
100 Mile House to<br />
250·395·2834<br />
Williams Lake<br />
Princeton to Penticton 1·800·291·0911<br />
Revelstoke to<br />
1·866·618·8294<br />
Kamloops/Kelowna<br />
Salmo to Nelson 1·855·993·3100<br />
Williams Lake to Kamloops 1·866·933·7812<br />
5224<br />
www.bctransit.com
RURAL CARE<br />
MENTAL<br />
HEALTH AND<br />
SUBSTANCE<br />
USE<br />
PRIMARY<br />
HEALTH CARE<br />
SENIORS CARE<br />
SURGICAL ACCESS<br />
MENTAL HEALTH<br />
AND SUBSTANCE USE<br />
SURGICAL ACCESS RURAL CARE<br />
Teamwork<br />
ACTs<br />
to help those at risk<br />
above: Kelowna ACT Team<br />
Lead Lisa Wensink.<br />
Jeanette Judson, 54, has a powerful voice. Even<br />
when speaking about her struggles with mental<br />
illness, poverty and abuse, she is unabashed.<br />
“We need to talk about these things,” she<br />
says passionately. “We need to talk about<br />
mental health, affordable housing, and<br />
poverty. Our lives are not set in stone. I<br />
really want people to know that anyone<br />
could end up like I was.”<br />
Jeanette was found by an Assertive<br />
Community Treatment (ACT) team<br />
member living on the streets in Kamloops<br />
last summer, deep in crisis. She had been<br />
in and out of shelters for years, struggling<br />
to manage her mental health and make<br />
ends meet.<br />
Interior Health’s ACT team helped<br />
Jeanette stabilize and connected her with<br />
important social and health-care supports.<br />
continued on page 18 <br />
14 <strong>Healthier</strong> <strong>You</strong> spring 2016
ACT client Jeanette<br />
credits members of the<br />
ACT team for being an<br />
important part of her<br />
current well-being. “I<br />
know they want me to<br />
be healthy,” she says.<br />
spring 2016 <strong>Healthier</strong> <strong>You</strong> 15
Q&A<br />
Ho-<strong>You</strong>ng Chung, DDS<br />
Implant and Surgical Dentistry<br />
603-1801 Princeton-Kamloops<br />
Hwy (Hwy 5A South)<br />
Kamloops, British Columbia V2E 2J7<br />
Phone: 250-372-7177<br />
Fax: 250-372-7109<br />
Email: admin@kamloopsimplants.com<br />
Web: www.kamloopsimplants.com
Kamloops Dental<br />
and Implant Solutions<br />
We understand that missing one tooth or all<br />
teeth can have a significant impact on your<br />
lifestyle. Missing teeth can cause a variety of<br />
health concerns, including issues related to<br />
speaking and eating and can affect your overall<br />
well-being.<br />
Dr. Ho-<strong>You</strong>ng Chung, DDS, founder of Kamloops Dental and Implant Solutions<br />
provides innovative dental and implant solutions in a safe, gentle, and caring<br />
setting. With a model of patient-centred care, Dr. Chung and his dedicated implant<br />
and surgical team are committed to helping their patients regain their selfconfidence<br />
and quality of life.<br />
Q What innovative dental and implant solutions do you provide?<br />
A Whether it’s having wisdom teeth removed or dental implants placed, many of our patients have some level of<br />
dental anxiety. We understand that even the thought of having dental work done can be a challenge for many; this is<br />
why we offer several levels of sedation for our patients.<br />
Our goal is to provide same-day implant solutions to help minimize the number of procedures and visits. If you have a<br />
broken front tooth that cannot be saved, we can remove that tooth, place an implant, and attach a new tooth all in one<br />
appointment. This is an alternative to waiting many months for grafting to heal and wearing a partial denture that you<br />
have to take in and out.<br />
If you have a loose, floppy denture and want to be able to eat better, we can place implants and have your denture<br />
“clip on” all in one appointment. Patients who pursue this option at other clinics potentially wait 6-12 months before<br />
they have their denture securely fitted into their implants. We want our patients to heal as quickly as possible, and at<br />
the same time, provide affordable and predictable dental implant solutions.<br />
Q What makes your dental implant centre unique?<br />
A We want our patients to eat better, smile more, and feel younger. It’s the story of our patients who come to us that<br />
truly makes an impact. Whether it’s a 93-year-old widower who wants to eat better, the husband who wants his wife to<br />
have her smile back, or the young woman who is about to get married and has a broken front tooth — they all have a<br />
story to tell. We are here to listen to our patients and want them to feel at home.<br />
Q What makes you different from other dentists?<br />
A We are a referral-based centre with patients coming from Kelowna, Vernon, Penticton, Chilcotin Valley, and of<br />
course, Kamloops and its surrounding areas. We want to provide exceptional care by focusing our practice on implant<br />
dentistry.<br />
Q How do you share your passion for implant dentistry with other dentists?<br />
A I am a faculty instructor at the Bites Institute for Implant Training in Burnaby, BC, a dental implant educational<br />
centre dedicated to teaching other dentists incorporate implant dentistry into their everyday practice. As part of Bites<br />
Institute, I have the pleasure of lecturing across Canada to fellow dentists. I also am a mentor for a monthly dental<br />
study group at our clinic in which other local dentists meet and share ideas.<br />
sponsored content
Kelowna committee brings partners<br />
together to help vulnerable clients<br />
In Kelowna, a new Community Advisory Committee<br />
has been established to advise around social issues<br />
that impact ACT clients. This year, housing has been<br />
the Committee’s focus. The group now includes close<br />
to 20 members including: RCMP; Canadian Mental<br />
Health Association; John Howard Society; Kelowna<br />
General Hospital; Ministry of Justice; Outreach Urban<br />
Health/Rutland Aurora Health Centre; Gospel Mission;<br />
Métis Commission; Ki-Low-Na Friendship Society;<br />
Alexandra Gardner; City of Kelowna; a person with<br />
