Airwaves Winter 2018

RTSO 

RTSO 

Airwaves 

Winter 2018 

In This Issue 

Welcome to our new Executive Director...........07 

Committee Reports...........................................14 

. 

Thank you for your service ...............................30 

Better Breathing 2018.....................................34 

Mindfulness.....................................................51 

RT Week.............................................................54 

MOHLTC Updates…............................................70 

Management’s Corner.......................................83 

Ask aRTee..........................................................86

18 Wynford Drive, Suite 405 

Toronto, ON M3C 0K8 

Tel: 647-729-2717/Fax: 647-729-2715 

Toll Free: 1-855-297-3089 

E-Mail: office@rtso.ca 

www.rtso.ca 

2018 RTSO Executive, Board of Directors and Committee Chairs 

Kaela Hilderley, RRT, CRE, BEdAEd 

Mike Iwanow RRT, MBA 

Rob Bryan, RRT AA, A-EMCA 

Shawna MacDonald, RRT FCSRT 

Robyn Klages, RRT, BSc. 

Sue Martin, RRT, MA, FCSRT 

Mike Keim, MA, RRT 

Farzad Refahi, RRT, CRE, HBSc. 

Marianne Ng RRT, BSc, MHSM 

Louise Chartrand, RRT, PhD(c) 

Sara Han, RRT, CRE, BSc. 

Sylvia Mortimer, RRT, CRE 

Dilshad Moosa, RRT, CRE, CTE, MASc. 

Nancy Garvey, RRT, MAppSc 

President 

President-Elect 

Past President; Chair, Executive Committee 

Director; Editor, RTSO Airwaves 

Director; Chair, Student Affairs Committee 

Director; Chair, Hospital-Based Leadership 

Committee 

Director 

Director 

Co-Chair, Research Committee 

Co-Chair, Research Committee 

Co-Chair, Community RT Committee 

Co-Chair, Community RT Committee 

Executive Director 

Interim Project Advisor 

Our mission: to promote, advance and protect the interests of respiratory therapists in 

Ontario through research, professional advocacy, growth and development. We do this 

through strategic partnerships, professional collaboration and leadership. 

Our vision: The RTSO is the voice of respiratory therapists in Ontario, dedicated to 

providing the best in respiratory care and lung health for all Ontarians, one breath at a time. 

RTSO Airwaves is a publication of 

Editor - Shawna MacDonald, RRT 

Layout/Design - Elisabeth Biers 

and may not be reproduced in full or in part 

without prior permission from the RTSO 

Opinions expressed in RTSO Airwaves do not necessarily 

represent the views of The RTSO. Any publication of 

advertisements does not constitute official endorsement of 

products and/or services. 

Page 1 RTSO Airwaves - Winter 2018

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OutgoingPresident’s Message 

Rob Bryan 

A-EMCA, RRT AA 

A Year in Review 

What a remarkable year 2017 was for the 

RTSO, marking the beginning of new era 

for our organization. As part of our long-term vision to enhance our advocacy capacity 

and modernize of our front office, the Board of Directors committed to an aggressive 

restructuring plan that led to a purchase service agreement with the Ontario Lung 

Association and the hiring of a new Executive Director (ED). 

For the first time in our history, the RTSO now has a front office with enhanced 

administrative, financial and registration support services and communication resources, 

including access to the Ontario Telemedicine Network (OTN) and physical facilities for 

supporting face-to-face meeting and networking for committee work, leadership meetings 

and educational workshops. This journey began with transitioning the front office to our 

new location, as securing these resources greatly enhances the ability of the RTSO to 

communicate with our key healthcare stakeholders, contribute to MOHLTC transformative 

healthcare initiatives and participate in Ontario lung health strategies. 

I am very proud of the work we have done over the past two Boards that helped build 

this foundation that now gives Ontario RRTs a credible, viable association, one which is 

capable of asserting our profession’s perspective as equal and valued members of the 

healthcare profession. 


Outgoing President’s Message 

Thank you! Thank You! 

I would like to take this opportunity to thank Stephen Laramee and Elisabeth Biers for 

managing our front office over the past 10 years, contributing to where we are today. 

Thank you to Nancy Garvey for her time and dedication to the RTSO as our Interim ED this 

past year. Nancy was invaluable in helping transition the RTSO front office and tirelessly 

promotes and advances our advocacy platform. 

I would like to thank the 2017 Board of Directors and Committee members for all their 

hard work and dedication to our practice and profession… instrumental to our success this 

past year! 

I would like to thank a few people from the Ontario Lung Association (OLA) for being so 

welcoming and providing us with incredible courtesy and professional service. Tomoka 

Fujita is our registration and financial service clerk who handles and processes RTSO 

memberships & Suresh Naraine is Chief Financial Officer (CFO) of the OLA who oversees 

the RTSO’s financial records. Tim Alcock is Vice President, Programs and Operations, 

OLA; Sherry Zarins is the ORCS ED; to them we extend our gratitude for the opportunity 

to participate in Better Breathing 2018. The RTSO looks forward to future strategic 

engagement with the OLA and ORCS for years to come! 

Executive Director Role 

Many of you know we hired an ED in November, Nilda Patey, who unfortunately submitted 

her resignation at the end of December. The search then continued to find a suitable 

candidate to fill this position. I am pleased to announce that the RTSO Executive was 

successful in recruiting and hiring Dilshad Moosa as the RTSO’s new Executive Director. 

Dilshad is a well-respected, accomplished RRT in Ontario with a long history of lung 

health advocacy, Ministry engagement and comes to us with experience in both nonprofit 

and industry. She is extremely passionate about the many facets of our profession and the 

impact we contribute to patient outcomes. 

We couldn’t have found a better, more qualified person to champion and grow this pioneering 

role with the RTSO. Welcome, Dilshad! We wish you great success in your new role! 

Congratulations and Best Wishes! 

RTSO Airwaves - Winter 2018 Page 4

Outgoing President’s Message 

Congratulations to our 2017 service award recipients! You can read about these awards in 

detail in this issue of RTSO Airwaves. 

Nancy Garvey 

Madonna Ferrone 

Stephen Laramee 

& Elisabeth Biers 

RTSO Gord Hyland Award 

RTSO Pinnacle Award 

RTSO President’s Award 

Congratulations to those receiving a Student Achievement Award: 

Amanda Rampersaud 

& Shirley Quach 

Anna Enerio 

Shawna Reesor 

Michener Institute of Education at UHN 

Conestoga College 

Fanshawe College 

Well done! We eagerly look forward to following your career paths and hope to see them 

prosper with many accomplishments and landmarks! 

I would like to express my best wishes to the new 2018 Board of Directors (BOD). You can 

find their names and titles listed inside the front cover of this and every edition of RTSO 

Airwaves. A warm welcome to Kaela Hilderley in her new role as RTSO President, and 

thank you to Mike Iwanow for taking on the role of RTSO President Elect. 

Passing the Presidential Torch & Closing Remarks 

On that note I have officially passed the presidential torch on to Kaela. I want to express 

my sincere gratitude to the Respiratory Therapy professional body in Ontario for the 

opportunity to serve as the Co-President and Chair of the Executive Committee, allowing 

me to give back to the profession that gave me a fulfilling career and the ability to serve 

my RT community. 

Thanks so much, 

Rob 


Incoming President’s Message 

Kaela Hilderley 

RRT, CRE, BEdAEd 

Happy New Year! I am looking forward to going 

through 2018 in this role as President with all of 

you. Over the past few years the landscape in our 

healthcare system in this province has been very 

dynamic and the RTSO is working on continuing 

to be the voice of our profession throughout 

these changes. Thank you to all of those that have 

contributed to our efforts, whether small or large, 

as it is only because of you that we are able to do 

this work. We know that Respiratory Therapists 

makes a difference! 

I hope with this edition of RTSO Airwaves that you 

will join me in feeling a sense of pride for what the 

RTSO has been working on for our profession, and 

even encourage you to participate in any capacity 

that you feel you can. Have a great idea you think 

we should hear about? Want to lend your expertise 

to one of our committees in some capacity? Have a 

colleague you think deserves some recognition for 

something weird and wonderful they are doing as a 

Respiratory Therapist? I encourage you to reach out 

to us and let us know. Together, we are stronger! 

I look forward to working with you this year to be 

the voice of our profession. 

Kaela Hilderley, RRT, 

CRE is the Respiratory Educator 

at the Elliot Lake Family Health Team 

located in Northern Ontario. A Respiratory 

Therapist since 2011, she has been expanding 

the role of the RRT in the ELFHT since accepting 

the position in 2012. Obtaining TEACH certification 

in smoking cessation, the CRE designation and 

completing a Bachelors of Education in Adult 

Education, she is passionate about health 

education and expanding the role of 

Respiratory Therapy. 

khilderley@rtso.ca 

Kaela 


On behalf of the RTSO and the Board of Directors 

and the Executive Committee, it is my pleasure to 

introduce you to Dilshad Moosa RRT, CRE, CTE, MASc 

as the Executive Director of the RTSO. 

“When human beings experience breathlessness, 

it is not uncommon for their lives to become 

unraveled.” (Dilshad Moosa) 

Dilshad is truly passionate about lung health and 

proud to be part of an established network that 

helps patients breath better. She is a results-oriented 

Respiratory Therapist and Certified Respiratory Educator, with broad experience as a National 

Professional Education Manager in the for-profit sector, executing a national integrated 

continuing health education strategy within a multinational pharmaceutical company. At 

the Lung Association, she was the Manager of Quality Improvement and Health System 

Engagement and for over ten years managed the Provider Education Program (PEP) where 

she honed her skills in health system engagements and knowledge translation methodology. 

She has a keen interest in real world research and quality improvement and has contributed 

to publications in this field. She loves to teach and continues to do so as faculty member and 

curriculum developer for the RESPTREC TM program. As a Respiratory Therapist for over 20 

years, she feels privileged to be representing you as the Executive Director of the RTSO. 

Dilshad’s leadership, dedication to the profession and our patients, and her commitment to 

leading organizational growth will strengthen RTSO’s way forward. 

Please join me in extending a warm welcoming to Dilshad! 

Sincerely, 

Rob Bryan RRT AA, A-EMCA 

RTSO Co-President and Chair of the Executive Committee 


Executive 

Director Update 

I am honored to join the RTSO as 

the Executive Director and feel truly 

privileged to join you in advocating for 

Respiratory Therapists and our important 

contribution, in all sectors of the health 

care system. 

I would like to extend a warm welcome 

to the newly appointed board members, 

Kaela Hilderley RRT, CRE, BEdAEd 

– President; Mike Iwanow RRT, MBA - 

President-Elect; Farzad Refahi, RRT, CRE, 

HBSc – Director; Sylvia Mortimer RRT, 

CRE - Community RT Committee Co-Chair; 

and Nancy Garvey, RRT MAppSc who has 

graciously agreed to support our team as 

Interim Project Advisor. 

Dilshad Moosa RRT CRE CTE MASc 

Better Breathing Conference 

I was especially delighted to attend my 

15th Better Breathing conference on 

January 26-27 this year. As always, the 

conference, an Ontario Thoracic Society 

(OTS) / Ontario Respiratory Care Society 

(ORCS) collaboration, never fails to deliver 

on its excellent education programs, 

opportunities to network and visit with 

our corporate sponsors. 

New this year was the Respiratory Therapy 

Society of Ontario (RTSO) education 

program featuring acute and community 

streams, as well the RTSO sponsored 

poster session, award ceremony and 

reception. I would like to acknowledge 

and thank the many Trail-Blazing RRT’s 

who contributed to the success of the 


conference by presenting, volunteering or attending our first collaborative OTS/ORCS/ 

RTSO conference. A special thanks to Mike Keim, RRT, MA, Chair of the ORCS Education 

Committee and Mika Nonoyama RRT PhD, Clinical Scientist to the RTSO Research 

Committee who chaired the poster session. It is evident that when like-minded 

organizations with a common goal of improved lung health band together, we can all 

pause to breathe a sigh of relief. 

Rob Bryan RRT, AA, EMCA-A, President/Chair Executive Committee; Nancy Garvey RRT, 

MAppSc; and Shawna MacDonald, RRT, FCSRT, Director, Editor, RTSO Airwaves; thank you 

for your leadership towards making this collaboration a reality. Looking forward to an 

even Better Breathing Conference in January 2019. 

I am truly amazed at the caliber of the work our volunteer Board, Executive, committee 

and special interest group members contribute! It is an exciting time of growth for our 

society and we are keen to welcome new members and volunteers. 

Coalition of Regulated Health Professional Associations (CORPHA) 

CORPHA is an informal network of the province’s health care professional associations 

regulated under the Regulated Health Professional Act (RHPA). CORPHA, in part, offers 

a platform for two-way communication with the Ministry of Health and Long-Term Care 

(MOHLTC). 

On January 29th, the CORHPA members held their first of three meetings for 2018. 

Assistant Deputy Minister Denise Cole, Health Workforce Planning & Regulatory 

Affairs Division, provided a regulatory update. She announced the new restructuring 

of the division, launched as of January 2018. She reiterated the intention to deliver 

on her mandate to focus on implementation and on strengthening capacity to deliver 

equitable access to patients with an interdisciplinary focus. 

The new division organizational structure is as follows: 

1. Health Workforce Regulatory Oversight Branch (formerly Health System Labour 

Relations and Regulatory Policy Branch) is responsible for all affairs relating to 

regulatory oversight of Ontario’s healthcare workforce, including administering the 

Regulated Health Professions Act. 

2. Health Workforce Planning Branch (formerly Health Workforce Policy Branch) 

3. Office of the Provincial Chief Nursing Officer (replaces the Nursing Policy and 


Innovation Branch). The newly appointed Provincial Chief Nursing Officer, Dr. 

Michele Acorn was introduced. 

4. Office of the Assistant Deputy Minister, is a new unit, focused on Business Integration 

Other items relevant to the RTSO on the agenda included: 

Modernization of RHPA: Assistant Deputy Minister Cole is envisioning a risk-based 

approach to the RHPA with transparency and accountability. She mentioned a position 

document is in final review with her and should be released within the next couple 

of weeks. Some of the regulations under review are for Chiropractors, Midwives and 

Physiotherapists. Ontario is leading a Pan Canadian approach which will be hosted on 

the McMaster Health Forum web-site. 

PSW Registry: The ministry has partnered with the Michener Institute of Education 

at UHN Information Technology (IT) department to establish a Personal Support 

Worker (PSW) registry for non- regulated professions as a proof of concept. A phased 

implementation and evaluation approach that supports guidelines and code of ethics 

will be supported. The Registry will be hosted by the Michener Institute in the interim 

until 2019. 

