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1Building Healthier Communities Accreditation Highlights • May 2011

Building Healthier Communities

Accreditation HighlightsMay 18, 2011


Welcome to the biannual 2011 edition of Building Healthier Communities, Horizon Health Network’s (Horizon) community newsletter which highlights events and services from Atlantic Canada’s largest health-care organization.

We are pleased to dedicate this edition of our newsletter to highlight and celebrate our recent accomplishment of receiving accreditation status from Accreditation Canada. Accreditation is a voluntary, national survey program for assessing health-care organizations against pre-determined standards of excellence.

As an open organization we are proud to share our successes related to the survey as well as our challenges. We will use the survey results to continue to make ongoing improvements to the services we provide to our patients and clients.

This was the first accreditation survey for Horizon since the organization was formed, and accreditation status is not granted lightly. We believe this accomplishment as such a young organization demonstrates how far we have come in such a short time.

The successful outcome of Accreditation 2010 illustrates the stellar job of our staff and physicians to overcome those challenges.

The Survey

In September, 16 surveyors from across Canada visited 30 Horizon sites over the course of six days. During that time, they evaluated 2,983 separate criteria for accreditation and we met 2,804 of those criteria, an outstanding result of 94 per cent.

There was also a separate survey completed of Horizon’s laboratory services. The surveyors praised the laboratory’s professional, dedicated and well-trained personnel, as well as their outstanding physical environments, and safety and quality management programs.

Of particular note was the surveyors’ recognition of the organization’s sound fiscal direction and the significant involvement of the medical staff in providing valuable input to policy and program development.

As with any accreditation process, Horizon was provided with recommendations for addressing our challenges and becoming an even better provider of patient care. The surveyors’ recommendations related primarily to patient safety and ensuring that our existing practices are implemented consistently across Horizon.

It is with great pride that we present to you our achievements in quality patient care. Some of the information contained within the report is clinical in nature. We have endeavoured to summarize these complex processes so our patients, families and communities have an understanding of how we are always trying to improve.

Our success as an organization is due to the dedication, commitment and excellent teamwork of our staff, physicians, Foundations, Auxiliaries, Alumnae and community partners who provide and support the best possible patient care to New Brunswickers.

Message from CEO & Board Chair

David Ferguson Board Chair

Donald J. Peters, P. Eng

President and CEO


Horizon received accolades for eight leading practices, which demonstrates our organization

as a national leader in health care.

The leading practices outlined in Accreditation Canada’s report are:

1. Horizon’s Research Ethics Board

2. Miramichi Public Health’s Baby-Friendly Initiative

3. Saint John’s Addiction and Mental Health’s process review following client suicide

4. Moncton area’s Medication Care Plan Manager software program for reconciling patient medication at discharge

5. Moncton area’s physician consult project

6. Fredericton’s Obstetrics/Perinatal Care Services’ home phototherapy service

7. Fredericton’s Cancer Care and Oncology Services’ clinical guideline application for determining who needs white blood cell growth factors

8. Saint John’s Infection Prevention and Control’s methicillin-resistant staphylococcus aureus (MRSA) Outpatient Clinic


Board of Directors

Rod BordenSaint John

Harry DoyleLower Coverdale,

Treasurer

Mavis HurleyUpper Kingsclear,

Vice-Chair

Karen BranscombeMoncton

Richard BreaultNeguac

Leo BurnsMiramichi

Dr. Natasha CampbellMoncton

Cathy CarnahanChelmsford

Lise Drisdelle-CormierRothesay

Madeleine DrummieOak Bay

Larry HacheyQuispamsis

Jean-Eudes Levesque

New Maryland

Donna MazerolleSaint John

Barbara A. QuigleyMoncton

Wayne RoachAroostook

Roxanne SappierTobique First Nation

David FergusonBoard Chair

Donald J. Peters, P. EngSecretary


Horizon is the largest health care organization in Atlantic Canada, operating 12 hospitals and more than 100 medical facilities, clinics and offices providing medical services ranging from acute care to community based health services to

New Brunswick, northern Nova Scotia and Prince Edward Island. With 1000 physicians, an annual budget exceeding $1 billion and approximately

13,000 employees, Horizon’s strategic vision focuses

on research, innovation and

education.