lived experience; a family member; Ministry of Social<br />
Development; BC Housing; and the ACT team.<br />
The Committee serves as an advisory body to the<br />
clinical and support staff and management of the ACT<br />
teams and provides valuable input into the planning and<br />
delivery of ACT team services in the Kelowna area.<br />
An individual with personal experience sits on the<br />
advisory committee along with a family member to<br />
ensure the client voice is present at the table during<br />
discussions. This unique committee meets quarterly<br />
and provides community input.<br />
continued from page 14<br />
Now she has a safe place to lay her head and access to<br />
a health-care team. Most of all, she has the ACT team –<br />
members of which she considers friends.<br />
“I was isolated. For years, I had no family, I had no<br />
friends. I was outside. It was cold and it was terrifying,” she<br />
says. “I am so thankful for the ACT team. I know they want<br />
me to be healthy and we are working together to the same<br />
goal. If it weren’t for them I honestly don’t know where I<br />
would be.”<br />
Jeanette is one of approximately 30 ACT clients in<br />
Kamloops, while a similar team in Kelowna also has about<br />
30 clients registered. After launching in mid-April 2015, the<br />
teams are actively reaching out to those in Kamloops and<br />
Kelowna with severe and persistent mental illness. They will<br />
eventually serve 80 clients in each community.<br />
ACT teams are actively involved in outreach and are on<br />
hand to stabilize crises whenever they occur. The team has<br />
on-call coverage 24/7.<br />
“These are individuals who frequently have substance use<br />
issues. They are homeless or at risk of homelessness, and<br />
18 <strong>Healthier</strong> <strong>You</strong> spring 2016
they are high users of hospital and police services. Their<br />
care needs are complex and they have not benefitted from<br />
our traditional mental health and substance use programs,”<br />
explains Lisa Wensink, ACT team leader in Kelowna.<br />
“Many are referred to the team from Interior Health’s<br />
Mental Health programs but we also hear from our<br />
partners, such as local police.”<br />
It is these partnerships and the multidisciplinary team<br />
behind ACT that makes the program so unique.<br />
The ACT team consists of: a team leader; occupational<br />
therapist; four nurses; a social worker; two community<br />
mental health workers; vocational rehab specialist;<br />
substance use specialist; peer support worker;<br />
administrative support; and a psychiatrist.<br />
“The team approach is powerful and that extends to<br />
our partners,” says Lisa. “A big part of our work is liaising<br />
with them to provide a really comprehensive service. We<br />
frequently are in contact with police, the Canadian Mental<br />
Health Association, and probation services, because many<br />
of our clients have had legal issues. We also work with the<br />
hospital to ensure the transition from hospital to home is<br />
seamless. We work with the Ministry of Social Development<br />
around financial support, and also with agencies such as<br />
food banks and shelters.”<br />
“The Kelowna RCMP work very closely with street<br />
entrenched individuals who reside in the city’s downtown<br />
core, and who are often prime candidates for the ACT<br />
team,” says Corporal Carrie Seale, a regular member of<br />
the RCMP for 18 years and currently working in the<br />
detachment’s Downtown Enforcement Unit (DEU).<br />
“Having worked in this area of policing for over half my<br />
service, I have personally noted that more and more of our<br />
clients who end up homeless on the streets, often also suffer<br />
from persistent mental health concerns, as well as various<br />
substance abuse and addiction issues.”<br />
“The ACT team liaises directly with the RCMP on a<br />
regular basis for referrals and will then follow-up with these<br />
Kamloops team helps house homeless<br />
Since May 2015, ASK Wellness Rapid Rehousing team<br />
and the ACT team have worked together to provide<br />
safe and affordable housing and community supports<br />
to mutual clients in Kamloops. This working partnership<br />
is already proving to be beneficial to landlords and<br />
tenants.<br />
Called the Rapid Rehousing team, they secure housing<br />
throughout the community in ASK’s name with the<br />
intention that clients will take over tenancy when<br />
deemed ready. ASK provides necessary support to the<br />
tenant/ landlord relationship, which is imperative to<br />
securing and maintaining housing.<br />
The ACT team provides the necessary clinical services,<br />
which reassures participating landlords that each tenant<br />
is adequately supported and available to them as<br />
needed.<br />
“ACT team members are always easy to get a hold<br />
of for assistance and consultation. Their service is<br />
24 hours each day, whether it be in person or by<br />
telephone, which reassures landlords that they have a<br />
support team to turn to if they need guidance,” says<br />
ASK Wellness Social Worker Kim Galloway. “One<br />
landlord in the program reported a 15 minute response<br />
time from the time she called for assistance. An<br />
ACT member along with a Rapid Rehousing member<br />
addressed her concern immediately and tenancy was<br />
maintained.”<br />
“As part of the Rapid Rehousing team, I have seen the<br />
success of this program grow very quickly. The roles of<br />
ASK and ACT are distinct; however, we work together<br />
to ensure the success of the program. Landlord<br />
response is very positive and there is a recognised<br />
appreciation for the level of commitment to both<br />
housing support and clinical services. We are excited<br />
for continued work with the ACT team and further<br />
expansion and development of our program.”<br />
We specialize in placing<br />
skilled medical<br />
field personnel.<br />
SPH ProvideS HealtH care<br />