Bill 87: Protecting Patients, 2017 Update: 

Bill 87 is the Minister’s first part of implementation of the Sexual Abuse Task Force 

recommendations. The task force report will focus on defining a patient, inclusion 

of additional information on the college registers and identifying offences requiring 

mandatory revocation. A request for proposals will be sought to host a sexual abuse 

symposium in the Fall/Winter of 2018 

Ontario Telemedicine Network: Dr. Ed Brown, CEO of the Ontario Telemedicine Network 

(OTN) presented on the future of telemedicine and the OTN. The OTN is a not for profit 

organization that provides access, support and connects patients and providers. One 

of the successful programs highlighted was the Chronic Disease Self-Management 

Program. The following video vignette featuring a patient testimonial was presented: 

https://www.youtube.com/watch?v=zXtF47XC0Hg 

The patient accounts much of the success of the program to having access to his Care 

Coordinator at the Family Health Team, Ana MacPherson, RRT, CRE, CTE, MASc. Ana is in 

a leadership role as the Clinical Coordinator for the South Simcoe Northern York Region 

Health Link, associated with the Southlake Regional Health Centre. 


Celebrating Pay Equity for RRT’s in Primary Care 

The MOHLTC is facilitating healthcare policy transformational change. As RRT’s having 

an active voice at the table ensures we are part of that change. Through our Community 

RT Special Interest Group we were able to advocate for pay equity for RRT’s in primary 

care. Sara Han BSc RRT CRE, Community RT Co-Chair, represented the RTSO at a meeting 

with the Association of Ontario Health Centres (AOHC), the Association of Family Health 

Teams of Ontario (AFHTO) and the Nurse Practitioners Association of Ontario (NPAO) 

and other interdisciplinary associations representatives on January 18, 2018 to discuss 

recruitment and retention investments for primary care professionals. We would like to 

celebrate with you that RRT’s have pay equity with our interdisciplinary colleagues. This 

is a major milestone, and evidence of the important advocacy role of the RTSO. 

Bill 71, The Lung Health Act 

On Tuesday, December 12th in the Legislature, Bill 71 The Lung Health Act was passed 

by unanimous consent. The Ontario Lung Health Advisory provides provincially-based 

advice and recommendations on lung health to the MOHLTC to make improvements in 

lung health awareness, diagnosis, treatment and care. The RTSO is proud to have been 

a member of the Lung Health Caucus and look forward to working collaboratively with 

our partners towards the implementation of an Ontario Lung Health Action Plan. 

The RTSO is well positioned to be a strong advocate for our profession and more 

importantly for our patients. Please join the RTSO and encourage your colleagues to 

join so we can grow our voice and leadership one breath at a time. 

Thank You, 

Dilshad 

Dilshad Moosa RRT CRE CTE MASc 

RTSO Executive Director 

office@rtso.ca 


Editorial 

Shawna MacDonald 

RRT, FCSRT 

RTSO Airwaves Editor 

Welcome to the Winter 2018 

edition of RTSO Airwaves! 

I hope you had a chance to rest, relax or recharge in some 

way, to celebrate tradition, do something new or exciting, and 

I hope you made he most of gatherings with family, friends 

and loved ones. As 2017 came to an end, I bid farewell to 

many difficulties that 2017 brought my way. This new year 

brings with it a renewed respect for the sacredness of life due to the loss of my father in 2017…a 

more profound understanding of the world, and surprisingly more optimism and compassion than 

ever before through many lessons and an “A-Ha!” moment or two, leading to a shift in perspective. 

Many of us set fresh goals or a resolution. This year I chose to set an intention to be increasingly 

mindful. I aim to be fully present and “all in”, to pay careful attention, to actively listen, to focus on 

what truly matters and can make a difference, and to fuel my passion for lifelong learning. What are 

your intentions? 

I encourage you all to become involved in the RTSO this year through maintaining your membership 

and getting involved. We need Respiratory Therapists in Ontario to step up -- to recruit new 

members; to volunteer; to share a story, journey or vision; or perhaps just share your time with us. 

The terrific news of the creation of Ontario’s Lung Health Advisory demonstrates that the Ministry is 

committed to improving the lung health of all Ontarians! Coupled with a new approach in workforce 

planning and health system transformation, this year will be an important one for the profession and 

for the RTSO to represent Respiratory Therapists across the province. Through being engaged and 

informed, we can only become stronger and more viable as a profession. Our collective voice is as 

strong as the level of engagement we have through our professional association membership…your 

voice matters! 

I look forward to learning from all of you, reading about our triumphs and our challenges as well as 

our many successes and accomplishments. Let’s write a good story this year! A story that keeps us 

united, strong, passionate and influential as healthcare professionals, across the province and around 

the world. 

Together, let’s make 2018 a fantastic year! 

~Shawna 


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Committee 

Reports 

Community RT 

Submitted by: 

Sara Han, 

BSc., RRT, CRE 

Co-Chair, RTSO 

Community Respiratory 

Therapy Committee 

First of all, our committee would like to welcome a new Co- 

Chair, Sylvia Mortimer, who will be 

joining Sara Han in chairing this 

committee. Sylvia currently works as 

a RRT/CRE at the Dufferin Area FHT 

in Orangeville. She will bring a lot 

of experience to the table as she has 

experience working in primary care, 

pulmonary rehabilitation, acute care 

and home care when she used to live 

on the East Coast. Welcome Sylvia! 

Sylvia Mortimer, 

BSc., RRT, CRE 

Co-Chair, RTSO 

Community Respiratory 

Therapy Committee 

Our Community RT Committee 

exists because there is a gap in 

respiratory therapy care support in 

the community/home setting. Several 

reports, generated within Ontario 1-5 

have confirmed this. These reports 

recommend that RT services be implemented or expanded in 

the community setting. These statistics are also confirmed by 

the many personal stories relayed by Respiratory Therapists and 

the patient/clients who are directly affected by this gap. Our 

goals are to establish eligible and fully funded RTs in 

the community/home setting. We see three main roles: 

Role 1: Long-term mechanical ventilation and complex 

airways respiratory care. 

This includes hospital based programs (transition and initial set 

up); respiratory home care companies and Community Care 

Access Centres (CCACs) 

The current issue: RT services are utilized and valued in the 

community but are often on an ad hoc basis and/or differ from 

one LHIN to another. 


Community RT Committee Report 

Role 2: Long term oxygen therapy respiratory care. 

This includes hospital based programs (transition and initial set up); respiratory home care 

companies and CCAC (ongoing care and follow-up). 

The current issue: RT services are utilized and valued in the community but are on an ad 

hoc basis and/or differ from one provider to another. 

Role 3: Chronic respiratory disease management and respiratory care. 

This includes respiratory education involving multiple lung diseases (including COPD and 

asthma), performing spirometry and other RT related roles within the scope of practice of 

RT located in the primary care setting (e.g., FHTs, CHCs, aboriginal health access centres 

and NP led clinics) and CCACs. 

The current issue: There are several RTs in the community doing this work, for example in 

FHTs, but not until November 2013 was there a formal RT role included in the majority of 

FHTs’ or related community based health team’s funding package (there were few centers 

that were exceptions to this). 

In the past couple of years, our committee, along with the support of the RTSO Board, 

successfully advocated for our profession to be placed on a compensation level equivalent 

to other regulated health care professionals in primary care. This advocacy effort also 

allowed us to inform the evaluators, Korn Ferry/Hay Group and organizations such as the 

Association of Family Health Teams of Ontario (AFHTO), Association of Ontario Health 

Centres (AOHC) and the Nurse Practitioners Association of Ontario (NPAO) about what we 

offer to the health care team. 

As Ontario’s Patients First Act continues to be implemented in practice, one of the focuses 

of this Act is to improve access to home and community care. Although there are many 

RRTs who work for CCACs, home care companies or are a part of hospital outreach teams, 

care provided is sporadic and not uniform across Local Health Integration Networks 

(LHINs). There is also a need for more RRT services taking care of our elderly and providing 

support to those who need chronic mechanical ventilation, complex airways care and 

long term oxygen therapy. As we did with our Primary Care advocacy, our committee has 

developed a home care task force to develop a generic job description for the home care 

RRT, highlighting our full scope of practice, to develop a position paper that can be 

used by the RTSO for advocacy to various organizations such as the Ministry of Health and 

Long Term Care and LHINs. 


Community RT Committee Report 

In other work, we are also looking to write a few articles for the next issue of the Canadian 

Journal of Respiratory Therapy (CJRT), which will focus on Primary Care. One of the articles 

our committee will look to submit is a position paper on the need for more community care 

training and skill development within Respiratory Therapy school curriculums. Hopefully by 

the next edition of RTSO Airwaves, we will be able to share this with you. 

There is a lot of work that has been done, but a lot of work that needs to be accomplished. 

We cannot do this without your support and input. Please don’t hesitate to be in touch 

through the office@rtso.ca to let us know about issues or examples and opportunities 

relative to your practice in Ontario! 

Sara 

References: 

1. Bayliss M, et al. College of Respiratory Therapists of Ontario’s Optimizing Respiratory 

Therapy Services: A Continuum Of Care from Hospital to Community. Toronto: 

HealthForce Ontario - Optimizing Use of Health Providers’ Competencies Fund 2008/09 

Final Report; 2010. 

2. Chronic Ventilation Strategy Task Force. Final Report: The Ministry of Health & Longterm 

Care; 2006 June 30. 

3. Long-term Ventilation Service Inventory Program. Final summary report: The Ministry of 

Health & Long-term Care; 2008 July 31. 

4. Ontario Spinal Cord Injury Solutions Alliance. Position Paper. Living fully in Ontario 

communities. People with spinal cord injuries & disease who use respiratory supports: 

Canadian Paraplegic Association Ontario & Ontario Neurotrauma Foundation; 2008 

August. 

5. Long-Term Ventilation Strategy Development for Ontario. Long-Term Ventilation Strategy 

Development for Ontario Progress Report: Toronto Central Local Health Integration 

Network; 2007 June 28. 


Introducing a new 

Community RT 

Committee 

Co-Chair 

Sylvia Mortimer, BSc., RRT, CRE 

I completed a Bachelor of Science degree with a double major in biology and 

psychology at the University of New Brunswick - Saint John Campus in 1998. 

Not knowing what to do next the Dean of Science at the time asked me if I have 

ever heard of Respiratory Therapy. I, of course, did not, so I shadowed an RRT at 

a tertiary care hospital and I was hooked! I completed my diploma in Respiratory 

Therapy Technology from the New Brunswick Community College in 2000 and 

have been a practicing RRT ever since. 

Coming from the East Coast originally, I have worked in acute care most of my 

career. However, in 2008 I completed my diploma in polysomnography and 

worked in a sleep lab for a year before I transitioned to smoking cessation and 

started the Ottawa Model for Acute Care in my hospital. I then slipped back into 

acute care and became a Clinical Practice Lead before moving to Ontario in 2010. 

Since arriving in Ontario I have worked in home care, Respiratory Rehabilitation, 

Adult and Paediatric Asthma clinics and acute care before settling down in 

primary care. I now work full time at the Dufferin Area Family Health Team (FHT) 

in Orangeville where I live with my husband Scott and our two children, Lauren 

and Charlotte. 

Sylvia 

Page RTSO 17 Airwaves - Autumn 2017 RTSO Airwaves - Winter Page 2018 30

Respiratory Therapy 

in Primary Care - 

From Technologist to 

Therapist and Beyond 

Submitted by: Sylvia Mortimer, B.Sc., RRT, CRE 

Dufferin Area Family Health Team 

When first starting work as a Registered Respiratory Therapist (RRT) at the Family 

Health Team (FHT) in 2012 it was a very technical role. At that time, primary 

responsibilities were conducting spirometry tests, inhaler instruction and some 

education for Asthma and COPD. Being a RRT within a Family Health Team was a 

trailblazing position at the time, as other health care professionals (such as registered 

nurses) in most FHTs were often performing these functions. 

Moving forward five years and the RRT role within a FHT has changed significantly. 

Firstly there are more RRTs within FHTs in the province. The value of having an RRT 

over another health care professional managing a patient with respiratory needs is 

becoming more apparent as we have a unique and specialized skill set. The needs 

of the aging community influence the need for services that an RRT and Certified 

Respiratory Educator (CRE) provides. Our day to day duties still include technical 

roles such as performing spirometry and education, but we have expanded the role 

and scope to include the provision of smoking cessation, airways clearance and 

developing comprehensive COPD and Asthma action plans. FHT RRTs also assist in 

the management of COPD, Asthma and other respiratory conditions rather than 

simply providing education and discharging the patient back into the community. 

Our presence, and expanded functions and scope, allow the FHTs to utilize the 

RNs in other programs and broaden the services that FHTs can offer. As detailed in 

Ontario’s Patients First Act, it is providing faster access to the right care. 


Respiratory Therapy in Primary Care - From Technologist to Therapist and Beyond 

As patients’ needs become more complex, the role of allied health including 

RRTs change to meet these needs. Increased collaboration amongst hospital and 

community partners is necessary to meet the needs of our common patients. We 

can effectively “case manage” our primary care patients without having assigned 

case managers within our care network. The results often keep patients in their 

homes, and in the community in which they need and want care, while we work 

together for the best patient outcomes possible. 

The environment of the FHT is constantly changing and evolving and we must 

adapt and grow within our teams and roles to meet this need. Thus, in order to 

be effective, RRTs will need to continue to grow and evolve as well to address the 

increased complexity of our patients while continuing to broaden our scope of 

practice within primary care. FHTs are very much about inter-collaboration and 

relying on colleagues to assist in managing these complex patients, thus providing 

support to the RRT as well as the patient. The FHT RRTs help patients self-manage 

not only their respiratory health but also their overall health and it is when we work 

together outside of our silos that we see the greatest impact in patient care. 

"CULTURE DOES NOT CHANGE BECAUSE 

WE DESIRE TO CHANGE IT. CULTURE 

CHANGES WHEN THE ORGANIZATION IS 

TRANSFORMED; THE CULTURE REFLECTS 

THE REALITIES OF PEOPLE WORKING 

TOGETHER EVERY DAY." 

--FRANCES HESSELBEIN 


Committee 

Reports 

Student Affairs 

Celebrating Ontario’s Respiratory Therapy Schools 

- Faculty and students - 

Forging the future for Respiratory Therapy! 

Respiratory therapists 

specialized body of 

knowledge, skills and 

abilities make a difference in 

our patients’ outcomes and 

quality of care! The RTSO 

Student Affairs Committee 

aims to support effective 

networking and information 

sharing opportunities 

among Program Faculty and 

students across the province! 

• Complementary student and new graduate RTSO membership 

• Restructuring Representation aligned with Ontario’s Respiratory 

Therapy Programs 


GE Healthcare 

To learn more visit: 

www.gehealthcare.com/carescape_R860 

HOW THE JEWISH HOSPITAL – MERCY HEALTH 

AND GE HEALTHCARE HOPE TO TAKE A BITE OUT 

OF ICU COSTS 

Admission rates to hospital Intensive Care Units 

(ICU) are rising dramatically – along with the cost 

of critical care. 1 Here’s how nutrition can impact 

the cost of care for ventilated ICU patients. 

GROWING ICU ADMISSIONS 

FIVE 

MILLION 

ICU Patients 1 

INCREASE 

ICU Patients 

2006-2015 2 

UP TO 

50% 

ICU Patients 

Malnourished 2 

Extending this solution across all 

U.S. hospitals could potentially 

impact hospital’s clinical and 

financial outcomes. 

Nutrition is critical 

in ICU recovery. 

GE’s critical care 

ventilators feature an automated 

nutrition assessment application 

to assist caregivers with their 

ventilated patients. 