OUR VISIONLeading for a

Healthy Tomorrow

OUR MISSION

Care for People,

Educate, Innovate

and Foster Research

OUR VALUESCompassion, Respect,

Integrity, Collaboration, Excellence,

Sustainability, Innovation


Accreditation Canada program

Continuous “Patient Care and Safety” improvements . . . through Accreditation

To maintain and improve the quality of care and service it delivers, Horizon participates in the Accreditation Canada program. The national voluntary program evaluates a health-care organization’s performance against national standards and criteria of excellence. The purpose of this evaluation is to assist health- care organizations to identify their strengths and areas for improvement and to identify a plan of action to better meet the needs of clients, families, and communities.

Over the past year, 31 regional teams involving more than 500 Horizon employees, physicians and volunteers prioritized quality improvement initiatives in preparation for Horizon’s first on-site accreditation survey. Additionally, every member of the Horizon team is involved in quality improvement activities on a daily basis.

In September, 16 surveyors from across Canada visited 30 Horizon sites during a six-day evaluation. During that time, they evaluated 2,983 separate criteria for all aspects of health care including patient safety, ethics, staff training and community partnerships. This was completed through observation, discussion and documentation. Horizon met 2,804 of those criteria, or 94 per cent.

Horizon’s successful Accreditation Canada status demonstrates the organization’s commitment to continuously improve patient care and safety. The status highlights the great work being done and identifies areas where more work is needed. Horizon looks forward to further developing the organization to ‘Lead for a Healthy Tomorrow’.


Horizon’s successful Accreditation Canada award demonstrates the organization’s commitment to

continuously improve patient care and safety


Leading PracticesLeading practices are creative and innovative, demonstrate efficiency in

practice, are linked to Accreditation Canada standards, and are adaptable by

other organizations.

Eight of Horizon’s health-care practices were identified as leading practices

by the Accreditation Canada surveyors. These leading practices are worthy

of recognition for what they contribute to specific fields and to health care

as a whole. They are considered commendable examples of exceptional

leadership focussed on patient safety and high-quality service delivery.

These practices also serve as excellent examples for other health-care

organizations who are seeking to advance or further develop their programs

and services.

Horizon establishes first centralized Research Ethics Board

Horizon is one of the only institutions in Canada to have successfully implemented a centralized ethics review process for all of its research projects that involve human participants. Horizon’s Research Ethics Board (REB) completes these ethical reviews for one of the largest health-care organizations in Atlantic Canada.

Horizon’s REB ensures all research conducted throughout the organization, or by researchers affiliated with Horizon, conforms to the highest scientific and ethical standards before the research begins. It also ensures that safeguards are in place to provide the greatest protection to patients and members of the community who serve as research participants.

Accreditation Canada identified Horizon’s REB as one of the most efficient in Canada, with an average of 40 days for a full review and 10 days

for quick reviews from submission to decision. This quick turn-around time allows research projects to move forward without delay. The review process is facilitated by a full-time Horizon REB Chair.

The board currently oversees more than 300 active research projects involving over 1,700 participants.

The Horizon’s REB’s membership includes representation from across the organization; as well as external expertise to reflect the diversity required to conduct thorough research ethics reviews.

The board currently oversees more than 300 active research projects involving over 1,700 participants. REB reviewed 60 new research study applications and 85 annual study re-approvals in the 2009-2010 fiscal year.


Accreditation Canada identified Horizon’s Research Ethics Board as one of the most efficient in Canada.

Standing: Audrey Lampert, Community Representative Fredericton; J. Maurice Legere, Community Representative Dalhousie; Al Kavanaugh, Community Representative Moncton;

Michael Coster, Non-Scientific Representative Miramichi Sitting: Eileen Malone, Vice-Chair Fredericton; Jacquelyn Legere, Chair Saint John


Miramichi Public Health to become province’s first Baby-Friendly designated community health service

Accreditation Canada identified Miramichi Public Health Services as a leader in recognizing breastfeeding as key to the health and well-being of Miramichi residents. Miramichi Public Health has worked very hard over the last number of years to meet the requirements to become a “Baby-Friendly” (BFI) designated community health service and is very close to realizing this goal.