workforce SolutionS<br />
from our domeStic and<br />
international databaSe.<br />
We are a placement agency with access to nurses,<br />
pharmacists, physical therapists and more in the<br />
field of health care.<br />
Request a sample profile from the database on our<br />
website. Or call our office directly to see how we<br />
can assist your business acquire workers with the<br />
knowledge and expertise you require.<br />
sphpoweratwork.com<br />
sphpoweratwork@gmail.com<br />
Tel: 250.314.6555<br />
TF: 1.855.CALLSPH<br />
(1.855.522.5577)<br />
390-546 St. Paul Street<br />
Kamloops, B.C.<br />
V2C 5T1<br />
spring 2016 <strong>Healthier</strong> <strong>You</strong> 19
left: Kelowna ACT Team<br />
Lead Lisa Wensink (centre<br />
back) cites teamwork,<br />
partnerships and peer<br />
support as keys to the<br />
program’s success.<br />
target clients countless times a day. ACT has often<br />
been the light at the end of the tunnel for officers<br />
who deal with the repetitive calls for service<br />
directly related to these troubled individuals,”<br />
explains Cpl. Seale. “As a result, the Kelowna<br />
RCMP has noted a decrease in calls for service<br />
with these specific clients. When circumstances<br />
arise that require police to intervene, ACT is<br />
usually just a quick call away,” adds Cpl. Seale.<br />
“When called upon, the ACT team provides a<br />
varied and comprehensive response, which ranges<br />
from attending the detachment’s cell block, to<br />
providing assistance in navigating a burdensome<br />
system, to taking over the care of clients at the<br />
hospital. ACT has been a valued partner of the<br />
RCMP, as the variety of services provided by this<br />
team is a recipe for success.”<br />
A lot of healing, hope and<br />
validation take place when<br />
peers come together.<br />
<br />
– Davina Kula, ACT Team<br />
Peer support is another key aspect of the ACT<br />
approach. The team includes a person with lived<br />
experience - someone who has been in the clients’<br />
shoes and is able to advocate and ensure their<br />
voices are heard during planning and discussions.<br />
Peer support puts the person first. It is not a<br />
replacement for clinical services, rather, a powerful<br />
complement to it.<br />
“We are the experts on ourselves and we can<br />
learn to self-advocate and use our voices. I<br />
would not be here without my vast peer support<br />
network. Peer supporters sit shoulder-toshoulder,<br />
holding each person in unconditional<br />
high regard, by role modeling wellness and<br />
empowerment, and reminding us that recovery<br />
is possible. We are the evidence,” states Davina<br />
Kula, peer support specialist with the Kelowna<br />
ACT team. “I am so grateful and blessed to bear<br />
witness to my peers living outside the illness<br />
during group outings, while we explore activities<br />
and practices for our wellness toolbox. A lot of<br />
healing, hope and validation take place when peers<br />
come together. Peer support in action!”<br />
“The peer support role is absolutely vital,”<br />
agrees Lisa. “They are often the voice of hope for<br />
the client. They are there to show that people can<br />
be well and healthy and that recovery is possible.<br />
They do a lot of engaging with people to make<br />
them feel less alone. They are often seen by the<br />
client as a safe person to be with, since clients may<br />
not have a positive view of health care.”<br />
Clients with the ACT program may be seen<br />
three times a week, or twice a day. They may be<br />
part of the program for two years, or indefinitely.<br />
The supports are driven by the client’s needs, and<br />
it is a long-term commitment.<br />
Although relatively new and still growing its<br />
client base, the program is working.<br />
“This is a really well–researched approach with<br />
a lot of supporting data in terms of decreasing<br />
homeless, decreasing hospital visits, decreasing<br />
legal issues,” says Lisa. “We have clients who have<br />
had a lot of challenges. They are able to start<br />
school, do some work, get housing – and start to<br />
trust our health system. They are able to live an<br />
optimum life in the community.”<br />
To learn more about the Assertive Community<br />
Treatment approach and how these teams are making<br />
a difference for some of the most vulnerable clients<br />
in Kamloops and Kelowna, visit www.act-bc.com.<br />
20 <strong>Healthier</strong> <strong>You</strong> spring 2016
For over thirty years, the Royal Inland Hospital Foundaon has existed to<br />
build long-lasng relaonships and inspire donors to support life-saving<br />
medical care at the one and only hospital in our community. With limited<br />
hospital funding and resources, the RIH Foundaon relies on the generosity<br />
of our supporters to fund crical health care iniaves that contribute<br />
to compassionate, high-quality care and the well-being of paents<br />
and their families.<br />
When you leave a legacy gi to the Royal Inland Hospital, you are having<br />
a direct impact on healthcare excellence at RIH for years to come. Legacy<br />
giving is a wonderful way to support the things you care about most,<br />
today and far into the future. Legacy gis provide life-saving care, stateof-the-art<br />
equipment and medical educaon opportunies that ensure<br />
the medical team at our hospital has the tools they need to care for our<br />
community.<br />
“It is impossible for the government to<br />
meet all of our needs. Therefore,<br />
those who are capable of contribung,<br />
no maer the amount, should<br />
consider supporng RIH. Our hospital<br />
is a great community resource and we<br />
need to support the talented doctors,<br />
nurses and other staff so they are able<br />
to properly care for each one of us.”<br />
Robbie Dunn, RIH Foundaon Legacy<br />
Circle Member<br />
A legacy gi can take many forms including a bequest in your Will, a gi of life insurance or beneciary designa-<br />