ICU Patients 

on ventilator 3 

THE JEWISH HOSPITAL 

RESULTS: 90-DAY STUDY 4 

MULTI-DISCIPLINARY CLINICAL NUTRITION PROGRAM 

28% 

REDUCTION 

Average ventilated ICU 

patient LOS 

~ 9k 

LESS 

Avg. cost reduction 

per ICU ventilated 

patient 

$6 

MILLION 

Projected 

annual savings 

1. Department of Health Policy, George 

Washington University School of Public 

Health and Health Sciences, Washington, 

DC, USA. http://www.ncbi.nlm.nih.gov/ 

pubmed/23672362 

2. Reid, CL. Nutritional requirements of surgical 

and critically-ill patients: do we really know 

what they need? Proc Nutr Soc. 2004 

Aug;63(3):467-72. 

3. The American Association for the Surgery 

of Trauma: Trauma Source - Mechanical 

Ventilation in the ICU. Note: % ventilated 

ICU patients referenced is a single source – 

actual % may vary) 

4. The Jewish Hospital Demonstrates Over 

2-Day Reduction in ICU Length of Stay with 

GE Ventilation. 2015. 

Note: GE does not guaranty any cost savings. 

These results are specific to The Jewish 

Hospital only. 

© 2015 General Electric Company. JB36390US 

GE and the GE Monogram are trademarks of 

General Electric Company.

Committee 

Reports 

Research Committee 

Marianne Ng RRT, BSc, MHSM and 

Louise Chartrand RRT, PhD (ABD) 

Co-Chairs, RTSO Research Committee 

To start 2018 with a blast, the Research Committee 

partnered with the Ontario Respiratory Care Society (ORCS) 

Research Committee in hosting a poster session at the 

Better Breathing conference this year. There were 19 posters 

selected from a joint abstract review. Thank you to all the 

Research Committee members for their efforts in trying 

a new process this year. A big shout out to Louise, Tara, 

Madeeha, Cassandra, Perrin, Tina and Jesse for their time in 

reviewing the posters. 

We would like to also thank you for all of the poster 

submissions and congratulate our poster award winners: 

Student Poster Award 

Shirley Quach – “Asthma Care Apps in the Patient Pocket: 

What does the literature report?” 

Program Award 

Robyn Klages and Tony Raso – “A traffic light Algorithm 

Based Approach to Managing Difficult Airways” 

Research Award 

Sara Han, Diane Feldman and Carole Madeley – 

“Utilization Of The Health Equity Impact Assessment To 

Ensure Equitable Delivery Of A Primary Care Respiratory 

Program “ 

Continuing with this blast of energy and momentum, the 

Research Committee will be focusing on using social media 

in providing resources and mentorship to our members. 

Last but not least, we would like to congratulate Nancy 

Garvey on receiving the RTSO Gord Hyland award. Not only 

was Nancy one of the “founders” of the RTSO Research 

Committee, but she has mentored many RTs in their 

research journey. 

Thanks, 

Louise and Marianne 


A Brief Recap of Better Breathing: 

The Research and Emerging Practices 

As a practicing health care professional, it is important to attend 

opportunities that will enhance the knowledge and bring innovative 

ideas onto the table for practice in the future. There are 

multiple outlets to self-educate and participate in professional 

development activities, and they are important for the growth of a 

respiratory therapist, regardless of where they are in their career. 

On January 25-27, 2018, the Ontario Respiratory Care Society 

(ORCS), Respiratory Therapy Society of Ontario (RTSO) and Ontario 

Thoracic Society (OTS) held their annual joint Better Breathing 

Conference (BBC). This avenue provided many occasions for 

individuals involved in the respiratory care of patients to inquire 

about new ideas and potential practices in the field. Attendees 

included, but are not limited to, respiratory therapists, occupational 

therapists, physiotherapists, nurses, physicians, social workers, and 

pharmacists, whom all have dedicated their practice to improving 

the lung health of all ages. 

Shirley Quach, 

RRT, HBSc 

Despite the large literature pool available for many of the accepted 

practices, continuous research is necessary for knowledge growth, 

validation, and quality assurance. Sometimes, ongoing research 

studies provide preliminary results that are beneficial to the health 

care community; however, their results are not ready for publication 

or for human clinical trials. Conferences provide the chance for 

researchers to report their preliminary findings to a group of keen 

interprofessionals who are open to the idea of advancing practices. 

Conferences offer many lectures that are meant to educate their 

audience of new and emerging practices and therapies. Take for 

example, Dr. Ron Cohn’s presentation about CRISPR technology. 

CRISPR, Clustered Regularly Interspaced Short Palindromic Repeats, 

a genome editing system, is familiar to the genome engineering 

field. CRISPR is used for editing specific locations in DNA, possibly 


A Brief Recap of Better Breathing: The Research and Emerging Practices 

correcting mutations (1). CRISPR may not be a term common to those working with patients directly, 

but it should not be completely foreign to them. Presented by Dr. Cohn, there is the possibility that they 

may have discovered the location of mutations for those with Duchenne Muscular Dystrophy (DMD). This 

discovery is astounding as there is the potential to use CRISPR to edit these specific genes which could 

alter the expression and severity of DMD. If CRISPR could be used for the purposes of fixing the mutated 

regions, this could change the therapeutic treatments and prognosis of DMD. However, at this point in time, 

the results are only preliminary as more research is necessary for the genome engineering field to explore 

and validate the potential of CRISPR before it can be performed on humans and to be used for treatment. 

Another interesting topic that is gaining a lot of attention is the use of sleep-monitoring applications. 

Dr. Christopher Li presented his personal experience as a physician who is involved in interacting with 

patients who need sleep therapies. There are many glamorous sleep-monitoring applications and devices, 

such as Fitbit, that are advertised for providing information about one’s sleep and to monitor their health. 

But are these applications and devices appropriate to suggest use and are they accurate enough to be 

diagnostic? Because the advancement of technology is rapid with a large consumer pool, as health care 

professionals, their use should not be completely dismissed. By dismissing them, it is similar to dismissing 

the patients’ choice in lifestyle, which is an important component to consider when assessing, and 

prescribing therapies. It is important as evolving health care professionals to consider new technology 

that may be attractive and commonly used by patients. By being wary of these new technology, it helps 

prepare health care workers for when patients come to the clinic seeking professional interpretation and 

advice about their use. 

Another great aspect of conferences is the opportunity for interprofessional discussions about certain 

topics. One of the events at BBC included a debate between Dr. Dina Brooks and Shelley Prevost, RRT 

on whether general rehabilitation should replace pulmonary rehabilitation. Pulmonary rehabilitation is 

designed to provide support, and exercise to assist patients to live an unrestricted lifestyle not limited 

by their breathing ( 2 ). The use of pulmonary rehabilitation is not new and have been shown through 

research, if executed appropriately, provides benefits. And part of being a health care professional and 

advancing practice, is to continue to challenge practices. Just because something has been proven to 

show benefits, it is not appropriate for health care professionals to stop improving practices. Dr. Brooks 

challenged the continuous use of pulmonary rehabilitation; and that the focus should be general 

rehabilitation instead. Dr. Brooks brought up a good point during her debate, that sometimes, patients 

in pulmonary rehabilitation may not need pulmonary rehabilitation for a particular day, but require 

rehabilitation for something else. With general rehabilitation, it would be promoting the rehabilitation 

of all systems, and to address a particular system on a given day when needed. Shelley disagrees with 

the idea of transitioning to general rehabilitation, and believes that pulmonary rehabilitation should 

still be the mainstay method. Shelley stated that rehabilitation that focuses on one’s breathing should 

be the priority as difficulty in breathing contributes to poor management of other comorbidities. That is 

a very strong point, because if one cannot breathe, how can they have the energy to manage the rest? 

This debate was enlightening because it sheds some light on the potential emerging therapies that 


A Brief Recap of Better Breathing: The Research and Emerging Practices 

needs more investigation. The idea of general rehabilitation seems to be relatively new, and needs more 

research to support the use. Again, this shows that even when there are established and proven therapies, 

it can be questioned and further improvements can be considered. 

As practicing health care professionals, it may be difficult to find time to sit down and read about the 

latest research articles and ponder their possible implementation in practice. Time constraints make it 

difficult for ensuring continuous education; but conferences provide that opportunity to allow those with 

limited time to hear about summarized emerging practices. The BBC provided many topics and various 

streams for attendees to learn and enhance their existing knowledge. The use of the obtained knowledge 

may not change practices overnight; however, it gives working professionals a chance to augment their 

knowledge and be aware of the ongoing initiatives and changes in practices. 

References 

1. https://www.broadinstitute.org/what-broad/areas-focus/project-spotlight/questions-and-answers-aboutcrispr 

2. https://www.copdfoundation.org/Learn-More/Pulmonary-Rehabilitation/What-is-Pulmonary- 

Rehabilitation.aspx 

"ENGAGED, ENTHUSIASTIC, 

AND LOYAL EMPLOYEES ARE 

PIVOTAL DRIVERS OF 

GROWTH AND HEALTH IN ANY 

ORGANIZATION.” 

– PATRICK LENCIONI

Congratulations 

Phoebe Lam! 

In the Summer 

issue of RTSO 

Airwaves, a 

research poster 

submitted by Phoebe 

Lam and colleagues 

was published. 

The evidencebased 

poster 

showcased the 

unique contribution Respiratory Therapists provide 

to the interdisciplinary team and highlights 

an awareness of other healthcare professions’ 

perceptions about the AA profession and its impact 

on interprofessional care (IPC). 

We are proud to announce that this research 

has now been published in the Journal of 

Interprofessional Care, with access directly via 

the following link: 

http://www.tandfonline.com/eprint/euRhr4G4kdPecXBHuVN9/full 

Congratulations to all involved in this important 

contribution! 


Committee 

Reports 

Leadership Report 

Hi everyone! 

The RTSO Leadership Committee meets monthly 

to work on issues to support RT Leaders in the 

hospital-based environment. Currently we’re 

working on: 

• Development of a ‘generic’ job description 

for front-line hospital based Respiratory 

Therapists. We envision that this document could be 

helpful in developing and expanding RT roles, especially 

went working with non-RRT administrators. The plan is to 

have a Board approved document that can be shared with 

managers, hospital and LHIN CEOs and the Ministry of Health 

and Long-Term Care and its agencies (ex. Health Quality 

Ontario, HealthForce Ontario, etc.) Paula Smith RRT is 

leading this working group. 

Submitted by: 

Sue Martin 

RRT, FCSRT, MA 

Director, RTSO 

Leadership Chair 

• Leadership Summit 2018 – following on last year’s very 

successful inaugural Leadership Summit plans are underway 

for this year’s conference. This one-day symposium is for 

RRT leaders and leaders of RRTs in hospital based roles. It’s 

a great opportunity to network with your colleagues and to 

discuss topics common to hospital leadership. Sue Jones RRT 

is leading the working group this year. Stay tuned for a ‘save 

the date’ message coming soon. If you would like to be sure 

to have your name included on our RTSO leaders database to 

receive these invitations please drop me a note at smartin@ 

rtso.ca 

• Pulmonary Diagnostics standards of practice for Ontario 

Respiratory Therapists. Tony Kajnar RRT-AA, RCPT(P) is 

leading the working group developing a framework to 

enhance the availably of pulmonary diagnostics which 


Committee Reports: Leadership Report 

adhere to the latest standards using quality and appropriately 

calibrated equipment and performed by well trained professionals. 

Communication, networking and education - both within RTSO 

membership and with stakeholders in pulmonary diagnostics will be 

part of this project. 

I had the terrific opportunity to attend Better Breathing 2018, network 

with many colleagues and to Chair the RTSO Acute Care lecture 

stream, where Tom Piraino RRT FCSRT and Dr. Tai Pham MD PhD 

provided two, two-part presentations updating us with the latest 

information on both ARDS management and weaning from ventilation 

strategies. Thanks to Tom and Tai for these well researched and 

engaging presentations! More on next year’s RTSO Better Breathing 

stream will follow in the coming months. Rob Bryan is leading the 

RTSO’s planning. Suggestions for topics and speakers are welcome at 

office@rtso.ca! 

Going forward, we know the Leadership Committee and the RTSO 

Executive will have the ability to represent Ontario Respiratory 

Therapists in many venues, especially at a provincial governmental 

level - potentially with the newly enacted Ontario Lung Health Advisory 

Council and other MOHLTC committees and at the LHIN level. To be 

recognized as representative of the profession, I believe the RTSO must 

be supported by a significant percentage of Ontario RRTs. We support 

the RTSO - and the RTSO supports us - when we are members. I 

encourage you to renew your membership now and to encourage your 

colleagues to join as well. Please give it your consideration. 

If you would like to communicate with the Leadership Committee - let 

us know what your RT passion is and how we can support you, interact 

with us on our job description, leadership summit and pulmonary 

diagnostic projects, or whatever is important to RT leadership in 

hospitals - please drop me a note at smartin@rtso.ca 

Best regards, 

Sue 


Introducing Director-At-Large: 

Farzad ‘Raffi’ Refahi HBSc RRT CRE 

I graduated from York University in 2008 with a major in 

Kinesiology and minor in Psychology. After a few years of work, 

I enrolled and completed the Respiratory Therapy program at 

The Michener Institute in 2014. 

My current role at 

Markham-Stouffville 

Hospital’s PFT lab involves 

patient education, 

pulmonary function 

testing and student 

development. I also 

hold a casual position at 

Medigas,which involves 

OSA and CPAP patient 

education and care. 

Giving back and 

supporting the Respiratory 

Therapy field, as well as 

advocating for RTs, is 

important to me. These 

are also the driving force 

behind my RT blog, 

‘Respiratory Therapy By 

Farzad’ (http://Respiratory. 

Blog). 

My role as RTSO Director-at-Large is an opportunity which will 

allow me to support the passionate team and wonderful work of 

the RTSO and continue to give back to our community. 


Thank You for Your Service 

The RTSO would like to thank and acknowledge the support of these fantastic volunteers 

that have contributed to the profession and to the RTSO’s vision and mission. 

Our mission: to promote, advance and protect the interests of respiratory therapists in Ontario 

through research, professional advocacy, growth and development. We do this through 

strategic partnerships, professional collaboration and leadership. 

Our vision: The RTSO is the voice of respiratory therapists in Ontario, dedicated to providing 

the best in respiratory care and lung health for all Ontarians, one breath at a time. 

Nancy Garvey RRT MAppSc 

From bedside RRT to Manager, to playing a key role in 

the establishment of the Primary Care Asthma Program 

(PCAP) and working as a Senior Program Consultant 

with the Ministry, to Chairing the RTSO Research 

Committee and mentoring for many years, these rich 

and rewarding experiences have contributed to Nancy’s 

vast wealth of knowledge, providing networking that 

has contributed to her exceptional leadership! Even in retirement, Nancy stepped 

up and in as Interim Executive Director last year. Her forward thinking, coupled with 

her ability to establish and maintain strategic partnerships, has directly contributed 

to creating and upholding the RTSO’s mission and vision, positioning us well for the 

future! Hats off to you, Nancy! 


Thank You 

Ginny Myles RRT CRE B.HA (Hons.) 