The Baby-Friendly Initiative is an internationally recognized strategy designed to increase the health and well-being of children and families through the protection, promotion and support of breastfeeding. To achieve BFI community health designation, Miramichi Public Health has to successfully complete “The Seven Point Plan for the Protection, Promotion and Support of Breastfeeding” for community-based facilities. These points represent the gold standard to promote breastfeeding as an infant feeding choice, support mothers in the establishment of successful breastfeeding practices and protect mothers from activities that undermine breastfeeding as a choice.

After a thorough assessment, based on the seven points for

designation, the results achieved were very impressive.

In a short period of time, Miramichi Public Health has implemented several initiatives and strategies to meet these points and re-establish breastfeeding as a cultural norm in the community. Their success was recently validated through a mock assessment by a master assessor for the national BFI authority. After a thorough assessment, based on the seven points for designation, the results achieved were very impressive. They highlighted the strong

leadership of the dedicated individuals who are committed to reaching this goal. Strong teamwork, teaching practices, knowledge and seamless delivery of care were highly commended by the assessor.

Horizon ’s hospitals, community health centres, and public health services work with mothers, babies and families to protect, promote and support breastfeeding. Each group is taking steps to achieve BFI designation.

Saint John Suicide reviews provide positive outcomes for change

Suicide can have a devastating impact on family, friends, health-care professionals and the community. Throughout the Saint John area, when this tragic event occurs with clients of the Addiction and Mental Health Program, a review is completed.

...strong commitment of the program to identify vulnerabilities in their processes

and systems of care, and making recommendations for change that

improve patient safety and reduce the risk of recurrence.

Accreditation Canada commended the strong commitment of the program to identify vulnerabilities in their processes and systems of care, and making recommendations for change that improve patient safety and reduce the risk of recurrence. The review is completed by health-care professionals from various specialties and sectors as well as family members in a supportive, environment. Identified action plans are monitored and reviewed on a quarterly basis.

Based on its success for making positive change, the review process model is being rolled out to Addiction and Mental Health services across Horizon.


Accreditation Canada identified Miramichi Public Health Services as a leader in

recognizing breastfeeding as a key to the health and well-being of Miramichi residents.

Lisa Caissie with her baby girl Charlee.


Moncton area’s Medication Care Plan Manager Software Program helps patients and their caregivers understand their medication

In May 2010 a new pharmacy computer program was launched at The Moncton Hospital which was designed and developed by hospital staff. The computer program is known as the Medication Care Plan Manager (MCPM). The program has increased efficiency and reduced the time it takes nursing and pharmacy staff to prepare and generate medication reports for their patients.

It allows pharmacy services to review and generate a complete list of medications for physicians to review which then act as a prescription. It provides physicians and community pharmacists with an easy to read current list of their patients’ medications.

The program has increased efficiency and reduced the time it takes nursing

and pharmacy staff to prepare and generate medication reports

for their patients.

The program then generates a list of medications in a card format that is provided to the patient. The card contains the name and strength of each medication required to be taken by the patient, what condition the medication is treating, how to take each medication, coloured photos of the medication, and any other additional instructions. The card assists patients in taking their medications accurately and provides them with valuable information about their medications.

Patients or their caregivers can also bring the card to appointments with other health-care providers. This helps in preventing the risk of new prescriptions being prescribed that may interfere with their current medications. It also acts as a tool to keep everyone involved in the patients care up to date and informed.

Moncton area’s Physician Consult Project improves patient care

The Physician Consult Project was developed in the Moncton area to identify opportunities for improving the time it takes for physicians to assess a patient admitted to hospital. The goal of the project was to minimize delays for physician notification to assess these patients and allow the patient to return home sooner.