on of your RRSP/RRIF. Everyone who makes a legacy gi to RIH Foundaon is welcomed into our Legacy Circle<br />
Society. It’s our way of recognizing your generosity and commitment to RIH. Call the RIH Foundaon at<br />
250.314.2836 for more informaon on how to create your own legacy at Royal Inland Hospital.<br />
www.rihfoundaon.ca
USE<br />
PRIMARY<br />
HEALTH CARE<br />
SENIORS CARE<br />
SURGICAL ACCESS<br />
MENTAL HEALTH<br />
AND SUBSTANCE USE<br />
SURGICAL ACCESS<br />
RURAL CARE<br />
Surgical<br />
initiative:<br />
Putting patients at the<br />
centre of their care<br />
Most of us regard surgery as something that is done to patients by<br />
physicians and nurses. But that thinking is going by the wayside at<br />
Interior Health hospitals, thanks to a quality initiative called Enhanced<br />
Recovery after Surgery (ERAS).<br />
“Enhanced Recovery is about doing WITH patients, and not TO<br />
patients,” says Garth Vatkin, Interior Health’s Quality Improvement<br />
Consultant for surgical initiatives. “When patients are partners in their<br />
care, it results in better outcomes.”<br />
Enhanced Recovery is designed to help patients recover from major<br />
surgery more safely and easily than ever before. It’s a multidisciplinary<br />
approach – every health-care professional who touches the patient<br />
is included and involved along the way, from initial consultation in<br />
the surgeon’s office, to pre-surgical screening, to the anesthesiologist<br />
and operating room staff, to the post-operative recovery team which<br />
includes nurses, pharmacists, physiotherapists, occupational therapists,<br />
and dietitians.<br />
above: Kelowna anesthesiologist<br />
Dr. Ron Collins is an advocate for<br />
Enhanced Recovery, an approach that<br />
puts more control in patients’ hands<br />
and results in fewer complications<br />
post-surgery.<br />
credit: Photo courtesy of the Royal<br />
College of Physicians and<br />
Surgeons of Canada.<br />
22 <strong>Healthier</strong> <strong>You</strong> spring 2016
“This team approach has a<br />
huge benefit – everyone works in<br />
conjunction, with the goal of best<br />
patient care in mind,” Garth says.<br />
“Patients themselves take a larger role<br />
and responsibility in their care. They<br />
are given more information than ever<br />
before about what to expect with their<br />
surgery, before, during and after. They<br />
are really willing partners in their<br />
treatment and recovery.”<br />
Enhanced Recovery was introduced<br />
within Interior Health in 2011,<br />
through a pilot project at Kelowna<br />
General Hospital led by Dr. Ron<br />
Collins, which focused on colorectal<br />
surgery. Colorectal was chosen because<br />
research is strong in this area and<br />
indicated that patient outcomes can<br />
be improved by implementing an<br />
Enhanced Recovery program.<br />
It was a groundbreaking initiative<br />
because the actions associated with<br />
Enhanced Recovery challenged<br />
traditional practices, such as:<br />
carbohydrate loading before surgery, as<br />
opposed to starving patients; chewing<br />
gum in post-op, and feeding people<br />
earlier, to stimulate bowels; speeding<br />
up mobility by encouraging patients<br />
to walk from the stretcher to his or her<br />
bed; and removing the catheter earlier.<br />
Dr. Collins and his team began<br />
seeing positive outcomes from the<br />
work. Length of stay for patients<br />
started to decrease and patients<br />
expressed higher level of satisfaction by<br />
being more involved and accountable<br />
in their care.<br />
“I think the real success of ERAS<br />
is that it demonstrates how a<br />
multidisciplinary team of committed<br />
front-line providers can positively<br />
impact the health-care system,” Dr.<br />
Collins says. “This initiative very<br />
deliberately mobilized patients to<br />
participate more actively in their own<br />
recovery, and they prove to be willing<br />
and capable partners. We also now<br />
clearly understand that many, if not<br />
most, complications can be avoided by<br />
changing the way we provide care.”<br />
Others in Interior Health took notice<br />
of KGH’s results. By October 2013,<br />
through the sponsorship of Doctors<br />
of BC’s Special Services Committee,<br />
ERAS had spread to six other hospitals:<br />
Royal Inland Hospital in Kamloops;<br />
Penticton Regional Hospital; Vernon<br />
Jubilee Hospital; Kootenay Boundary<br />
Regional Hospital in Trail; East<br />
Kootenay Regional Hospital in<br />
Cranbrook; and Cariboo Memorial<br />
Hospital in Williams Lake. Each site<br />
has introduced ERAS in varying ways,<br />
depending on what best suited their<br />
individual hospital and patient needs.<br />
Royal Inland in particular was an<br />
enthusiastic participant and has shown<br />
great gains. For example surgical site<br />
infections have dropped by nearly 65<br />
per cent, and the average length of<br />
patient stay has dropped to 5.2 days,<br />
from 7.6 days before ERAS.<br />
One reason Royal Inland has<br />
been able to excel is that it has<br />
coupled its Enhanced Recovery<br />
program with its National Surgical<br />
Quality Improvement Program<br />
(NSQIP). NSQIP is a data-driven,<br />
outcomes-based surgical quality<br />
improvement program that enables<br />
hospitals to identify opportunities<br />
for improvement for patient care and<br />
outcomes. The program follows the<br />
entire surgical patient’s journey from<br />
pre-operative, through intra-operative,<br />
to 30 days after their surgery.<br />
Donna Lineker, Royal Inland’s<br />
manager of post-anesthetic recovery,<br />
day care surgery and pre-surgical<br />
screening, says the key to the<br />
Kamloops hospital’s success has been<br />
the teamwork of the care providers,<br />
championed by surgeon Dr. Tom<br />
Wallace.<br />
“It’s a group effort. The entire team<br />
is doing what’s best for the patient,<br />
based on good, scientific research and<br />