Ginny Myles was a recognized leader advocating for and teaching 

RRTs and other health care provides smoking cessation techniques 

when she joined the RTSO Board of Directors in 2013. During her 

time on the Board, she Co-Chaired the Community RT Task Force 

with Sara Han, leading a successful advocacy initiative for primary 

care and homecare settings. During the last two years as a Director, 

Ginny made valuable contributions to the Board’s strategic plan 

and direction, supporting the RTSO’s restructuring initiative and 

furthering advocacy initiatives that will benefit RRTs across the 

province. Thank you, Ginny, for being a great example not only for 

RRT practice but also for serving the profession in a broader context as a member of the RTSO 

Board of Directors! 

Kyle Davies RRT BSc. MBA 

Kyle Davies has served on the Board of Directors for over 6 years. 

Kyle has held directorships as Leadership Committee Chair and 

2 terms as President of the Board of Directors. Kyle lead the 

initiative that launched our social media programs during his first 

term as President and chaired the RTSO Inspire Annual Education 

Conference in the past. Kyle has greatly contributed to the growth 

of the RTSO during his volunteer tenure, completing his Masters 

and following a career path in hospital Administration, pioneering 

new roles for RRTs in healthcare leadership. Thank you for your 

valuable contributions, Kyle! We wish you all the best in your future endeavors! 

Les Marsden RRT BSc. MBA 

Les Marsden has volunteered with the RTSO for 4 years and 

held different portfolios on the Board of Directors including 

Leadership Committee, Membership Committee, and last year 

was appointed to the Executive Committee to help recruit 

and hire our first Executive Director. Les is a passionate RRT 

and a developing leader in our profession. He is taking time 

to focus on completing his Masters in Administration and 

spending quality time with his growing family. Thank you for 

your service, Les! 


Thank You 

Stephen Laramee & Elisabeth Biers 

Stephen Laramee and Elisabeth Biers have been an integral part of our organization for 

the past 12 years. 

Stephen Laramee first joined us as RTSO Business Manager. He oversaw our 

organization’s growth and restructuring. Stephen’s leadership and guidance through 

his service to the RTSO has helped our association adapt and growth new membership 

programs that allowed the Board of Directors and Executive Committee to best serve 

the RRTs in Ontario and remain engaged with various healthcare stakeholders. 

Shortly after Stephen joined the RTSO, Elisabeth Biers was welcomed as the Operations 

Manager. Her portfolio include membership, administration, graphic design and 

production of RTSO Airwaves, front office communications and overseeing our social 

media and electronic communications. 

On behalf of the Board of Directors and the professional body, Rob Bryan, A-EMCA, RRT, 

AA, was pleased and privileged to award both Stephen and Elisabeth the 2018 RTSO 

President’s Award on January 26, 2018, for their outstanding contributions, tireless 

support and years of service to the RTSO and to the practice of Respiratory Therapy in 

Ontario. Thank you both so very much! 


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change or disconnection of patient for transport. 

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Flusso and Swing Valve Technology are trademarks used 

under licence by McArthur Medical Sales Inc. 

US and International Patents Pending

ONTARIO RESPIRATORY CARE SOCIETY 

RESPIRATORY THERAPY SOCIETY OF ONTARIO 

Better Breathing 2018 Conference 

Thursday, January 25 – Saturday, January 27, 2018 

Toronto Marriott Downtown Eaton Centre Hotel 

RTSO Planning Committee 

Rob Bryan RRT, AA, A-EMCA 

Shawna MacDonald RRT, FCSRT 

Nancy Garvey RRT, CAE, MAppSc 

RTSO Friday Afternoon Sessions 

Acute Care Stream 

Chaired by Sue Martin 

RRT, MA, FCSRT; RTSO Director Leadership Committee Chair 

1a. What Patients think we do: 

The Evidence-based Management ARDS Patients - 

Thomas Piraino RRT, FCSRT; Clinical Specialist, Centre of Excellence in Mechanical Ventilation, St. 

Michael’s Hospital, Toronto; Assistant Clinical Professor (Adjunct), Department of Anaesthesia, Division 

of Critical Care, McMaster University, Hamilton. 

1b. What we Really do: 

The Epidemiology of ARDS Patient Management: The LUNG SAFE Study 

Dr. Tai Pham MD, PhD; Research Fellow Critical Care Department, St. Michael’s Hospital 

2a. Gone with the Wind: 

The Challenge of Understanding Weaning Outcomes in Mechanically Ventilated Patients 

Thomas Piraino RRT, FCSRT; Clinical Specialist, Centre of Excellence in Mechanical Ventilation St. 

Michael’s Hospital, Toronto; Assistant Clinical Professor (Adjunct), Department of Anaesthesia, Division 

of Critical Care, McMaster University, Hamilton. 

2b. Come Sail Away: 

What is the WIND Study, and What Does it Mean for Future Clinical Trials 

Dr. Tai Pham MD, PhD; Research Fellow Critical Care Department, St. Michael’s Hospital 


ONTARIO RESPIRATORY CARE SOCIETY 

RESPIRATORY THERAPY SOCIETY OF ONTARIO 

Better Breathing 2018 Conference 

Thursday, January 25 – Saturday, January 27, 2018 

Toronto Marriott Downtown Eaton Centre Hotel 

RTSO Friday Afternoon Sessions 

Concurrent Sessions - Part Two 

Community Care Stream 

Chaired by Sara Han RRT, CRE, BSc,; RTSO Community Respiratory Therapy Committee Co-Chair 

1. Supporting Providers Using Quality Standards for COPD 

Sue Jones RRT, FCSRT; Quality Improvement Specialist LSSBB, Health Quality Ontario 

2. RRTs: Blazing New Trails in a Changing Health-Care System 

Ana MacPherson MASc, RRT, CRE; Clinical Coordinator, South Simcoe Northern York Region HealthLink, 

Central LHIN 

Madonna Ferrone RRT, CRE; ARGs/PCAP Coordinator Asthma Research Group Inc. 

Christina Dolgowicz BHSc, RRT, CRE; Lung Health Coordinator Lanark Renfrew Health & 

Community Services 

Followed by Poster Session & Reception 

Sponsored by The Respiratory Therapy Society of Ontario 

Chaired by Mika Nonoyama RRT, PhD; Chair Research and Fellowship Committee; Assistant Professor 

Health Sciences, University of Ontario Institute of Technology, Oshawa; Project Investigator (Respiratory 

Therapy), The Hospital for Sick Children, Toronto; Lecturer (Status Only), Department of Physical Therapy, 

University of Toronto. 


Better Breathing 2018 

The Better Breathing Conference brings together healthcare professionals from many 

disciplines, all focused on the respiratory health of the people of Ontario, including 

academic and community respirologists, nurses, respiratory therapists, physiotherapists 

and pharmacists. Over the 3 days, there were more than 270 health professionals joining 

in on engaging scientific sessions, plenary sessions and debates (http://lungontario.ca/forhealth-professionals/better-breathing-conference/). 

New this year was the Respiratory Therapy Society of Ontario (RTSO) education program 

on January 26th, featuring acute and community care streams. 

Dr. Tai Pham MD PhD and Thomas Piraino RRT FCSRT presented the WIND and LUNG SAFE 

studies and RRTs Ana MacPherson, Madonna Ferrone & Christina Dolgowicz presented 

Blazing New Trails in Changing Healthcare System. The RTSO also sponsored the ORCS/ 

RTSO poster session, followed by the RTSO Awards Ceremony, with a cocktail reception. 

We’ve included some highlights and photos from January 26th in this issue…we hope you 

enjoy the glimpse enough to join us next year! 

You can watch some great video testimonials on why you should attend Better Breathing 

at http://lungontario.ca/for-health-professionals/better-breathing-conference/videotestimonials/ 

The RTSO hopes to continue to grow this collaboration with our lung health partners 

and supporters, for years to come! Please save the date for next year’s Better Breathing 

Conference – January 24- 26, 2019 which will be held at the Toronto Marriott Downtown 

Eaton Centre. 

Mark your Calendar 

Better Breathing 2019 

January 24-26 


Better Breathing 2018 

RT TRAILBLAZERS! 

Better Breathing Presentation Summary: 

Role of the Interprofessional Team in a Health Links Approach to Care 

~submitted by Ana MacPherson, MASc, RRT, CRE, CTE 

The Ontario healthcare landscape is continuously evolving to meet the demands of our 

complex population, working on limited resources. With that, organizations’ and providers’ 

roles/responsibilities need to evolve alongside our healthcare system to better meet the 

demands. Professions need to be well equipped to meet the demands of our aging and 

growing population, and focused on hospital to home and community care. 

The Health Links approach to care focuses on the coming together of providers and health 

organizations across sectors to work as a team in partnership with patients who have 

complex needs, to provide coordinated, efficient and effective care. 

There are opportunities for the interprofessional care team to bring forward their 

expertise and to provide valuable contribution to better care for their patients. 

As RRTs with advance learning and certification such as CRE, CTE or SFI, we can leverage 

our knowledge and skills in the medically complex patients, either as chronic disease 

managers and/or care coordinators. The core competencies for Care Coordination, Case 

Management or System Navigation, as defined by Health Quality Ontario, are well within 

the RRT Scope of Practice. 

As we celebrate a milestone in the RT profession, we should also embrace the evolution 

of the RRT role and responsibilities. As RRTs, we are being recognized as key providers, 

subject matter experts and leaders in this new era of healthcare transformation. As an RRT, 

I urge you to be part of the solution! 

Ana MacPherson, MASc, RRT, CRE, CTE 

Clinical Coordinator SSNYR Health Link 

Southlake Regional Health Centre 

Email: amacpherson@southlakeregional.org 


Special Thanks our RTSO Stream 

Speakers at Better Breathing 2018! 

Thank you so much to our amazing speakers at the 

RTSO Stream of Better Breathing 2018 on Friday, January 26th 

Dr. Thomas Piraino 

RRT, FCSRT 

Sue Jones RRT FCSRT QI Specialist LSSBB, Health Quality Ontario 

Thomas Piraino is the Clinical 

Specialist – Mechanical Ventilation 

for the Centre of Excellence in 

Mechanical Ventilation at St. 

Michael’s Hospital in Toronto 

Ontario, and a Lecturer (Adjunct) 

for the Department of Anesthesia, 

Division of Critical Care at 

McMaster University. He has spoken 

internationally at various respiratory 

and critical care conferences, he 

is a published researcher and 

author on the subjects of invasive 

and noninvasive mechanical 

ventilation, and monitoring in the 

critical care environment. He is 

also a member of the Editorial 

Board of the Respiratory Care 

Journal, and the Canadian Journal 

of Respiratory Therapy. (source: 

https://criticalcarecanada.com/faculty/ 

scientific-faculty/dr-thomas-piraino/ ) 

Thomas Piraino RRT FCSRT, Clinical Specialist, Mechanical Ventilation 

Centre of Excellence, St. Michael’s Hospital Toronto (left) 

with Dr. Tai Pham MD PhD Research Fellow, Critical Care, 

St. Michael’s Hospital Toronto (right) 


Special Thanks our RTSO Stream Speakers at Better Breathing 2018! 

Dr. Tài Pham 

MD, PhD 

Tài completed his training in 

Anesthesia and Intensive Care in 

Paris. His qualifications include a 

Master of Public Health, and several 

University Degrees in the field of 

Critical Care: Infectious diseases 

in the ICU; Ultrasonic Techniques 

in Anesthesia and Intensive Care; 

Mechanical Ventilation. Tài’s 

main areas of interest comprise 

observational studies in the ICU, 

mechanical ventilation, ARDS and 

he is a member of the executive 

committee of the LUNG SAFE study 

recently published in the JAMA. He 

has worked in the Respiratory Team 

and the REVA network led by Pr 

Brochard in Paris and is currently 

both a Research Fellow in Pr 

Brochard’s laboratory and a Clinical 

Fellow in the Medical Surgical ICU 

of St Michael’s hospital in Toronto. 

He is also involved in the ECMONet 

research network. (source: https:// 

criticalcarecanada.com/faculty/ 

scientific-faculty/dr-tai-pham/ ) 

Left-to-right: Christina Dolgowicz BHSc RRT CRE, 

Madonna Ferrone RRT CRE & 

Ana MacPherson MASc RRT CRE CTE 

Sue Martin RRT MA FCSRT 

Sara Han RRT CRE BSc 

Amazing, informative presentations and great trail-blazing work! 

With gratitude to Sue Martin RRT MA FCSRT (ACUTE) and 

Sara Han RRT CRE BSc (COMMUNITY) 

for chairing these streams! 


The RTSO Pinnacle Award 

Congratulations to this years’ recipient of the Pinnacle Award: 

Madonna Ferrone RRT CRE! 

Congratulations to Madonna Ferrone RRT CRE on receiving the 

RTSO Pinnacle Award! 

Pictured above is Madonna (left) accepting the Award from 

incoming RTSO President-Elect Mike Iwanow (right) 

Madonna Ferrone RRT CRE has 

exemplified the dedication, 

leadership, and work within 

high performing health care 

teams throughout her career 

in respiratory therapy and 

particularly over the past 

ten years working for the 

Asthma Research Group Inc. 

(ARGI [R-gee]). Truly a “trailblazer”, 

she’s made significant 

contributions to defining the 

new and innovative roles for 

RRTs in primary care working 

with Dr. Chris Licskai in the 

Windsor-Essex area and across 

the province to develop and 

implement asthma, COPD, 

heart failure and atrial fibrillation 

patient self-management programs administered in an electronic point of service 

system. Working within research and quality improvement frameworks, they have 

provided evidence of significant improvements in patient and provider outcomes that 

has resulted in them receiving 

• An Ontario Minister’s Medal Honouring Excellence in Health Quality and Safety, 

Team-based Initiative/Program for their Comprehensive Regional Respiratory 

Care Program in 2013 

• A European Respiratory Society award for best primary care research paper for 

their COPD randomized controlled trial in 2016. Madonna has established 

respectful, valued interdisciplinary relationships with colleagues in primary care 

while enhancing the role and knowledge of the RRTs working with her in the 

Windsor-Essex area. She’s organized regular program update and education 

sessions for local staff, including a regularly scheduled meeting of a primary 

care lung health collaborative made up of RRT/certified respiratory educators, 


THE PINNACLE AWARD 

The Pinnacle Award is a premium award, 

awarded only to a Respiratory Therapist 

in Ontario who has contributed to the 

profession in a unique manner. 

To be considered for this award the 

following criteria must be met to qualify: 

• must be a member in good 

standing with the RTSO. 

• must hold a valid license with the 

CRTO; 

• must have shown dedication to the 

profession by: 

1. being an active member of 

the RTSO for a minimum of 10 

years; and, 

2. served either as a Director or 

Executive Member of the RTSO 

Board of Directors and/or a 

RTSO Committee Chairperson 

and/or a RTSO appointee to a 

CSRT Committee; or, 

3. organized a special function 

which benefited the Society 

in general or specific to a 

particular cause; 

• must have benefited the RTs in 

Ontario in either a: 

1. professional; and/or, 

2. educational; and/or, 

3. organizational; and/or, 

4. moral; and/or, 

5. scientific; and/or, 

6. financial manner. 