The former process was often complex and time consuming. After an analysis of the process was completed, a new streamlined process was developed. The new process requires that the request for a consult be entered into the existing physician dictation system. Physicians regularly work in this system so they receive timely and clear information about requests to assess a patient admitted to hospital.

The new process has resulted in more timely and efficient patient care and will easily integrate with the provincial One Patient One Record system, New Brunswick’s electronic health record initiative.


Pharmacist Erin Clarke, is involved in the Medication Care Plan Manager

software program.


Fredericton’s home phototherapy service allows babies with jaundice to go home sooner.

Neonatal Nurse, Alyssa Duplessie and mother Natasha Springer with her newborn at the Dr. Everett Chalmers Regional Hospital.


Fredericton’s home phototherapy service allows babies with jaundice to go home sooner

Phototherapy, a treatment used to treat newborn babies with jaundice, has been traditionally offered only in hospitals. In the Fredericton area a new program helps families treat their new baby who has jaundice in the comforts of their own home.

The treatment has been made possible through the use of a ‘bilibed’. This specialized bed incorporates lighting to treat newborns and is loaned to families at the time of discharge. Horizon staff teaches the parents how to administer the treatment.

The home phototherapy service in Fredericton has been available for nine years, and has been hugely successful in getting babies with jaundice home

sooner. Families who have accessed the service have been very satisfied and

highly recommend at-home treatment.

Parents who decide to treat their babies at home are encouraged to record information including feedings, minutes of phototherapy per hour and temperature readings. There is also a 24-hour hotline for additional information and support.

The home phototherapy service in Fredericton has been available for nine years, and has been hugely successful in getting babies with jaundice home sooner. Families who have accessed the service have been very satisfied and highly recommend at-home treatment.

Fredericton’s Cancer Care and Oncology Service

The Fredericton and Upper River Valley Oncology Service has adopted and implemented The American Society of Clinical Oncology (ASCO) clinical guideline for appropriate use of white blood cell growth factor. This allows health-care workers to provide the best care based on evidence.

It gives the patient the best possible treatment outcome by minimizing the

need for hospitalization and decreasing delays in treatment.

White blood cell growth factor is a medication that helps increase the number of white blood cells in the blood. The guideline was adopted in 2009 to minimize the incidence of neutropenia - a decrease in white blood cells below the normal range often caused by chemotherapy. It gives the patient the best possible treatment outcome by minimizing the need for hospitalization and decreasing delays in treatment.

The guideline provides direction about which patients should receive the growth factor with their first chemotherapy treatment and which patients may not need it at all. Patient and treatment risk factors are captured on a form and the information is then entered into a data base. The information is then used to identify current practice, and determine if the guideline is being met. The aim is to always ensure that the patient receives the very best care possible.

This approach provides both an evidence-based and team-based approach to care. Health-care professionals feel confident that when growth factor support is offered to the patient that it is based on evidence. Similarly, patients feel confident knowing that they are receiving the highest quality care. The team approach allows


all members of the team to understand why white blood cell growth factor support will or will not be offered, thereby enabling each member to communicate the same message consistently to the patient and avoid confusion.

This creative but relatively simple approach allows for more appropriate and timely administration of white blood cell growth factors, helping avoid treatment delays and gives the patient a better chance at the best outcome for his or her situation, all while avoiding unnecessary hospitalizations.

Saint John’s Infection Prevention and Control’s methicillin-resistant staphylococcus aureus (MRSA) Outpatient Clinic offers patient support

The Infection Prevention and Control (IPC) Methicillin Resistant Staphylococcus Aureus (MRSA) Outpatient Clinic at the Saint John Regional Hospital uses education to help MRSA positive people and their families overcome fear, confusion, and stigma that often accompany a MRSA positive result.

The clinic opened in March, 2008, and is one of two clinics of

this type in Canada.

MRSA is the term for Staphylococcus aureus bacteria that have become resistant to several classes of antibiotics. MRSA is found in both community and hospital settings. Most people who have MRSA do not get sick with it. An

infection caused by MRSA is more likely to occur if a person’s immune defenses are down. These types of infections may be more difficult to treat as the medications commonly used are not always effective.