best practice,” Donna says. “It makes it<br />
easy. Everyone knows the expectations<br />
and can see the results. Patients are<br />
going home in two-and-a-half, three<br />
days, and they aren’t coming back.<br />
This is excellent quality patient care<br />
that is patient-centred.”<br />
The proof is in the patient<br />
feedback. Consider these<br />
follow-up comments from<br />
patients:<br />
“Excellent personalized care. Had<br />
great follow up by surgeon, surgical<br />
resident, anesthetist, recovery room<br />
nurse and nurse in charge.”<br />
“Excellent nursing care. They really<br />
helped me mobilize which sped my<br />
recovery.”<br />
“(Enhanced Recovery) was pivotal in<br />
my recovery and it should be used<br />
in all surgeries it is applicable to.<br />
It provided me and my family with<br />
all the information we needed to<br />
be comfortable and ‘in the know’<br />
with my recovery and all the steps<br />
along the way. This was a ‘top<br />
notch’ experience and I fully credit<br />
(Enhanced Recovery) with my great<br />
outcome and surgical experience.”<br />
Interior Health’s success with<br />
Enhanced Recovery has made it a<br />
provincial leader in the initiative. In<br />
November 2014, Royal Inland and<br />
Kelowna General joined the Provincial<br />
ERAS Collaborative, which is cochaired<br />
by Garth and Dr. Collins,<br />
along with Dr. Ahmer Karimuddin,<br />
general surgeon at St. Paul’s Hospital<br />
in Vancouver. The Collaborative’s<br />
goal is that every patient undergoing<br />
surgery in B.C. will be part of an ERAS<br />
pathway as part of his or her surgical<br />
experience.<br />
“People know this is the best way<br />
to practice,” Garth says. “We know<br />
that complications are avoidable,<br />
and improved ‘processes of care’<br />
equate to improved results. We are all<br />
accountable for our patients’ outcomes<br />
– and the multidisciplinary approach<br />
of Enhanced Recovery has shown to<br />
result in positive outcomes.”<br />
More info:<br />
Please visit<br />
www.enhancedrecoverybc.ca<br />
spring 2016 <strong>Healthier</strong> <strong>You</strong> 23
HEALTH AND<br />
SUBSTANCE<br />
USE<br />
SURGICAL<br />
ACCESS<br />
PRIMARY<br />
HEALTH<br />
CARE<br />
RURAL CARE<br />
MENTAL<br />
HEALTH AND<br />
SUBSTANCE<br />
USE<br />
PRIMARY<br />
HEALTH CARE<br />
SENIORS CARE<br />
SURGICAL ACCESS<br />
MENTAL HEALTH<br />
AND SUBSTANCE USE<br />
SURGICAL ACCESS<br />
RURAL CARE<br />
Right<br />
care<br />
keeps<br />
seniors<br />
home<br />
below: Standing outside the door to<br />
the ER at Royal Inland Hospital, Allied<br />
Health Social Worker Wendy Sims<br />
works to provide a quick response to<br />
frail elderly who find themselves in the<br />
ER but could go home with supports.<br />
Staff in Kamloops took an active role in a project to help ease the<br />
pressure on hospitals this winter by focusing on frail seniors who<br />
could get well at home with proper supports.<br />
Karen Cooper, director of Allied Health, IH West, oversees the<br />
six disciplines that provide services – primarily to older adults –<br />
designed to either prevent an admission to hospital or hasten their<br />
recovery so they can go home more quickly.<br />
Physical and occupational therapists from Community Allied<br />
Health and a registered dietitian, respiratory therapist, and speech<br />
language pathologist from Royal Inland Hospital were on the Winter<br />
Surge team for 2016.<br />
As well, Social Worker Wendy Sims, also based at Royal Inland, was<br />
the first point of contact by emergency department or Home Health<br />
staff to recommend services for a senior who doesn’t need to be in an<br />
acute care setting.<br />
“Wrapping the right service around the patient results in higher<br />
success rates,” Karen explains.<br />
As an example, she highlights the speech-language pathologist who<br />
might discover a patient with recurring pneumonia has a swallowing<br />
issue that is causing aspiration of food particles into the lungs.<br />
“We are excited to be able to show the value of bringing in the<br />
Allied Health disciplines through a project like this.”<br />
“Winter Surge provides an opportunity to demonstrate what Allied<br />
Health professionals can do at any time of the year to help patients<br />
reduce their stay in hospital or avert an admission altogether.”
ADVERTORIAL<br />
SITTING IS NOT THE NEW SMOKING.<br />
BUT WE SHOULD STILL DO LESS OF IT.<br />
The most over-used dramatization currently used in workplace<br />
wellness is “sitting is the new smoking”. I disagree. I am sitting<br />
right now to write this article and I hardly believe it is having<br />
the harmful affects that smoking a cigarette would have on<br />
my body. I do not require sitting-cessation therapy. Sitting is<br />
necessary. We just need to do less of it.<br />
Have you ever summed up all of your hours of sitting and<br />
laying down in the day (24 hours)? Does the time spent in<br />
inactivity outweigh your physical activity? Large volumes of<br />
physical inactivity in the day may put you at risk for a chronic<br />
disease. In 2013 The University of Texas School of Pubic Health<br />
recorded the training time and inactivity time for 218 distance<br />
runners (marathon and half marathon distance). The median<br />
training time was 6.5 hours/week. Median total sitting time was<br />
8 – 10.75 hours per day. This study suggests that recreational<br />
distance runners can be highly sedentary and highly active at<br />
the same time! Just because you go to the gym, go running or<br />
walk daily, you are not safe from the risks of excessive sitting.<br />
Movement is medicine. A medication that we should take<br />
as often as possible. There are many reasons that we may sit for<br />
extended periods. To change the sitting situation sometimes<br />
takes creativity. For example, if you work a job that requires you<br />
to sit day in and day out all day without the opportunity for<br />