• must be nominated by a member in 

good standing with the RTSO and 

provide a written brief detailing 

the activities and rationale for 

nominating the individual; and,be 

approved by the Board of Directors 

of the RTSO. 

The Pinnacle Award 

physicians, administrators and other health 

professionals. She has established close 

strong working relationships with Lung 

Association colleagues, including her 

involvement as a Ministry funded Primary 

Care Asthma Program (PCAP) program 

coordinator in the Windsor/Essex region 

and serving as coordinator chair from 2012- 

2017. In her capacity within PCAP, she has 

worked to prevent duplication of resources 

while making valuable contributions 

to continuously improve resources and 

processes being utilized. Her ultimate goal 

and work resulting in significantly improved 

outcomes for the patients seen through the 

ARGI programs and the providers associated 

with them. 

Madonna has also facilitated the implementation 

of the ARGI programs and electronic database in 

multiple sites across the province, one project in 

particular being the Ministry of Health and Long- 

Term Care joint initiative with RX&D in the COPD 

Value Demonstrating Initiative. She’s worked with 

researchers at the Institute for Clinical Evaluative 

Sciences as well as locally with Dr. Licskai, serving 

as a model for us all in contributing to evidence 

of effectiveness and efficiency associated with 

respiratory therapists care. 

We know RRTs make a difference...and Madonna 

Ferrone serves as an example for us all as to the 

effect that difference can make! 

Madonna was nominated by Nancy Garvey RRT 

MAppSc and the nomination was supported by 

Sara HanBSc RRT CRE 

Well deserved! Congratulations, Madonna! 


The Gord Hyland 

Award 

This award was established to 

recognize Gord Hyland and all of his 

contributions to the profession of 

Respiratory Therapy. 

Gord Hyland was selected to the 

Registrar position with the College 

of Respiratory Therapy of Ontario 

(CRTO) in April 2002 at a very 

turbulent time for the Profession. 

From the beginning Gord showed true 

commitment to the profession and a 

compassion when dealing with all of 

the professional issues at the time. 

Gord worked in the health care field 

for over 30 years. He originally was 

trained as a Medical Laboratory 

Technologist, and worked at Toronto 

Western Hospital and Toronto General 

Hospital in management and research 

for 14 years. Gord also worked as the 

Assistant Director of Administration 

and Consultation in Immunology 

for the Society of Laboratory 

Technologists, as well as working for 

the College of Opticians of Ontario 

before joining the CRTO. 

Throughout Gord’s career as 

Registrar he always showed constant 

professionalism, a commitment and 

dedication to the RT profession, 

compassion and objectivity in every 

situation. Gord was a true leader, 

and his contributions will never be 

forgotten by the profession. 

ELIGIBILITY 

The candidate must be a member in 

good standing with the RTSO and 

CRTO. 

CRITERIA 

The candidate should be chosen 

for their great leadership skills, 

and should exemplify many of the 

characteristics we saw in Gord Hyland. 

The Gord Hyland Award 

Congratulation to this years’ recipient of 

the Gord Hyland Award: 

Nancy Garvey 

RRT MAppSc! 

Accepting the Award from RTSO President-Elect Mike Iwanow (left) 

on Nancy’s behalf is her son Joe Garvey (right) 

An outstanding leader dedicated to both the RTSO and the RT 

profession, we are pleased to announce that the recipient of 

this year’s Gord Hyland Award, Nancy Garvey RRT, MAppSc., 

exemplifies the spirit of this award in every way. Nancy is a 

passionate RRT who has served as a frontline clinician and RT 

department leader in a pioneering program at Peel Memorial 

Hospital (now known as William Osler, Brampton site), and she 

developed a reputation as a key figure in both RT research and 

academic communities. Nancy’s vast clinical knowledge and 

experience in Respiratory Therapy and respiratory health led 

her to a very influential and fruitful career with the MOHLTC, 

helping to shape policy and respiratory health strategy, 

touching the respiratory health of many Ontarians through this 

great work. 


The Gord Hyland Award 

Nancy began her volunteer work with the RTSO alongside Dr. Mika Nonoyama, RRT, PhD, RTSO 

Clinical Scientist, Co-Chairing the RTSO Research Committee, where this dynamic duo were 

instrumental in establishing the Terms of Reference to promote RT driven research, knowledge 

translation and evidence-based best practice initiatives. The two also worked diligently to establish 

our advanced practices bursaries and poster awards. 

After retiring from her post with the MOHLTC, Nancy, unlike most people that would have adapted 

to a life of leisure, reflected on a career full of benchmarks and accomplishments and chose to ramp 

up her volunteer role with the RTSO, focusing on growing the advocacy portfolio of the Society. 

By working closely with the RTSO Community RT Special Interest Group (SIG) and engaging 

various stakeholders, Nancy helped coordinate and establish a role description for RRTs in Primary 

Care and Family Health Teams across Ontario. She also tirelessly worked with the RT Community 

SIG on financial compensation for RRTs in Primary Care, and this work led to those RRTs receiving 

remuneration at the same level as that of peer Regulated Health Professionals. 

Nancy’s advocacy efforts include representing the RTSO at the Lung Health Act deputation for Bill 

71 with the Ministry in June 2016 as part of the Ontario Lung Health Alliance. Nancy was also a 

key architect and author of the RTSO’s Patients’ First response to the Minister of Health, which was 

received with accolades. This work opened up opportunities for the RTSO to engage face-to face 

with various Ministry stakeholders including the Deputy Minister of Health to present the role of 

RRTs in health care transformation and in the Patients’ First initiative. 

In 2017, the RTSO went through a major transformation. This included the relocation of our front 

office and realignment of many of our key operational and organizational functions and programs. 

Nancy pioneered the Executive Director (ED) role as our Interim ED, and she was instrumental in 

transitioning our new head office, critical membership programs and day-to-day operations. 

I asked Nancy why she is so dedicated and giving of her time and expertise and she simply said that 

she wanted to give back to a profession that she had benefited so much from. Inspirational words! 

This is why Nancy will always be looked upon as a true gem, cream of the RRT crop, exemplifying 

all the virtues and values we honour as a leader dedicated to the RT profession Nancy’s nomination 

was unanimously accepted and endorsed by the RTSO Board of Directors and the RTSO Executive 

Committee and was presented at Better Breathing 2018 by Dr. Mika Nonoyama, RRT, PhD. 

Congratulations, Nancy; this is well deserved! Thank you for advocating for lung health, and for all 

that you have done for the RTSO and the RT profession in Ontario! 

Rob Bryan A-EMCA, RRT AA 

RTSO Past President/Treasurer 


RTSO Student Achievement Awards 

The award recipients are selected based on the criteria and supporting evidence, as 

outlined on the nomination form. Candidates are nominated by faculty from their 

respective programs. The selection is then ratified by the RTSO Board of Directors. 

Four (4) Student Achievement Awards were presented during the RTSO Reception and 

Awards Ceremony at the Better Breathing 2018 Conference on January 26, 2018: 

Anna Enerio – Conestoga College 

Anna is a graduate of this year’s Respiratory Therapy Program at Conestoga College, 

and was nominated by both Jennifer Barton BA RRT and John Traill RRT. 

Anna demonstrates exemplary leadership and dedication to the profession. She 

has been active in the community, on Student Advisory Council and was also a Pre- 

Health tutor. She presented at the 2017 CSRT conference, and was nominated for the 

ProResp Student Award of Excellence. 

Anna’s smile, positive attitude and eagerness to learn have made her shine in the 

clinical environment. 

Congratulations, Anna! 

Amanda Rampersaud – 

Michener Institute of Education at UHN 

Amanda was nominated by Martha Williams RRT BHA CRE/CTE and the nomination 

was supported by Kathleen Olden-Powell RRT M.Ed CAE FCSRT. 

Amanda exhibited leadership capabilities by initiating a campaign for World Mental 

Health Day, volunteering with RTs Without Borders (RTWB), submitting an article for 

publication in RTSO Airwaves as well as the Sick Kids newsletter regarding her work as a 

Respiratory Technician. Amanda organized an RT social event, provided “survival tips” 

for new students, and participated in the creation of an RT Week video. 


Amanda has a 

cheerful and 

helpful demeanor, 

is a hard worker 

and shows great 

initiative and 

professional 

ambassadorship. 

Student Achievement Awards 

Congratulations, 

Amanda! 

Shirley Quach – Michener Institute of 

Education at UHN 

Shirley was nominated by Kathleen Olden-Powell RRT 

M.Ed CAE FCSRT and the nomination was supported 

by Martha Williams RRT BHA CRE/CTE. 

Shirley exhibited leadership capabilities by acting as 

Event Logistics VP for Michener’s Charity Committee, 

assisting with Multiple Mini Interviews (MMIs) for 

3 years, tutoring for Michener’s Student Success 

Network, and Shirley volunteered for a plethora of 

other RT-related events and activities. 

Shirley is committed to life-long learning and has 

embarked on an independent research project 

for which she published an abstract in CJRT, RTSO 

Airwaves, and the Ontario Public Health Association 

(OPHA), presenting at both the CSRT Educational 

Forum in Halifax (May 2017) and the OPHA’s Fall 

Forum (November 2017). 

Congratulations to all of our 

RTSO Student Achievement Award 

recipients this year! 

Pictured above from left to right: 

Shirley Quach (Michener Institute of 

Education at UHN) 

Shawna Reesor (Fanshawe College) 

RTSO out-going President, Rob Bryan 

Anna Enerio (Conestoga College) 

Amanda Rampersaud (Michener 

Institute of Education at UHN) 

Shirley continues to volunteer on the RTSO Research 

Committee and is active with various data collection 

and research projects, volunteers with RTs Without 

Borders (RTWB) and continues to mentor. 


THE Student 

Achievement 

AWARD 

Student Achievement Awards 

Shirley practices with outstanding kindness, caring 

and compassion with a positive attitude and great 

bedside manner. 

Congratulations, Shirley! 

The Respiratory Therapy Society of Ontario 

(RTSO) Student Achievement Award is 

given each year to graduating students 

from an accredited program in Respiratory 

Therapy in the Province of Ontario who have 

demonstrated outstanding professionalism 

during both their didactic and clinical 

training. The candidate must be a member 

in good standing with the RTSO. 

The award consists of an individual plaque 

and a monetary reward. 

The nominee may demonstrate 

professionalism by one or more of the 

following: 

• exhibiting leadership capabilities 

• influential in establishing a 

positive clinical environment 

• demonstrating good 

communication skills with 

colleagues and patients 

• dependable and accountable 

• acting in a manner consistent with 

established ethical standards 

• promotion of the profession of 

Respiratory Therapy through their 

involvement with the RTSO, their 

educational institution and/or 

affiliated charitable organizations 

Shawna Reesor – Fanshawe College 

Shawna was nominated by Julie C. Brown RRT 

MASc(c) FCSRT and supported by Paul Williams 

RRT, BEd, EMCA, FCSRT. 

Shawna demonstrates leadership and dedication to 

the profession through professional promotion of 

RT’s as well as lung health promotion. Shawna was 

involved with RT Week activities, Lung Association 

fundraisers and various student recruitment 

activities. 

Shawna exhibits a positive, outgoing, energetic 

personality that garnered admiration and respect 

from classmates, professors, clinical staff and 

patients alike. 

Congratulations, Shawna! 

“If you are going to achieve 

excellence in big things, you 

develop the habit in little 

matters. Excellence is not an 

exception, it is a prevailing 

attitude.” -Colin Powell 


RTSO 

Poster Presentation Abstracts 

(more may follow in our next issue, 

permissions pending) 

UTILIZATION OF THE HEALTH EQUITY IMPACT ASSESSMENT TO ENSURE EQUITABLE 

DELIVERY OF A PRIMARY CARE RESPIRATORY PROGRAM 

Sara Han, Diane Feldman and Carole Madeley, The Lung Association, 401-18 Wynford Dr. 

Toronto, ON. M3C0K8 

Background 

The Primary Care Asthma Program (PCAP) is an evidence-based, standardized program model under 

the Ministry of Health and Long-Term Care (MOHLTC) Asthma Program. The program currently includes 

standardized asthma and COPD tools through a partnership with The Lung Association – Ontario (TLA). 

PCAP is delivered within a multi-disciplinary team of providers led by a Certified Respiratory Educator 

(CRE) across Ontario. 

Health equity is the provision of healthcare with the goal of removing avoidable or remediable 

differences among groups of people 1 . PCAP partnered with the MOHLTC to conduct a needs assessment 

using the MOHLTC Health Equity Impact Assessment (HEIA) 2 . 

Brief Summary/Abstract 

Ten PCAP coordinators across Ontario completed the MOHLTC HEIA and results were compiled by the 

PCAP Provincial Coordinator. A focus group was held, facilitated by the MOHLTC and the Centre for 

Addiction and Mental Health (CAMH), to review the results and discuss how the findings can be used 

to make delivery of the program more equitable across the province. During the focus group, each 

coordinator reviewed their own assessments and heard their colleagues from across the province talk 

about their assessments. Some sites were already mitigating the impacts of the identified gaps (e.g., 

PCAP was only offered in one city, but accepting patients from another neighbouring town making it 

difficult for patients to access the clinic. The PCAP educator arranged for a policy change to travel to the 

neighbouring clinic to see those patients). The results of the HEIA that PCAP undertook were presented to 

The Lung Association – Ontario (TLA). Out of the six impacted populations identified by PCAP, TLA decided 

to develop asthma resources that addressed low literacy and language barriers. A pictorial triggers 

booklet was developed for educators to use with their patients with low literacy or English as a second 

language titled, Common Asthma Triggers: An Education Companion. An infographic depicting the impact 


Poster Presentations 

of asthma was also developed to address these barriers. Using an assessment tool such as the HEIA 

and partnering with organizations such as CAMH and the MOHLTC, PCAP was able to identify program 

gaps and look at ways to address patient’s needs by changing policy and service on a local level and 

developing tools on a provincial level. As Ontario moves towards a health care system designed around 

the patient as detailed in the Patients First Act, it will be important to continue to design and improve 

programs, policies and tools to address the social, economic, environmental and cultural determinants of 

health for the patient. 

1. World Health Association (WHO) 

2. http://www.health.gov.on.ca/en/pro/programs/heia/ 

3. http://www.lunghealthframework.ca/ 

Asthma Care Apps in the Patient’s Pocket: What does the literature report? 

Shirley Quach 

Background 

The Public Health Agency of Canada (PHAC) reports that 2/3 of Canadians diagnosed with asthma do 

not have adequate control over their symptoms which could compromise their daily activities and 

reduce their quality of life. Available therapies to control asthma require continuous motivation and 

positive reinforcement to ensure patient compliance. Currently, there are many accessible apps which 

are available and are designed to provide education and management suggestions to help individuals 

monitor their symptoms and to execute their care plan. 

Objectives 

Primary objective: To identify and summarize potential benefits and limitations of using mobile apps for 

asthma control in the current literature 

Secondary objective: To suggest and advocate for topics to be incorporated into a standardized asthma 

care app 

Methods 

PubMed, Cochrane and UT libraries databases were used to collect various studies that investigated the 

use of mobile, electronic apps or portals to administer asthma education, care and self-management. 