The clinic opened in March, 2008, and is one of two clinics of this type in Canada. The MRSA clinic was formed to provide an opportunity for education and follow-up for outpatient MRSA positive outpatients. Through the clinic, the patient’s MRSA status may also be tracked and updated in order to allow for more efficient use of inpatient resources should the person be admitted to hospital later. The clinic also serves those who have been in contact with an MRSA positive person. These patients are screened and their MRSA status determined quickly and efficiently.

Since the initial opening of the Saint John Regional Hospital IPC MRSA Outpatient Clinic in 2008, satellite clinics have been created at both the Sussex Health Centre and the Charlotte County Hospital.


The clinic helps overcome fear, confusion, and stigma that often accompany a MRSA positive result.

Dr. Duncan Webster, Infectious Diseases Specialist, Saint John Regional Hospital


Our StrengthsThe Accreditation report identified many areas of strength within

Horizon. The following pages highlight those identified strengths

that include Horizon’s services, programs, staff, physicians and

important community stakeholders. Together, Horizon’s team is

continuously making quality and patient care improvements to

ensure the best possible care is provided.

Program prevents the risk of medication errors

Horizon’s health-care facilities have implemented new processes to ensure patient medication information is collected and shared properly to prevent the risk of medication errors. This information is gathered at the time of admission to hospital or receipt of services at ambulatory care clinics, emergency departments, community health centres/clinics or the Extra Mural Program.

It is important for health-care professionals to be aware of all medications a patient is taking including prescriptions, vitamins, herbs, supplements, and over-the-counter medicines. This process also includes the patient identifying if they have any allergic reactions to medications. This important information assists health-care professionals in the treatment of the patient to ensure new medications will not interfere with those currently being taken.

Horizon also informs patients about their medications when they are being discharged from hospital. Pharmacists and other health-care professionals provide patients with a list of their medications and instructions in taking their medication. This provides a valuable opportunity

for patients to ask questions regarding their medication, learn about side effects and how often the medication needs to be taken.

Falls Prevention - an essential element of patient safety

Horizon’s Health and Aging Program in the Saint John area has implemented a new falls prevention strategy to reduce falls among patients in Horizon facilities.

The consequences of a fall, especially with the elderly population, can cause concern. Falls can cause serious injury, lead to delayed recovery and longer hospital stays.

Not unlike other patient programs within Horizon, the Health and Aging Program experienced an increase in the number of falls. To address this patient safety issue, the clinical team developed and put into place a falls prevention strategy based on sound research. The new falls program includes evidence-based actions and targets a number of risk factors through the education of all members of the clinical team to work together with the patient and their family to reduce the chances of a serious fall.


Horizon’s Health and Aging Program in the Saint John area has implemented a new falls prevention strategy to reduce falls among patients in Horizon facilities.

Krysta Amirault, Patient Service Worker assists Kenneth Ayer at the Residental Care Unit at the Saint John Regional Hospital.


The strategy was first piloted throughout St. Joseph’s Hospital and Ridgewood Veterans Wing in 2007. The evaluation results were significant with a 40 per cent decrease in the number of serious fall related injuries. The program was then implemented at the Saint John Regional Hospital.

The Horizon Falls Prevention Committee is in the process of implementing this patient safety strategy throughout Horizon facilities with the goal of reducing the number of injuries related to falls in the organization.

Horizon’s Health Emergency Management Plan protects employee and staff safety

Horizon is putting in place an inclusive Health Emergency Management Plan to address any emergency that may affect the delivery of care. The plan will focus on the four essential elements of emergency planning; improvement, preparedness, response, and recovery. A key component of the plan will be the introduction of standardized emergency codes across Horizon which includes over 100 sites.

Under the Health Emergency Management Plan all necessary emergency procedures will be developed, implemented, maintained, and tested to meet current safety codes and accreditation standards. Members of the Accreditation Canada survey team recently reviewed the work in progress on the plan and stated there has been solid leadership in the development of excellent emergency response plans for the entire network.

The development of these plans is done in cooperation with community partners at the local, regional, and provincial levels in order to maintain mutual awareness and integration of emergency plans.