breaks, you may not be able to request walk breaks from your<br />
employer but you may however be able to slightly modify your<br />
workstation to allow you to sit and stand in rapid succession<br />
(also known as a squat) you can do this movement at intervals<br />
throughout the day to break up the time spent sitting. Research<br />
has shown us that movement at work can result in increased<br />
productivity and job satisfaction and decreased absenteeism<br />
due to the health improvements movement can have on the<br />
body.<br />
As is always the case, speak to your Physician or Nurse<br />
Practitioner if you are not currently active and will be increasing<br />
your physical activity dramatically.<br />
Sitting is a necessary part of living. We need to sit for at least<br />
a small amount of time every day. We do not and have not<br />
ever needed smoking. Therefore, sitting is not now nor has it<br />
ever been smoking. Movement is however medicine. Take your<br />
medicine and ENJOY!<br />
Jennifer Edgecombe<br />
Exercise Specialist Coordinator with the City of Kamloops, Parks and Recreation<br />
BSc. HK, American College of Sports Medicine Certified Clinical Exercise Physiologist<br />
jedgecombe@kamloops.ca<br />
250.828.3742<br />
SENSATIONAL<br />
SURVIVORS<br />
250-828-3742<br />
Mission<br />
A goal-oriented exercise program dedicated to working with<br />
women in all stages of cancer to improve physical<br />
strength, rehabilitation and support.<br />
By Physician/Nurse Practitioner Referral Referral<br />
forms at www.keeponmoving.ca/physicians<br />
or call 250-828-3742
CARE<br />
ACCESS<br />
CARE<br />
PRIMARY<br />
HEALTH CARE<br />
SENIORS CARE<br />
PRIMARY<br />
HEALTH CARE<br />
SENIORS CARE<br />
RURAL AND<br />
ABORIGINAL<br />
HEALTH<br />
MENTAL<br />
HEALTH AND<br />
SUBSTANCE<br />
USE<br />
RURAL AND<br />
ABORIGINAL HEALTH<br />
SURGICAL ACCESS<br />
MENTAL HEALTH<br />
AND SUBSTANCE USE<br />
SURGICAL ACCESS<br />
Paving the way:<br />
Telehealth clinics for<br />
post-transplant follow-up<br />
Transplant patients living in rural communities<br />
can be faced with a number of challenges when<br />
travelling long distances to attend an appointment.<br />
But for Cranbrook resident<br />
Paula Smith, a new telehealth<br />
service for post-kidney<br />
transplant patients has<br />
eliminated all of these.<br />
Paula’s kidney function<br />
first started to decline more<br />
than 10 years ago. Then, in<br />
2010, while Paula’s kidney was<br />
functioning at only 15 per<br />
cent, the worst happened – her<br />
husband passed away.<br />
“Just five weeks after<br />
my husband died, I had a<br />
peritoneal dialysis catheter implanted in my<br />
abdomen and was getting prepped for dialysis,”<br />
recalls Paula.<br />
For three and a half years, Paula was on<br />
dialysis waiting for a kidney transplant and in<br />
January 2014 her brother, a<br />
perfect match, volunteered<br />
one of his.<br />
“Everything just fell into<br />
place and then moved really<br />
quickly. I had my transplant<br />
in February 2014,” says<br />
Paula. “There were no<br />
complications for either of<br />
us – I have never felt this<br />
happy, healthy, and alive in<br />
my entire life.”<br />
For surgery, Interior<br />
Health transplant patients<br />
travel to Vancouver, but routine follow-up<br />
appointments occur in clinics across Interior<br />
Health. Still, the closest post-transplant clinic to<br />
Paula is more than 200 kilometres away in Trail,<br />
meaning a drive of three hours each way.<br />
continued on page 28 <br />
above: Paula with her brother, who<br />
donated a kidney to her in 2014. The<br />
transplant was a great success.<br />
26 <strong>Healthier</strong> <strong>You</strong> spring 2016
Kamloops’<br />
Dental Hygiene SPA<br />
Smile Spa<br />
1 st<br />
Visit our Licensed Professional Staff<br />
in our Relaxing Spa-like Atmosphere<br />
We offer:<br />
• Scaling, Polishing and Fluoride<br />
• Affordable in-office and take home whitening kits<br />
• A Variety of Dental Hygiene Products<br />
• Custom Sports Guards<br />
Walk-ins Welcome!<br />
Contact us Today: (236) 425-0503<br />
#102 -755 McGill Rd. Kamloops, BC V2C 0B6<br />
DR. D. CIRIANI<br />
We are pleased to introduce this unique alcohol and<br />
opiate home-detox program to you. For the rst me<br />
in Brish Columbia, individuals who would prefer not to<br />
detox in a hospital, treatment centre or detox unit set-<br />
ng will be able to do so at home with 24-hour medical<br />
supervision, nursing care and support services. If you<br />
would like more informaon to help you decide if this<br />
treatment model would be safe for you,<br />
Call Us Today! 888-512-2616<br />
Supporng <strong>You</strong>r Decisions to Make <strong>Healthier</strong> Choices in 2016<br />
Kamloops Healthy Weights<br />
for Children<br />
Shapedown BC<br />
Shapedown BC: A FREE program for<br />
children and teens (aged 6-17) and their families<br />
SHAPEDOWN BC is a family based group program that<br />
helps children and teens, and their families, achieve a<br />
healthier lifestyle.<br />
HOW DOES IT WORK? Through aged based group<br />
programs and individualized support, the Kamloops<br />
Shapedown team of a Registered Dietitian, Fitness<br />
Instructor, Registered Social Worker and Pediatrician,<br />
helps families to make positive changes in eating habits,<br />
activity level, parenting skills and self-esteem.<br />
HOW DO I JOIN? Ask your family Doctor, Pediatrician, or<br />
Nurse Practitioner to send us a referral. Or contact us for<br />
more information.<br />
Kamloops Healthy Weights for Children<br />
Shapedown BC<br />
Public Health<br />
519 Columbia Street, Kamloops, BC V2C 2T8<br />
PH: 250.851.7300 | FAX: 250.851.7301<br />
www.interiorhealth.ca/Shapedown<br />
Stay<br />
independent<br />
in your own home!<br />
In home care offers practIcal assIstance In<br />
everyday lIfe and offers a means of lIvIng<br />
Independently In your own home as long as possIble.<br />