Poster Presentations 

Results 

Results from the literature review were conflicting; small investigational studies found positive feedback 

from patients and demonstrated improvement in asthma, and revealed that using a form of electronic 

portal, app or texting helped patients self-educate, manage and adhere to their care plan. However, 

systematic reviews that investigated the use of mobile apps to manage asthma found that there was no 

statistically significant difference in asthma control with the use of apps. 

Discussion 

Mobile apps are becoming more popular and are used as tools to monitor people’s health. The use of 

a mobile app to facilitate asthma management could take advantage of modern technology to provide 

convenient and reliable information in an engaging format. Numerous small studies have reported 

asthma care apps’ potential for management and control of symptoms. However, limitations that should 

be addressed in future app design include accessibility, literacy levels, age appropriate content. 

Asthma care apps should include up-to-date, patient friendly, well-accepted care guidelines, as well as 

features that emphasize the crucial messages of complying with care plans and highlight dangerous 

signs and symptoms. Video demonstrations and information on using medication delivery devices is also 

worth including to reinforce proper use and to provide instruction to those without access to qualified 

health care providers. The incorporation of online forums could also facilitate connections between 

patients, and with asthma care educators who may be able to quickly address patient concerns and 

questions. 

Conclusion 

There is still the lack of studies identifying and investigating a well-accepted, medically approved asthma 

care app and its effect on patients. Information consistency is a clear issue, as some apps may not be 

up-to-date or be in agreement with standardized asthma care guidelines. Proposing and advocating 

for the creation of this app is crucial as asthma continues to be poorly managed despite the available 

resources.The potential use of a peer reviewed app created by asthma care educators could be a powerful 

resource to ensure patients receive the appropriate care and education they need at home. Furthermore, 

a standardized app would allow future research investigators to systematically investigate what aspects 

affect patients’ quality of life and asthma condition most, and could facilitate trust and continued usage 

by patients with asthma and their health care providers. 


Mindfulness: 

Being Present in 

the Moment 

Kevin Middleton, 

RRT, BSc, MEd 

Kevin Middleton leads the Simulation 

and Outreach Program at McMaster 

Children’s Hospital. He is a volunteer 

facilitator within Hamilton Health 

Sciences’ Mindfulness programs offered 

through HHS’ Office of Clinical and 

Organizational Ethics. 

Mindfulness offers us an approach to our 

life and our work that can strengthen our 

resilience, boost our levels of compassion, and 

enhance our fulfillment. What is mindfulness 

you ask? Mindfulness is defined as “a mental 

state achieved by focusing one’s awareness 

on the present moment”. Simply put, 

Mindfulness involves a conscious choice to 

be present in a given a moment; to have 

your attention focused on what is actually 

happening at that moment in time. Think 

about it. In our daily life, how often are we 

multitasking? How much time do we spend 

with our thoughts occupied by the past? How 

much time do we spend with our thoughts 

planning or attempting to foresee the future? 

When we multitask, when our thoughts are 

occupied in the past or the future, we end 

up missing what is actually happening in the 

present, in the now. 

The present moment is the only time that 

actually exists. The past is called history. It does 

not exist anymore. The future does not exist 

either, as it is yet to come. When our attention 

is occupied by the past, or focused on the 

future, we end up missing the experience 

of what is happening in the present. Living 

without being present in the here-and-now 

does not go without consequences. Going 

about our lives without being present prevents 

us from truly listening to each other and 

results in miscommunication. It can deny us 

crucial understanding during an interaction 

with a patient, colleague, or loved-one. It 

can rob us of the opportunity to make real 

connections with others. It can result in errors 

and omissions. And the list goes on. 


Mindfulness: Being Present in the Moment 

Conversely, presence provides us with the opportunity to experience the joy or 

wonder that may arise in a given moment. Presence also provides us with the 

opportunity to experience the sadness or pain that may exist in a given moment. 

Ultimately, the present moment is the only period in time when we can encounter 

the full human experience and can therefore, be truly alive. 

Living our lives in the present requires conscious intent on our part. Developing our 

own capacity for mindfulness is an ongoing progression that can be strengthened 

through practise. Mindfulness practice has many different forms, from breathing 

practices to meditation practices, movement practices, and yoga. One of the most 

common mindfulness practices are breathing practices that use the breath as an 

anchor to bring your attention to the present moment. 

Focusing our attention on our breathing can be very powerful in bringing our 

awareness to the current moment. Take a deep breath and slowly exhale. What do 

you notice? Many notice that a breath can centre us, calm us, act as a “reset”, or 

perhaps even help clear our mind. Each breath that we take gives us a new moment 

to be present in. I would encourage everyone to try the following: next time you 

approach a patient or prepare to walk into a meeting, try taking one conscious 

breath before entering the room. Be curious about the effect the breath can have in 

helping you to be present and the effect that your presence has on that interaction. 

When your mind wanders from the present (which it naturally will), take a fresh, new 

breath and gently bring your awareness back to the present. When repeatedly using 

the breath as your anchor, you will build your capacity to live in the present moment. 

As Respiratory Therapists, we have all experienced the joys and rich rewards of being 

engaged in our profession. At the same time, we have experienced the physically, 

mentally, and emotionally demanding aspects of the work we do. Those in the 

helping professions are becoming increasingly aware and willing to acknowledge the 

profound affect that our work has on us. Adopting healthy strategies is necessary 

to our ability to cope, to remain resilient, to maintain compassion for both ourselves 

and others, and to continue to be personally fulfilled in our work. 

Mindfulness can strengthen our resilience, boost our levels of compassion, and 

enhance our fulfillment. Living mindfully can enrich all aspects of our lives. 

Remember to just breathe, as bringing your attention to the present can be as simple 

as a single breath! 

For more information and resources on mindfulness, please visit http://www. 

shinehhs.ca/get-healthy/be-mindful/ 


Mindfulness: Being Present in the Moment 

References 

Ellard, J. (2016). Mindful Practices: Compassion Works. Mindful, Feb 2016, p. 65-68. 

Hamilton Health Sciences Office of Clinical and Organizational Ethics (2017). 

Kabat-Zinn, J. (2013). Full Catastrophe Living: Using the Wisdom of Your Body and Mind 

to Face Stress, Pain, and Illness. New York: Bantam Books. 

Luken, M., & Sammons, A. (2016). Systematic Review of Mindfulness Practice 

for Reducing Job Burnout. American Journal Of Occupational Therapy, 70(2), 

7002250020p1. http://dx.doi.org/10.5014/ajot.2016.016956 

Mindfulness Based Stress Reduction for HHS Staff and Physicians Course Guide. Hamilton, 

ON: Hamilton Health Sciences Corporation. 

“I alone cannot change the world, 

but I can cast a stone across the 

water to create many ripples.” — 

Mother Teresa 


RT Week 

October 23-29, 2017 

Thank you for your submissions 


RT Week at 

Hamilton 

Health Sciences 

RT Week at Hamilton Health Sciences 

(HHS) has been recognized and 

celebrated for many years. Public 

displays at our community kiosks, 

hospital news announcements, daily 

“Lunch & Learns”, social activities and 

two Respiratory Therapy awards are some 

of the many highlights to this special 

week. 

Our HHS RT Educational Retreat was 

also held just before RT Week, on 

October 18th, at Carmen’s Banquet 

Centre in Hamilton, Ontario. This 

highly engaging event was organized 

by a group of volunteer staff Respiratory 

Therapists led by Kendra Mantha and 

Allison Nykolaychuk, HHS RT Education 

Clinicians. Designed with Respiratory 

Therapists in mind, the event showcases 

speakers, workshops and professional 

networking supported by healthcare 

partners and many great RT product and 

service vendors. It was a great success! 

Details regarding the 2017 HHS RT 

Annual Awards, which were presented at 

the HHS 2017 RT Educational Retreat, are 

provided below. A hearty congratulations 

to both Jennifer Lewis and Jennifer Le 

Roux on this well-deserved professional 

recognition! 


Excellence Award 

Jennifer Lewis, RRT at the Juravinski site, 

Hamilton Health Sciences (HHS) was the 

recipient of the 2017 HHS Respiratory 

Therapy Excellence Award, an award that 

celebrates an outstanding Respiratory 

Therapist who consistently demonstrates 

excellence in their role and it’s relation 

to patient care delivery and teamwork. 

Nominators provided their reflections and 

information about the nominees in the 

following domains: Clinical Excellence, 

Teaching /Education Skills, Leadership 

Skills and Professional Accomplishments. 

Below are some details from the 

interdisciplinary nomination: 

“Jennifer maintains incredible 

compassion and concern for the 

patient’s well-being and wishes. 

She is a strong advocate to ensure 

that inappropriate actions or 

procedures are not pushed upon 

patients and families. She is also 

an advocate for the opposite – to 

ensure that patients who require 

immediate or emergency attention 

receive it in a timely manner.” 


“Jennifer has embraced the new 

role at the Juravinski Hospital as 

a RACE (HHS’ adult critical care 

response team) RT. She has been 

a very strong advocate in this role 

to ensure functionality, proper 

workload, etc.” 

“Jennifer is a huge advocate 

for ventilators for non-profit 

organizations and has travelled and 

worked with International Children’s 

Heart Foundation. She organized 

the donation of ventilators to 

this same organization that were 

distributed amongst some of the 

most needed areas.” Jenn gave a 

captivating, inspiring, and educational talk 

on this great work at the 2016 HHS RT 

Educational Retreat. 



Bedside Teaching Award 

Jennifer Le Roux, RRT at the Juravinski site 

of Hamilton Health Sciences (HHS), was 

the recipient of the 2017 HHS Respiratory 

Therapy Bedside Teaching Award, an 

award that celebrates an outstanding 

Respiratory Therapist who consistently 

demonstrates educational excellence with 

Student Respiratory Therapists (SRT’s) at 

HHS. The nominators for this award are 

all SRT’s who have had clinical rotations 

through HHS. 

Sheri DiMurro (left) and Alison 

Chadwick (right), Chair and Co- 

Chair for the HHS RT Practice 

Council, present the 2017 RT 

Excellence Award to Jennifer Lewis 

(centre), on October 18, 2017 

at the HHS Respiratory Therapy 

Educational Retreat. 



Here is what was written about Jennifer 

Le Roux by a student: 

“Jennifer is by far the best 

teacher I’ve had! I’ve learned so 

much from her and she lets you try 

everything. She is constantly giving 

good feedback and ways to improve. 

With student feedback in the 

comp tracker she really takes her 

time to grade you well and leave 

a comment that will help improve. 

Even when she’s super busy or 

tired she puts herself out there 

to teach or get you to attempt 

new skills. She will literally ask 

the nurses if there are any IVs, 

injections, or anything in our skill 

set that needs to be done. Very 

much appreciated. She also builds 

up confidence for doing things on 

your own. I don’t think the other 

students at the general had the 

chance to work with her. But I 

think everyone would vote her if 

they did.” 

Allison Nykolaychuk, HHS RT 

Educator (left), presents the 2017 

RT Bedside Teaching Award to 

Jennifer Le Roux (right), on October 

18, 2017 at the HHS Respiratory 

Therapy Educational Retreat. 

“New Year’s Day. A fresh start. A new chapter in life waiting to 

be written. New questions to be asked, embraced, and loved. Answers 

to be discovered and then lived in this transformative year of delight 

and self-discovery. Today carve out a quiet interlude for yourself in 

which to dream, pen in hand. Only dreams give birth to change.” - 

Sarah Ban Breathnach 


RT Week at 

Toronto General 

Hospital 

Madeeha Chatoo RRT, 

Wincy Ng RRT, 

Martha Montano RRT 

has made a difference in their lives or 

their loved ones life. 

“RT’s are very important people 

and part of the health care 

team. They are caring and 

dependable! They should be 

respected and appreciated for 

the wonderful work that they 

do.” ~ Anonymous 

The Michener Instititute also joined us 

to showcase their programs and the 

possibilities of career advancement 

through the Continuing Education 

Program. 

This year, we hosted a 

successful poster display 

to educate the public, 

staff, and patients about 

the role of Respiratory 

Therapists. Associations 

such as The CSRT 

and RTSO provided 

informational items. We 

had approximately 80 

visitors at our booth who 

participated in a draw 

by answering a short 

questionnaire regarding 

our profession. 

Generous donations from home oxygen 

companies and respiratory equipment 

suppliers allowed prizes to be provided. 

We had a feedback/suggestion box for 

participants to write comments. It is 

always rewarding to see comments from 

staff and patients about how our role 

Left to Right: Wincy, Madeeha, Martha 

Promoting the profession during RT 

week is always a rewarding experience; 

allowing us to showcase how RT’s are 

integral members of the health care 

team. It provides us with a feeling of 

satisfaction and gratitude when we see 

staff, visitors and patients wanting to 

learn more about the profession. 


RT Week 2017 at 

The Michener Institute 

of Education at UHN 

Submitted by: 

Kathleen Olden-Powell, 

with contributions from 

Shawn Fowlds and 

Meera Sathananthan 

Before, during and after RT week 2017, The 

Michener Institute of Education was buzzing 

with RT week-related activities. Planning 

started on September19th with students 

and faculty meeting to select events to 

celebrate RT week and to select the charity 

to receive the funds raised during the week. 


RT Week 2017 at The Michener Institute of Education at UHN 

Events were kicked off with our 

Annual Stethoscope Ceremony Friday 

October 20th. Inspiring speeches 

were delivered by the RTSO’s acting 

Executive Director Nancy Garvey, as 

well as by Carole Hamp and Melanie 

Jones-Drost from the CRTO, Clement 

Hui from Respiratory Therapists 

without Borders (representing the 

charity selected for this year) and 

various Michener Leaders. Family 

members and friends of the second 

year students attended to witness the 

event, along with the first and third 

year RT students. Each second year RT 

student had their stethoscope placed 

around their neck by a faculty member 

and all RT faculty and students present 

recited the oath, which includes such 

promises as pledging commitment to 

“the care of the sick, the promotion of 

health and the service of humanity”. 

During her speech, Nancy Garvey 

announced that the CN tower would 

be lit with the colours of the RTSO for 

one night during RT week and some of 

the students went out and took photos 

on the night to commemorate this 

recognition. 

RTSO Interim Executive Director, Nancy Garvey 

RRT MAppSc, addresses the audience at the 

Stethoscope Ceremony. 

The formal part of the 

Ceremony finished with the 

premiere showing of the 

RT week video prepared by 

the first and second year RT 

students. The video, titled 

“The Patient Experience” 

followed a patient requiring 



emergency surgery and his recovery 

guided at every step by an RT. The 

patient completed his journey with 

enrolling in Michener’s RT program. 

The video was shot using GoPro 

technology which added to it’s “I’m 

there with the patient” feeling. For 

anyone who needs a moment of 

inspiration, watch the video: it is 

amazing! The “outakes” shown as the 

end add to the entertainment factor: 

https://www.youtube.com/watch?v=g1Qr 

9rysAoA&feature=youtu.be 

The CN Tower was lit for one night 

with the colours of the RTSO. 

The 90-second version of this video was 

submitted to the CSRT Video Contest, 

and the extended 5-minute version 

was shown on loop via the giant lobby 

screen for all of RT week. 