Security provide a safe environment for staff and patients

Horizon strives to provide the safest environment possible for its patients, visitors, staff, and volunteers within each facility. During the accreditation survey, seven Horizon facilities were reviewed for their physical environments and safety measures.

Horizon’s Security and Safety Officers provide invaluable, yet often invisible, support services within each Horizon facility. With the increase in demand for health-care services, their attention assures communities receive access to the highest quality care possible. This includes a safe work environment for all staff, patients, volunteers and public who enter a Horizon facility.

Security personnel perform a wide variety of job functions such as the aid of motorists in distress, provide safety escorts, handle disturbances and respond to staff calls for assistance. They are also an integral member of emergency and disaster planning.


Security Officers John Campbell and Joseph Delong view video

surveillance cameras at the Upper River Valley Hospital in Waterville.


• Number of inpatient’s admitted ................................152

• Number of nursing hours

in inpatient rehabilitation .......................................33,189

• Number of inpatient rehabilitation

hours from rehabilitation professionals ...........21,928

• Number of outpatient rehabilitation

hours from rehabilitation professionals .........24,304

• Number of inpatient attendances ......................13,762

• Number of outpatient attendances ....................3,943

• Number of inpatient attendances in the: - Adult Program ..........................................................13,189 - Pediatric Program .......................................................337 - Autism Program ...............................................................3 - Assistive Technology .................................................233

• Number of outpatient attendances in the: - Adult Program ..........................................................3,934 - Paediatric Program ................................................. 2,193 - Autism Program ..........................................................582 - Assistive Technology ............................................... 1567

2009-2010 Stan Cassidy Centre for Rehabilitation Facts:

Kyle Sharpe enjoys the slide at the Stan Cassidy Centre’s therapeutic outdoor park.


Horizon partners with Correction Services Canada in Telecorrections Project

Horizon has partnered with Correction Services Canada in a Telecorrections Project. The project involves medical specialists at The Moncton Hospital providing consultative services to inmates at the Westmorland Institution and Dorchester Penitentiary through the use of video conference and other information and communications technologies.

This project will improve access to specialized medical care for the inmates. The clinical areas of focus are plastic surgery, general surgery and ear, nose and throat. The program also has the potential to expand to other medical and health professional specialties.

Stan Cassidy Centre for Rehabilitation offers services to patients with complex disabilities

The Stan Cassidy Centre for Rehabilitation (SCCR), part of Horizon, is located in Fredericton, is New Brunswick’s Provincial Tertiary Neurological Rehabilitation Centre for adults and children.

A variety of specialized clinics and preventative services are offered by the centre’s team, made up of various professionals, to clients with complex disabilities from across the province.

Meeting client special needs are at the forefront of all programs provided at SCCR. Services are developed for adults, children and youth as well as specialties in autism and assistive technology.

Innovative rehabilitation features at the SCCR include an independent living suite and transitional living suites to help the patient explore their ability to adapt to daily living while still receiving medical care.

SCCR is home to the first therapeutic park in Atlantic Canada. The newly opened therapeutic park serves as a training ground and break area for patients recovering from traumatic injuries or disabilities caused by disease. Many of the centre’s patients require the use of walkers, wheelchairs, canes, crutches or other equipment to be mobile. The park’s design includes different terrain that allows the patient to practice maneuvering over curbs, sand, cobblestone, gravel and ramps. The Park is designed for use year-round, presenting seasonal mobility obstacles for clients to successfully challenge and overcome.

Another accomplishment of the Centre is its participation is in a national Telehealth project. The Tertiary Telerehabilitation Demonstration project combines the use of traditional telehealth technology, such as videoconferencing, with new formats, like secure web-based patient portals to provide clinical care to patients with a diagnosis of stroke, neuromuscular disease, traumatic brain injury and cerebral palsy. The technology has been implemented at the Miramichi Regional Hospital and The Moncton Hospital. The project is one of the first national projects to be funded under the Canada Health Infoway’s Patient Access to Quality Care Program.