SPH provides fully screened and qualified in-home caregivers for seniors and persons<br />
with disabilities as well as childcare nannies.<br />
They have a dynamic team with experience and sensitivity to match the needs of clients<br />
with the experience and skills of workers. Federal and Provincial credentials guarantee<br />
placements to be effective and safe in their practice.<br />
Visit our website or call our office for more details on how we can provide help with a<br />
individual needs assessment for our services.<br />
SPH in Home care ServiceS are for SeniorS, PerSonS witH<br />
diSabilitieS and cHildren.<br />
sphpoweratwork.com<br />
sphpoweratwork@gmail.com<br />
Tel: 250.314.6555<br />
TF: 1.855.callsph<br />
(1.855.522.5577)<br />
390-546 St. Paul Street<br />
Kamloops, B.C.<br />
V2C 5T1
continued from page 26<br />
Kim McDuff, transplant redesign project coordinator, along<br />
with her colleagues at the Kootenay Boundary Regional Hospital<br />
Kidney Transplant Clinic in Trail, recognized the need to find<br />
other options for patients who have to drive long distances for<br />
follow-up appointments. They decided to develop a pilot project<br />
where post-transplant patients were given the option to attend<br />
their clinic appointment in Cranbrook and connect to Trail via<br />
telehealth.<br />
“Telehealth offers a way to provide adequate and continuous<br />
care for our post-transplant patients not living in Trail,” says Kim.<br />
In collaboration with BC Transplant, telehealth appointments<br />
were offered for the first time for post-transplant patients. The<br />
pilot ran from November 2014 to May 2015 with 12 patients using<br />
the service.<br />
Georgi Winger is the renal nurse at Cranbrook Wellness Centre<br />
who facilitates the appointment between the patient and the Trail<br />
Kidney Transplant Clinic.<br />
“Although we’ve only been doing telehealth with post-transplant<br />
patients for a short time, the feedback has been nothing but<br />
positive,” says Georgi. “They are so grateful to be able to meet with<br />
the transplant team and receive the care they need without having<br />
to take the time to travel to Trail. Prior to telehealth, Paula would<br />
have to take a day off work for her appointments in Trail, plus<br />
spend money on gas and meals. I believe telehealth has reduced<br />
the emotional and financial stress of many of our patients which,<br />
I’m sure, has a positive impact on their health and well-being.”<br />
During the follow-up appointment, Georgi records Paula’s<br />
blood pressure, weight, and pulse; checks for edema (excess of<br />
fluid); and relays the information via telehealth videoconferencing<br />
to the team in Trail. On the receiving end is Teresa Buckley,<br />
transplant clinic nurse, and a transplant nephrologist, social<br />
worker, and dietitian.<br />
“It’s expensive for people to take an unpaid day off work and<br />
stressful to drive the mountain pass to Trail,” says Teresa. “With<br />
telehealth, this health-care service is more accessible and increases<br />
the continuity of care.”<br />
Through telehealth, Paula is able to connect with each of the<br />
care providers involved in her post-recovery care plan without<br />
having to drive to Trail each time.<br />
“To me, there is no difference in the service provided,” says<br />
Paula. “I’m just glad I don’t have to make the drive… It’s such a<br />
benefit for patients who would otherwise have to travel.”<br />
Telehealth for transplant patients is expected to expand to other<br />
areas of Interior Health.<br />
“Right now we are looking at other rural sites in Interior Health<br />
with renal nurses who can facilitate these appointments,” says<br />
Teresa. “We have also just begun to facilitate appointments for<br />
pre-transplant patients, before they go to Vancouver for surgery.”<br />
The first pre-transplant appointment took place in early January<br />
and more are expected throughout 2016.<br />
Did you know…<br />
One organ donor can save eight<br />
lives. Visit www.transplant.bc.ca<br />
to learn more.<br />
above: Paula Smith (R), standing<br />
with renal nurse Georgi Winger and<br />
the telehealth unit in Cranbrook, no<br />
longer has to drive to Trail for her<br />
appointments.<br />
below: Transplant clinic nurse Teresa<br />
Buckley is part of the transplant team<br />
at the other end of the telehealth<br />
video ready to review Paula’s postrecovery<br />
progress.<br />
28 <strong>Healthier</strong> <strong>You</strong> spring 2016
Kiss lousy dentures<br />
goodbye!<br />
Kiss lousy<br />
dentures<br />
goodbye!<br />
Slipping, sliding, loose or painful dentures?<br />
Come see Dr. Chambers, Board Certified Dental Specialist. He<br />
has over 20 years of experience<br />
creating comfortable dentures, Call now and get a<br />
stabilizing dentures with dental FREE INITIAL<br />
implants and making fixed<br />
CONSULTATION!<br />
dentures that never need to be<br />
($150 value)<br />
removed.<br />
Duncan Chambers, DDS, FRCD(C)<br />
Certified Dental Specialist<br />
Also in Penticton<br />
Suite 201 - 550 West Ave.<br />
Kelowna, BC V1Y 4Z4<br />
Phone: 250-862-2483 or<br />
Toll Free: 1-855-862-2483<br />
www.kelownaprosthodontics.ca<br />
Call now and get a<br />
FREE INITIAL
Healthy eats for<br />
family camping trips<br />
With spring weather upon us, the itch to get outdoors<br />
enjoying nature becomes difficult to ignore. Here are<br />
some meal tips from one family who loves to camp.<br />
By Interior Health Registered Dietitian Simone Jennings<br />
Since we have a toddler, I make sure we are<br />
organized with food. Kids need good nutrition<br />
to keep their behaviour in check (i.e. allow us<br />
parents to have a good time). Plus little ones require<br />
a lot of attention, which means less time to spend<br />
cooking and washing dishes.<br />
For this reason I plan for simple meals and make and<br />
freeze food before we go. I start by planning each<br />