At the end of 

the stethoscope 

ceremony, second 

year student Chelsea 

Mott received an 

e-mail message 

from the Office of 

Toronto’s Mayor, John 

Tory. The message 

confirmed that the 

application written 

by Chelsea and her 

classmate Thanushan 

Vinayagathevarajah 

to officially declare 

RT week had been 

accepted. We 

jumped for joy! The 

declaration was 

posted, along with the 



video and Tweets related to 

RT week on the giant screen 

in the Lobby. 

Since all three years of 

students were at Michener 

on October 20th, a Pub 

Night was organized for that 

evening. Students from all 

three years classes met and 

mingled at the Prenup pub. 

Second year student Chelsea Mott 

received an e-mail message from the 

Office of Toronto’s Mayor, John Tory 



A bake sale was held on Monday, 

Tuesday and Wednesday of RT week 

in Michener’s lobby. Second-year 

students Amanda Bundoc and Meera 

Sathananthan hand-crafted a beautiful 

poster advertising the event. Respiratory 

Therapy faculty and students from all 

three years baked treats that were sold in 



the lobby, as well as on the RT Treats 

Trollies which were toured floor to 

floor selling homemade baked goods 

to faculty and students around the 

school who were unable to visit 

lobby. Students donned aprons for 

the event and all treats were labeled 

and had ingredient lists attached to 

allow people to choose a treat that 

didn’t interfere with their allergies or 

food sensitivities. First year student 

Shannon Smith designed “I Support 

RT Week” stickers, which were given 

to each person who purchased 

treats. It was heartwarming to 

see students and faculty from other 

programs wearing the stickers 

around the school with pride. 

Approximately $800 was raised 

for RTs without Borders. 

On Tuesday October 24th an 

Information Booth shared the 

lobby with the bake sale to 

encourage students, faculty 

and visitors to the school to 

engage in a discussion about 

respiratory health. 

RT Week Bake Sale 

Wednesday October 25th was 

the date of the 10th annual 

RT Olympics. Four teams with 

the clever names of “Better 

Than The Resp”, “We Be Lung 

Together”, “Heart Throbbers” 

and “He/She Who Shall Not Be 

Named” were each composed 

of two first year and two 

second year RT students. The 

sequence of tasks was timed 



Above and right: 

10th annual RT Olympics 

to determine the winner and 

students could not progress 

to the next task until they had 

successfully completed the 

current one. This event, held 

in the Michener gym, drew a 

crowd of cheering faculty and 

students. Many of the students 

were wearing their new RT 

week T-shirts, purchased from 

our RT colleagues at SickKids. 

RT Week pancake breakfast 

Thursday October 26th 

was the day of the RT Week 

pancake breakfast in the 

Michener cafeteria. Students 

and faculty arrived very early 

to set up and start food 

preparation. The pancake 

station was decorated with 

posters advertising the 



sale and students 

wearing signs were 

strategically posted 

in the building to 

direct hungry staff 

and students to the 

pancake-making 

station where 

strawberries, Nutella, 

whipped cream 

and other yummy 

items were added 

to custom-made 

concoctions. 

At the CSRT conference in May 2017, 

third year student Richa Shah heard 

Evan Richards’ inspiring “RT Heroes” 

talk and she asked if he’d be willing 

to speak at Michener during RT week. 

He graciously accepted the invitation 

and we were delighted that he was 

willing to speak twice: once to the 

“Word of the day” 

first year students and once to the 

second year students during their 

lunch breaks on Thursday, October 



26th. Third year students who are out in 

their Clinical Placements were invited to 

attend as well. The RT students teamed up 

with Michener’s Charity Committee who 

were hosting a food drive that same week 

to assist Covenant House in Toronto, a 

shelter with community outreach to youth 

and young adults. Recognizing that food 

insecurity contributes negatively to the 

Social Determinants of Health, RT students 

and staff and contributed 

259 food items. 

Throughout the week, 

funds were raised with the 

“Word of the Week” and 

the “Word of the day”. 

Anyone caught uttering 

these words needed to 

add money to the fund 

for their error. Words used 

were specific to our world hence likely to be 

said. 

Difficult Airway 

Simulations 

In October of 2016, Michener was 

approached by the educational organizer 

for CHEST (the annual conference of the 

American College of Chest Physicians) 

indicating that the 

conference would be 

held in Toronto in 2017 

and that they were very 

keen to have RT student 

and faculty involvement. 

On Saturday, October 

28th CHEST hosted 

a difficult airway 

simulation session for 



36 of our second and third year RT 

students. The simulation was lead 

by Kevin Doerschug, Bernard Roth, 

David Bell, David Bowton, William 

Enfinger, Roy Ridgeway, Neala Cline, 

and Katherine Simonson and normally 

would have been an extra fee to 

conference registrants but the fee was 

waived. The full conference opened 

officially on Sunday October 29th and 

finished on Wednesday November 

1st. All faculty, second and third 

year students had the opportunity to 

attend the conference and registration 

was waived (a savings of $550.00 to 

each person who attended). Third 

year student Sam Gennidakis wrote 

this inspiring blog post describing 

the conference: http://blog.michener. 

ca/simulation-virtual-patient-toursand-interactive-learning-professionaldevelopment-for-the-student-rt-at-the- 

2017-chest-conference/ 

RT week continued into the following 

week with attendance at CHEST and 

also with a Dodgeball tournament on 

Wednesday November 1st. 

Participants were charged a small 

entrance fee which went towards the 

fundraising for RTs Without Borders. 

We are very fortunate to have 

the support of our Facilities staff, 

Cafeteria staff, Communications 

Associate Brianne Tulk and 

Photographers Tim Chipman and 

Alex DeOliveira. Their efforts help to 

make RT week at Michener possible. 

Additional photos: Alannah Beresh, 

Anna Edinger, Sam Gennidakis, 

Natty Liu and Richard Schuch. 


For Better 

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Outcomes 

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RT’s for Respiratory 

Needs Since 1990 

Over 100 clinics across Canada 

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Sleep Health Commitment TM to ensure 

long term CPAP compliance 

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Thinking about 

your career? 

ACHIEVE your 

potential with us!

We are pleased to share this update on the work supported by the Patients First Act, 2016, 

as we work together toward transforming the health care system. You can count on regular 

emails like this as your source of ongoing information and updates, which can also be 

shared with staff members, local and other stakeholders, and colleagues. 

Transforming Home Care - Levels of Care Expert Panel Report 

For this issue of Health System Integration Update, we are spotlighting the Levels of Care 

Framework, which is part of the ongoing transformation of our health care system to 

increase access, equity, integration, and improve patient experience. 

The Levels of Care Framework is the foundation of our transformation of home care, a tool 

that will improve consistency, transparency, support a real partnership with the client and 

caregiver and promote coordination between home care and other sectors. 

The Levels of Care Framework is one of the ten commitments of Patients First: A Roadmap 

to Strengthen Home and Community Care. The vision is to enable people to maximize their 

independence and thrive in their own homes and communities by understanding “what 

can I expect for me or my loved one?” Home and community care patients will be assessed 

into one of the Framework levels and their plans of service for personal support will be 

based on the client’s unmet care needs, taking into account their support from family and 

friends and other considerations such as medical conditions. As a patient’s and caregiver’s 

needs change, they may remain in a level but have their plans of service adjusted or they 

may be assessed into a different level with updated plans of service. 

The Levels of Care Expert Panel, co-chaired by Irfan Dhalla of Health Quality Ontario and 

Dipti Purbhoo of the Toronto Central Local Health Integration Network (LHIN) (formerly 

the Community Care Access Centre), was asked to provide evidence-informed policy 

recommendations and operational advice on this priority initiative. To reflect the linkages 

between home care and primary care, the panel included people who receive home and 

community care, caregivers, care coordinators, service providers, physicians and nurse 


MOHLTC - Transforming Home Care - Levels of Care Expert Panel Report 

practitioners. In addition, it included researchers, and experts in evaluation and quality 

improvement. 

The panel was asked to focus on issues related to clients’ placement into particular levels 

of support based on need, and consistent service allocation across the province. Their 

report was released this fall: http://health.gov.on.ca/en/public/programs/lhin/docs/loc_ 

report_2017.pdf 

Recommendations included: 

A seven-level framework to help assess the functional needs of adults who need home and 

community care services for a longer period of time and their caregivers and support the 

development of their plans of service. 

A more client- and caregiver-centred, consistent and effective assessment process. 

Improved information sharing and communication between home care, community 

services, primary care and acute care. 

A public website so that Ontarians will know the type and amount of support they may 

expect to receive based on their needs. 

Over the coming months, the ministry will work with LHINs and Health Shared Services 

Ontario to engage clients, caregivers and delivery partners to develop an implementation 

plan to roll out the Levels of Care Framework. 

Stay in Touch 

We value your feedback and want to provide you with the information you need. If you 

have questions or comments or would like to join our email list, please send an email to 

patientsfirst@ontario.ca. 

You can find this update archived at http://health.gov.on.ca/en/news/bulletin/2017/ 

hb_20170127_26.aspx and some Frequently Asked Questions at http://www.health.gov. 

on.ca/en/news/bulletin/2016/hb_20161207_faq.aspx. 






French Language Health Services Forum 2017 

A French Language Health Services (FLHS) Forum was hosted by the Ministry of Health and 

Long-Term Care (MOHLTC) on November 15, 2017. The Minister of Health and Long-Term 

Care (Minister) reinforced Ontario’s commitment to do more for Francophone populations 

who face challenges in obtaining health services in French. 

The over 100 participants included leaders of all Local Health Integration Networks (LHINs) 

and French Language Health Planning Entities (Entities),‎ as well as members from the 

French Language Health Services Advisory Council (FLHSAC). Dr. Eric Hoskins, Minister 

of Health and Long-Term Care, the FLS Commissioner, the Deputy Ministers of MOHLTC 

and of Francophone Affairs, and the Chair of the FLHSAC also provided opening remarks 

congratulating the LHINs, and Entities on the progress achieved to date and encouraging 

participants to build on their success to continue advancing FLHS across the province. 

Key highlights from the Forum include: 

The formal launch of the Guide to Requirements and Obligations Relating to French 

Language Health Services (http://www.health.gov.on.ca/fr/public/programs/flhs/highlights. 

aspx ) to help strengthen health system performance and accountability. 

• The commencement of an FLHS data collection project across all 14 LHINs in 

November 2017, led by Le Réseau des Services de Santé en français de l’Est de 

l’Ontario. 

• The launch of a FLHS Working Group to assess FLHS capacity, identify FLHS 

indicators, and develop recommendations for amendments to the LHIN-Entity 

Funding and Accountability Agreement to ensure alignment with current 

legislative and regulatory requirements. 

• The Minister committed that the ministry would host the Forum annually. 


MOHLTC - French Language Health Services Forum 2017 

The Forum provided participants with an overview of recent progress achieved by the 

FLHS project team and ministry including: 

• Amendments to O. Regulation 515/09: Engagement with the Francophone 

Community, clarifying the collaborative consultation, planning and reporting 

obligations of the LHINs and the Entities; and 

• A range of FLHS data collection and indicator development initiatives underway to 

support planning for FLHS at the LHIN and sub-regional level. 

Overall, the day was informative, productive, and positive. Participants had the 

opportunity to engage in constructive discussions about improving LHIN-Entity 

collaboration at the local level to support improved access to FLHS. Many expressed 

satisfaction with the recent progress in advancing the framework for FLHS and their 

support for more regional initiatives by the LHINs and Entities to enhance local access for 

Francophones to French language health services. 

For additional information about the FLHS Forum and its outcomes, please contact 

Alexandra Magistretti at Alexandra.Magistretti@ontario.ca. 

Congratulations to the Association of Family Health Teams of Ontario 

(AFHTO)’s Bright Lights 2017 Award Winners (October 2017)! 



West Durham Family Health Team 

Award category: Effective Leadership and Governance for System Transformation 

Achievement: Leadership is not a title –Taking a proactive approach to change, adopting 

processes to ensure their leadership is skills-based, patient-centred and inclusive. 

Belleville Nurse Practitioner-Led Clinic 

Award category: Planning Programs for Equitable Access to Care 

Achievement: Primary Care Low Back Pain Pilot – Successfully implementing a new 

interprofessional approach to managing low back pain. This improved patient outcomes 

with less reliance on medications and fewer ER visits, and fortified collaboration both 

within the team and with other organizations. 

Leamington and Area Family Health Team 

Award category: Employing and Empowering the Patient and Caregiver Perspective 

Achievement: Changing the Culture Around Advance Care Planning – Breaking taboos 

through an education program for patients, caregivers, families and the community, 

destigmatizing conversations around end-of-life care. 

St. Michael’s Hospital Academic Family Health Team 

Award category: Strengthening Partnerships 

Achievement: Health Justice Initiative– Implemented a multilevel program to address legal 

issues that present a barrier to better health, including providing onsite legal assistance for 

patients, educating staff and undertaking advocacy at the system level. 

eHealth Centre of Excellence, Centre for Family Medicine Family Health Team 

Award category: Optimizing Use of Resources 

Achievement: Coordinated Access to All Services – Demonstrating leadership in digital 

health through the development and spread of a system wide coordinated approach to 

access to a wide variety of care and services. 

Thamesview, Tilbury District and Chatham Kent Family Health Teams 

Award category: Using Data to Demonstrate Value and Improve Quality of Care 

Achievement: Primary Care Impact on an Integrated Case Management Model for the 

Frequent User – Adopted an integrated case management model that improved the 

healthcare experience of individual patients with complex needs, simultaneously reducing 

ER visits and hospital admissions. 

North York Family Team 

Award category: Clinical Innovations for Specific Populations 

Page RTSO 37 Airwaves - Autumn 2017 RTSO Airwaves - Autumn Page 2017 36 



Achievement: Multidisciplinary Approach To De-prescribe Sedative Hypnotics In The 

Elderly - Introduced a two-stage, inter-professional insomnia reduction program for older 

adults, resulting in improved mood and sleep quality, reduced anxiety and lower drug use. 

Stay in Touch 







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Clinical Leadership at the LHINs 

For this issue of Health System Integration Update, we are spotlighting Clinical 

Leadership in Ontario’s Local Health Integration Networks (LHINs), part of the ongoing 

transformation of our health care system to increase access, equity and integration, 

and improve patient experience. 

Transforming any complex system requires strong leadership at all levels. Ontario 

has world-class leaders in the areas of health system research, in quality and safety, 

in population and public health, community and social services, and in a variety of 

clinical domains. Our health care system would not be what it is today without strong 

leadership working every day to improve the health of Ontarians and the health care 

they receive now and in the future. 

Enabled through the Patients First Act, 2016, Ontario’s LHINs are well positioned to 

leverage their expertise, partnerships, and understanding of the unique needs of 

their regions to better integrate local health care services and coordinate care in a 

way that better serves patients. One example is cultivating local clinical leadership. 

Clinical leadership, embedded within the LHIN structure, will help ensure clinical 

expertise is integrated into local planning and priority setting activities, alongside the 

voices of patients, caregivers and local health care partners. Clinical leaders can share 

the realities of clinical practice and provide advice on quality and safety and change 

management needs to develop improvement initiatives. 