The benefits of The Moncton Hospital’s Irving Ambulatory Care Centre to the provision of health

care are numerous, and will improve patient access to diagnostics, treatment, follow-up

and patient education.

Kelly Perry, ECHO Tech, Irving Ambulatory Care Centre, The Moncton Hospital


The Moncton Hospital’s Irving Ambulatory Care Centre improves patient access

The Irving Ambulatory Care Centre, a recent addition to The Moncton Hospital, is a great example of how determination and collaboration can benefit an entire community.

The merger of patient services within one centre was carefully planned and executed with the input of health professionals from various areas of patient care.

This centre marked the beginning of a new era in the delivery of top-notch health services. The expansion has enabled Horizon health professionals to deliver patient care more effectively by including 18 ambulatory care clinics, a modern emergency and trauma referral centre, a state-of-the-art laboratory, as well as an underground parking garage, all within one centre.

The benefits of this new centre related to the provision of health care are numerous and include: improved patient access to diagnostics, treatments, follow-up and patient education.

The clinics found within the centre offer a wide array of services, including gastroenterology, ophthalmology, urology, orthopedics, cardio and neuro electro diagnostics, and diabetes education, plus many more. Referral is necessary to access the services provided in these clinics.

A highly skilled team that includes physicians, registered nurses, licensed practical nurses, pharmacists, registered dietitians, diagnostic staff, and volunteers deliver excellent patient care in the centre.

Laboratory services vital to Horizon

Laboratory services serve a very important function within a health-care setting. They provide health-care practitioners with vital information about the possible causes, presence, and severity of health problems.

During the recent Accreditation visit, laboratory services across Horizon were evaluated to determine if they met national standards of practice. Results indicated they met these standards while practicing outstanding safety and quality management programs. The Accreditation surveyors highlighted Horizon laboratory personnel as extremely competent in their daily roles and described them as well trained, always professional and dedicated to the work they do and the services they provide.

Horizon’s continuing education program was also identified as a major strength. This program helps ensure professionals are provided with knowledge of the current best practices that improve patient safety, quality control and management.

Diagnostic Imaging provides critical diagnostic information

Diagnostic Imaging is the clinical eye of Horizon, providing technologies that physicians use to literally look inside a patient’s body for information about medical conditions.

An assortment of equipment and procedures can create pictures of the activities inside the body. The technology a physician uses will be dependent on the symptoms presented and the part of the body being examined. X-rays, computed tomography (CT) scans, nuclear medicine scans, magnetic resonance imaging (MRI) scans and ultrasound are all types of diagnostic imaging.


Within Horizon it is vital that each diagnostic imaging department function with efficiency. Throughout the organization these departments are managed by well trained, knowledgeable, and patient centred professionals who aim for top quality patient care.

Horizon’s diagnostic imaging staff considers patient safety to be a top priority at all times, and have multiple points to check a patient’s identity before any diagnostic procedure is performed. Along with identity verification, staff ensures that any risk factors are identified, including pregnancy status, any implants, and risk to fall, before they proceed with testing.

Diagnostic Imaging facts

• Diagnostic Imaging has over 500 staff members, is located in 17 facilities and performs about 2,000 examinations per day

• 670,869 Diagnostic Imaging exams completed annually (2009-2010):

- Radiography ...................................392,949 - Diagnostic Mammography .............. 13,342 - Breast Screening ...............................33,015 - Interventional Radiography ............ 12,217 - Ultrasound .......................................78,700 - Magnetic Resonance Imaging (MRI) 19,643 - Computed Tomography (CT)........... 79,245 - Nuclear Medicine ..............................24,513 - PET Scan ............................................... 667 - Combined functions ..........................12,703 - Other programs .................................. 3,875

• Approximately 70 to 75 per cent of emergency patients receive or require a diagnostic test of some form

• In the recent accreditation survey, Diagnostic Imaging met 101 of 102 standards (99 per cent) applicable to the program

Infection Prevention and Control Programs protect patient safety

Infection Prevention and Control programs have been widely recognized as clinically effective and cost effective in preventing and controlling the spread of infection across the health-care field.