breakfast, lunch and dinner. I also plan to use certain<br />
foods in multiple meals and snacks, such as cheese,<br />
yogurt, and bread, to save space in the cooler.<br />
Of course we also pack less healthy snacks for around<br />
the fire, whether it’s making S’mores or passing around<br />
a bag of chips. Having a family favourite camping treat<br />
is a fun part of creating traditions. But, like at home, it<br />
is important that most of our food be nutritious.<br />
30 <strong>Healthier</strong> <strong>You</strong> spring 2016
Here are some foods that are<br />
often found in our cooler:<br />
Things to prepare before you go<br />
• Make and freeze whole grain muffins, pancakes,<br />
or loaves<br />
• Pre-measure bags of rolled oats with nuts, seeds and<br />
dried fruit to cook on the camp stove<br />
• Hard boil eggs for protein at breakfast or lunch<br />
• Cook rice, quinoa or pasta the night before you<br />
leave and have it in the first couple of days<br />
• Make and freeze chili and/or pasta sauce. It will act<br />
as ice in the cooler and keep for a couple of days<br />
• Freeze lean meats or fish with marinade in Ziploc<br />
bags so they are ready for the BBQ<br />
• Make and freeze hamburger patties. Use ground<br />
chicken, turkey or lean grass-fed beef<br />
Breakfast<br />
• Eggs and toast<br />
• Greek yogurt with fruit and granola<br />
• Cold cereal (choose something low in sugar) with<br />
milk or yogurt<br />
• Peanut butter and jam sandwich with sliced apples<br />
and oranges<br />
• Oatmeal (as described above) or packages of plain<br />
instant oats (just add hot water)<br />
Lunch<br />
• Whole grain pitas with hummus and cut up veggies<br />
• Sandwiches: egg or tuna salad, or veggies and cheese<br />
on whole grain bread<br />
• Use leftover chili with grated cheese in wraps to<br />
make burritos<br />
• Hot dog alternative: chicken or turkey sausage on a<br />
whole grain bun (choose sausages that are lower in<br />
sodium and free of preservatives)<br />
Dinner<br />
• Chili and buns<br />
• Pasta sauce with whole grain noodles<br />
• Lean meat of your choice with a variety<br />
of vegetables<br />
• Grilled veggies: toss a variety of chopped veggies in<br />
olive oil with fresh herbs and wrap in tin foil and<br />
grill. Try carrots, potatoes, yams, beets<br />
and/or onions<br />
• Lean hamburger patties on a whole grain bun<br />
Snacks<br />
• Trail mix: nuts, seeds, dried fruit, chocolate chips<br />
• Whole grain crackers and cheese<br />
• Apple slices and peanut butter<br />
• Muffin, yogurt and fruit<br />
• Campfire cones: sugar cones, chocolate chips, mini<br />
marshmallows, chopped strawberries and banana.<br />
Wrap in tin foil and grill over the fire<br />
PRESCRIPTIONS<br />
Specialty Compounding, Injection<br />
Services, Medication Reviews,<br />
Free Delivery within City limits.<br />
HEALTH CARE<br />
Ostomy, mastectomy, stocking and<br />
wound care supplies. Certified<br />
Mastectomy and Stocking fitters.<br />
POWER D WN + PLAY<br />
MEND: where families get fit and healthy for free.<br />
Mind, Exercise, Nutrition, Do it!<br />
TELEMEDICINE SERVICE<br />
See a doctor now!<br />
Delivering interactive healthcare<br />
in real time.<br />
273 VICTORIA STREET | (250) 372-2531 | WWW.KIPPMALLERY.CA<br />
Want to get tested for sexually transmitted infections?<br />
Now you can get checked online.<br />
From laptop to lab, STI testing is in your hands.<br />
GetCheckedOnline.com<br />
Use code INTERIOR to create your account.<br />
Service is only available in Kamloops and Nelson.<br />
MEND is a fun, free program for families with 7-13 year olds interested in becoming<br />
more active and healthy through interactive group sessions.<br />
The program facilitates safe, effective and lasting lifestyle changes by improving<br />
children’s physical activity levels, nutrition and self-esteem.<br />
To learn more and register, call or email your community.<br />
Cranbrook: 250-489-0220 | jodine.toorenburge@cranbrook.ca<br />
Kamloops: 250-571-4136 | ksharples@kamloopsy.org<br />
Kelowna: 250-491-9622 ext. 234 | sblair@ymcaokanagan.ca<br />
Penticton: 250-490-2426 | mend@penticton.ca<br />
www.bchealthykids.ca<br />
spring 2016 <strong>Healthier</strong> <strong>You</strong> 31
Work with a RE/MAX<br />
Work<br />
Work<br />
with RE/MAX<br />
Miracle with Agent a RE/MAX and<br />
Miracle<br />
Miracle<br />
Agent and<br />
give kids Agent like Zhania and<br />
give<br />
give<br />
kids<br />
kids<br />
like<br />
like<br />
Zhania<br />
every chance Zhania to get<br />
every<br />
every<br />
chance<br />
chance<br />
to<br />
to<br />
get<br />
better. get<br />
better.<br />
better.<br />
ZHANIA, 8 YEARS OLD SICKLE<br />
ZHANIA, CELL DISEASE 8 YEARS AND OLD SICKLE<br />
ZHANIA, CELL CARDIOMYOPATHY DISEASE 8 YEARS AND OLD PATIENT SICKLE<br />
CARDIOMYOPATHY CELL DISEASE AND PATIENT<br />
CARDIOMYOPATHY PATIENT<br />
BE A<br />
BE MIRACLE<br />
MIRACLE MAKER.<br />
MAKER.<br />
Through the Miracle Home Program, our RE/MAX agents donate<br />
Through<br />
Through<br />
the Miracle Home Program, our RE/MAX agents donate<br />
a portion the of their Miracle income Home to Program, BC Children's our RE/MAX Hospital. agents Since donate 1992,<br />
a<br />
portion<br />
portion<br />
of<br />
of<br />
their<br />
their<br />
income<br />
income<br />
to<br />
to<br />
BC<br />
BC<br />
Children's<br />
Children's<br />
Hospital.<br />
Hospital.<br />
Since<br />
Since<br />
1992,<br />
RE/MAX has raised over $56 million in Canada.<br />
1992,<br />
RE/MAX<br />
RE/MAX<br />
has<br />
has<br />
raised<br />
raised<br />
over<br />
over<br />
$56<br />
$56<br />
million<br />
million<br />
in<br />
in<br />
Canada.<br />
Canada.<br />
www.TheRightAgents.com<br />
www.TheRightAgents.com<br />
www.TheRightAgents.com<br />
©2016 RE/MAX, LLC. All rights reserved. Each RE/MAX office is independently owned and operated. 15_60814<br />
©2016 RE/MAX, LLC. All rights reserved. Each RE/MAX office is independently owned and operated. 15_60814