Over the past several months, Ontario’s LHINs have been actively developing teams 

to help them achieve their expanded mandate, including the recruitment of LHIN 

Clinical Leads. A LHIN Clinical Lead could be a physician or nurse practitioner who 


MOHLTC - Clinical Leadership at the LHINs 

maintains clinical practice in Ontario and who, during their time with the LHIN, works 

with health care planners and decision-makers to ensure the clinical perspective is 

captured in local planning. Their role is to engage with other clinicians to help to 

advance local improvement initiatives and to ensure these initiatives are grounded in 

the realities of clinical practice and quality patient care. 

To date, more than 120 LHIN Clinical Leads have been recruited and are working at 

the sub-region, LHIN and provincial levels to spearhead system and practice level 

improvement activities. It is an impressive and diverse group with backgrounds in 

leading provincial organizations, hospitals or hospital departments, academia and 

research; all of whom are practicing physicians or nurse practitioners. Already we are 

seeing the benefits of broadened clinical leadership capacity regionally and locally, 

including: 

• Sub-region clinical leads are convening local tables of providers to co-design 

equity-based models to improve access to inter-professional, team-based 

primary care with close connections to home and community care and 

mental health and addictions. 

• Emergency and critical care clinical leads are developing regional surge plans 

and leading the response to local emergency or critical care needs. 

• Primary care clinical leads are assessing local primary care service capacity to 

address current and future challenges in primary care access and working to 

advance access to specialist strategies. 

• Executive-level clinical leaders are integrating clinical engagement activities 

into cohesive engagement plans and strategies to improve the coordination 

of local palliative care, primary care, home care and others. 

Stay in Touch 








OHIP+ Update from the Ministry of Health and Long-Term Care: 

Valved Holding Chambers 

On January 1, 2018, the Ontario government was pleased to announce the launch of 

OHIP+: Children and Youth Pharmacare. OHIP+ will benefit all Ontario families and 

young people aged 24 years and under by providing access to over 4,400 eligible 

prescription drug products funded through the Ontario Drug Benefit program. 

Update: Valved Holding Chambers 

Valved holding chambers (VHCs) are used in conjunction with metered-dose inhalers 

to deliver inhaled asthma medications. A VHC includes a one-way valve at the 

mouthpiece. This device traps and holds the aerosolized medication, which improves 

drug delivery by allowing the patient to take slow, deep breaths to inhale the full 

medication dose. The one-way valve prevents patients from accidentally exhaling into 

the tube. 

Effective January 1, 2018, Ontario will publicly fund select VHCs through the Ontario 

Drug Benefit (ODB) program. All ODB recipients aged 12 years and under with 

a valid prescription from a physician or nurse practitioner are eligible to receive an 

ODB-funded VHC. Eligible ODB recipients will be entitled to receive one (1) VHC (with 

or without mask/mouthpiece) per 365-day period. 

The following table outlines eligible ODB funded VHCs. 

Description 

AeroChamber Plus Flow-Vu Anti-Static Valved Holding Chamber 

Infant Small Mask 


Child Medium Mask 


Youth Mouthpiece 


Girls Mouthpiece 

Manufacturer 

Trudell Medical International 





OHIP+ Update from the Ministry of Health and Long-Term Care: Valved Holding Chambers 

Description 


Adult Mouthpiece 


Adult Small Mask 


Adult Large Mask 

A2A Aerosol to Airways Spacer 

A2A Spacer with Small Mask 

A2A Spacer with Medium Mask 

InspiraChamber 

InspiraChamber + Mask Small 

InspiraChamber + Mask Medium 

InspiraChamber + Mask Large 

Optichamber Diamond Valved Holding Chamber 

Optichamber Diamond Valved Holding Chamber + Small Mask 

Optichamber Diamond Valved Holding Chamber + Medium 

Mask 

Optichamber Diamond Chamber + Large Mask 

Manufacturer 




Clement Clarke International 

Limited 


Limited 


Limited 

INSPIRX INC. 

INSPIRX INC. 

INSPIRX INC. 

INSPIRX INC. 

Respironics Respiratory Drug 

Delivery (UK) LTD. 







Additional Information: 

See the Notice from the Executive Officer: Funding Valved Holding Chambers through 

the Ontario Drug Benefit Program (http://www.health.gov.on.ca/en/pro/programs/drugs/ 

opdp_eo/notices/exec_office_20171221.pdf) 

For pharmacies: 

Please call ODB Pharmacy Help Desk at: 1-800-668-6641 

For all other Health Care Providers and the Public: 

Please call ServiceOntario, Infoline at 1-866-532-3161 TTY 1-800-387-5559. 

In Toronto, TTY 416-327-4282 


ON 

FORMULARY 

all provinces and territories 

(except BC) 

Special authorization 

OFEV has been shown to: 2 

SLOW FVC decline 

REDUCE acute exacerbations * 

OFEV significantly reduced the annual rate 

of decline in FVC over 1 year vs. placebo 2 

OFEV FVC -113.6 mL/year 

placebo FVC -223.5 mL/year 

Difference: 109.9 mL/year (p

Clinical use: 

Should not be used in patients under 18 years of age. 

Contraindications: 

• Patients with known hypersensitivity to peanut or soya 

• Pregnancy 

Most serious warnings and precautions: 

Gastrointestinal perforations: Cases reported in clinical studies and postmarketing 

period; many post-marketing events were serious and some 

have resulted in fatal outcomes. Use OFEV in patients with a known risk 

of gastrointestinal perforation only if the anticipated benefit outweighs 

the potential risk. Permanently discontinue OFEV in patients who develop 

gastrointestinal perforation. 

Hemorrhage: Serious and fatal bleeding events reported in clinical trials 

and post-marketing surveillance systems. Use OFEV in patients with known 

risk of bleeding only if the anticipated benefit outweighs the potential risk. 

Other relevant warnings and precautions: 

• Risk of diarrhea, nausea and vomiting 

• Risk of weight loss; monitor weight 

• Should be taken with food 

• Use caution when treating patients with higher cardiovascular risk 

including known coronary artery disease 

• Not recommended in patients with moderate or severe hepatic impairment 

• Drug-induced liver injury 

• Liver enzyme elevations 

• Measure systemic blood pressure, hepatic transaminase and bilirubin levels 

before initiating treatment and periodically after as clinically indicated 

• Based on mechanism of action: potential for increased risk of 

thromboembolic events and impaired wound healing 

• Women: use adequate contraception during OFEV treatment and for at 

least 3 months after the last dose of OFEV 

• Not recommended for use in nursing women or in children and adolescents 

• Safety data for black patients are limited 

For more information: 

Please consult the Product Monograph at www.boehringer-ingelheim. ca/ 

sites/ca/files/documents/ofevpmen.pdf for important information relating 

to adverse reactions, drug interactions and dosing information which have 

not been discussed in this piece. 

The Product Monograph is also available by calling 1-800-263-5103 x 84633. 

References: 1. Raghu G, et al. An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline: Treatment of 

Idiopathic Pulmonary Fibrosis: An Update of the 2011 Clinical Practice Guideline. Am J Respir Crit Care 

Med 2015;192:e3-e19. 2. OFEV® (nintedanib) Product Monograph. Boehringer Ingelheim (Canada) Ltd., 

October 24, 2017. 

© 2018 Boehringer Ingelheim (Canada) Ltd. All rights reserved. 

OFEV® is a registered trademark of Boehringer 

Ingelheim International GmbH, used under license. 

RTSO 

POWER IN IPF TREATMENT 

TBIIPF 20148E PI S03.indd 1 

2/5/18 4:46 PM 

“Nothing great was ever achieved without 

enthusiasm.” -Ralph Waldo Emerson 


Management’s 

Corner 

Lucy Bonanno, RRT, MA, 

MBA, CAE, CHE, 

Chief Executive Officer 

Geraldton District 

Hospital 

“Be kind whenever 

possible. It is 

always possible.” 

~ Dalai Lama 

I was reading a really interesting article last week on 

personality traits and how they can either hinder your 

movement to management or they can fast track you to 

management. What I found intriguing is that, it really 

depends on what those traits are and how you use them 

in a professional setting. Thus, this is more of a summary 

of what I read, in my own words, that I think the reader 

will find interesting. 

Your Personality in the Workplace – 

Friend or Foe? 

It’s the one element we all have, and we take it with us 

everywhere we go, be it workplace or our private lives. 

Our personality! Some studies suggest we are born 

with specific traits (genetic predisposition) and others 

say our personality develops given our environment 

and how we are raised. While I am not a psychologist, 

nor have I studied this in any depth, just from my 

own life experience; I believe it’s both. Genetics are 

more powerful than what I feel science is even aware, 

yet, I also feel that the environment one is in, as a 

child, during those very sensitive developmental years 

from ages 1 to 10, how we are treated and what we 

experience also forms part of our personality. 

When we begin to think about what it takes to succeed 

at work, at any job, we tend to focus on traits such as 

intelligence, ambition levels, learning, and our ability to 

form relationships, also known as social skills. While these 

seem to be strengths, if not put into check, they can lead 

us into the destruction of our careers. You might ask, but 

how can that be, after all, aren’t they all strengths? 

This is true, however, in a study completed 20 years ago 

by husband and wife psychologists, Robert and Joyce 

Hogan, where they profiled hundreds of thousands of 

participants, be it front line employees, managers and 

leaders of various business sectors, it was found that 

when positive traits are taken to extremes, they actually 

hinder if not hurt, your professional life. 


They were able to identify 11 personality traits as ‘dark side traits’…traits that if not 

identified by the individual themselves, allowing for the person to turn them around 

to be a positive force for them, then these traits could actually wreak havoc in their 

work life. They divided these traits into 3 clusters. 

I have inserted the chart form, due to space challenges, to help summarize. Hopefully, 

it can help you identify if you might have some of them. I must confess I hit on a few 

of these and I found it quite eye opening. Remember to be open-minded when you 

read it and to be honest with yourself. 

Dark Traits, Defined 

Traits Definition Upside Downside 

Cluster 1: Distancing Traits 

Excitable 

Skeptical 

Cautious 

Reserved 

Leisurely 

Bold 

Mischievous 

Colourful 

moody, 

hard to please, 

emotional 

distrustful, sensitive to 

criticism, 

focused on negatives 

resistant to change, 

slow to make decisions 

aloof, indifferent to 

others 

overly cooperative 

but privately irritable, 

stubborn 

passionate, 

enthusiasm 

hard to fool 

careful, Precise 

stoic, calm 

relaxed, easygoing on 

the outside 

Cluster 2: Seductive Traits 

overly self-confident, 

entitled, inflated sense 

of self-worth 

risk-taking, 

excitement-seeking 

dramatic, 

doesn’t listen, 

attention seeking 

assertive, 

filled with conviction 

risk-tolerant, 

charmingly persuasive 

entertaining, 

expressive 

Imaginative eccentric ways creative, 

visionary 

Cluster 3: Ingratiating Traits 

Diligent 

Dutiful 

meticulous, 

detail-oriented 

eager to please, 

reluctant to act 

independently 

Management’s Corner 

hardworking, 

high standards 

compliant, loyal 

Source: “Dealing with the Dark Side”, by Rob Kaiser (Talent Quarterly, 2016) 

outbursts, 

volatility 

mistrustful, 

quarrelsome 

indecisive, 

risk-averse 

insensitive, 

uncommunicative 

passive-aggressive, 

driven by own personal 

agenda 

arrogant, grandiose 

impulsive, manipulative 

socially obtuse 

needs constant 

change, wacky 

perfectionistic, 

micromanaging 

submissive, 

conflict –averse 


Management’s Corner 

Apparently, through self-awareness and persistence, one can tame some of these so 

called dark traits (which I suspect, we all have). Also, research suggests that over the 

age of 30, to change the core aspects of one’s personality is very difficult. With high 

emotional intelligence and diligent goal setting, we are able to make some changes 

that will serve us well in the workplace. 

In closing, I will just say, career advancement is a function of how others see you. 

Unfortunately, even small slips, for example, responding impulsively to unpleasant 

emails – will cause significant damage to your reputation. If you’re having a bad 

day…. go for a walk, clear your mind, take a breather, but do not react negatively or 

over-react. And most importantly, don’t react with anger or rudeness. It never does 

anyone any good by being rude to another person. 

However, I will say, if I ever come across a few people in my past that were horrific to 

me, which was not deserved as they jumped to conclusions, I will politely tell them a 

few things I would rather not repeat here! 

A zoology teacher asks the class 

“What is the one animal in the jungle 

that a lion is afraid of?” 

The class answers: a lioness. 

~ Anonymous 


Dear aRTee, 

I made it through school and 

graduated, wrote the CBRC 

successfully, but I still cannot 

find a job. I think maybe 

I need to up my interview 

game. Do you have any 

advice? 

Unhappily Unemployed 

Dear Unemployed, 

Employers today are looking to see enthusiastic, engaged professionals. Show 

them your critical thinking and interpersonal skills. Demonstrate your empathy and 

compassion for patients, along with your curiosity, work ethic, team fit and passion 

for the profession. For this, you need to know yourself and what it is about you that 

makes you an ideal candidate for the position you are interviewing for. What are your 

strengths and assets, knowledge and skill set, weaknesses and improvement plan? For 

this, it is important to complete some self-reflection. 

Think about the following: 

• What are your strengths and what will they bring to the job? 

• What do you have to offer your future employer? 

• Do you have any short-term and long-term career goals? 

• To what level are you engaged in professional growth, development or advocacy? 

• How have others experienced you? (Think about preceptors, clinical instructors 

and any previous co-workers. Think about your clinical rotations and how you 

performed there. Also think about your online profile and what is “says” about you, 

and clean it up if you need to!) 

• What do you know about the organization that is hosting your interview? 

• How do you handle stressful or difficult situations? 

• What is your greatest weakness, and what are you doing to improve it? 

• It also helps to prepare some insightful questions for the interview. This 

demonstrates you have a true interest in the job and it also provides you with the 

opportunity to find out if this position is the right fit for you. 


Ask aRTee 

“Proper planning and preparation prevents 

poor performance.” ~ Stephen Keague 

Be sure to dress professionally…business casual is usually suitable. Avoid wearing 

heavy scents. Ensure you arrive 5-10 minutes early and be fully prepared for your 

interview, bringing extra resumes and copies of your references. 

Silence your phone or shut it off. 

Once you are called in, give a firm handshake and make eye contact, smile and politely 

introduce yourself. Be enthusiastic and confident. 

During the interview, be mindful not only of your choice of words, but of your body 

language and tone of voice, avoiding inappropriate language, bad manners and bad 

attitude! Answer the questions as best as you can. If you are asked a question about a 

negative experience or to share an experience where an error was made, be open and 

honest, sharing how or what you learned from that situation or experience. 

When the interview concludes, close with a statement that reiterates your fit, abilities 

and interests. Follow up within 24 hours with a thank you note or an email, and 

check back in on hiring status after the discussed timeline if this was discussed in the 

interview. 

“Choose a job you love and you will never have 

to work a day in your life.” ~ Confucius 

Good luck to you! May you be confident and shine! 


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©Copyright 2017, Praxair Technology, Inc. All rights reserved.

Airwaves Winter 2018

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