Horizon has demonstrated its commitment to infection prevention and control through the employment of knowledgeable professionals who are current on best practices, standards and guidelines. The infection prevention and control team works with colleagues to ensure that infection control practices and guidelines are implemented and maintained in all facilities throughout the health region.

Infection prevention and control is an important part of patient safety. It is well recognized that health-care associated infections are one of the most common complications affecting hospitalized patients.

One goal of the infection prevention and control team is to minimize these infections and other infection control risks. They provide expert knowledge, direction and education to all health-care workers, patients and the public on the importance of hand hygiene, one of most effective ways to prevent the transmission of infection.


To protect yourself against the

possibility of becoming ill due to

unwanted bacteria, use the following

guidelines in your everyday life:

• When you sneeze or cough, cover your mouth and nose. A good method is to cough into your sleeve.

• Use disposable tissues once and throw them away immediately. Used tissues left around is unhygienic .

• Wash your hands often using warm water and soap. In order to ensure that your hands have been properly cleaned, wash them for a minimum

of 30-40 seconds or the time it takes to sing Happy Birthday twice.

• If you are unable to wash your hands with soap and water, an alcohol rinse used for 20-30 seconds (until dry) is a great alternative.

• Turn off faucet handles with paper towels to prevent recontamination of your hands.

• Work surfaces used for preparation of raw meat and poultry must be regularly cleaned after use.

Safeguarding Against Germs

Dr. Gordon Dow, Infectious Disease Specialist, The Moncton Hospital


Improved patient flow leads to more timely care

Patient flow is the timely transfer of patients through the appropriate health-care channels, depending on the level of care required and their particular service needs.

Staff and physicians of Horizon strive for excellence in all areas, and place considerable importance and effort into support of patient flow throughout the entire organization.

Through all levels of care, from the individual professionals to the departments as a whole, from the facility and network level, and into the community, it is evident that innovative initiatives are in place to help with this area of service.

Currently, Horizon has a region-wide Emergency Program Network that provides a forum where leaders in emergency care can discuss and solve common issues, share best practices and plan for the future needs of patients seeking care in their departments.

One common issue discussed is emergency department overcrowding and long wait times. This network shares improvements and strategies that each department has implemented or is currently working on to improve patient flow and timeliness of care.

Other positive steps that Horizon has taken to create a more efficient patient-care system are to increase the MRI hours in various areas of the organization to address wait times as well as the implementation of a new speech dictation system that has reduced the time it takes to report findings.

To find a balance in patient flow is an ever-present challenge, and Horizon aims to be innovative and creative when it comes to refining systems and processes to ensure a more efficient flow of health care.


Horizon is very proud of its Accreditation status and the accomplishments it has achieved in a short period of time as a new organization. As with any Accreditation process, Horizon has been provided recommendations where it can make improvements to address challenges and become an even better provider of patient care.

Areas of improvement specific to Horizon are reviewed by lead teams. The majority of these areas are related to ensuring that current patient safety practices are spread consistently across the organization.

Ongoing challenges that continue to impact Horizon include:

• a lack of Alternate Level of Care (ALC) beds

• staff shortages in some areas of nursing, diagnostics, family physicians, and medical specialists

• increased wait times in Emergency Departments

• demand for a number of services which exceeds available capacity such as oncology, orthopaedics and clinics

• requests to launch programs without adequate resources

Horizon, like other Canadian health-care organizations, faces an enormous number of competing priorities with limited resources. The organization’s strategic plan, which is guided by the vision of Leading for a Healthy Tomorrow and its mission to care for people, educate, innovate and foster research, will guide its future decisions.

Horizon is committed to providing the best possible care to New Brunswickers and is committed to continued collaboration with its partners, such as government and community stakeholders, to address these issues and identify solutions.

Our Challenges

...become an even better provider of patient care.


Volunteers Catherine Hope and Louise Ongo at The Moncton Hospital.


Strong community partnerships are a key component in Horizon’s success in providing the best possible service. Community partnerships exist with all of Horizon’s services including hospitals, community health centres and clinics, Public Health, the Extra Mural Program, and Addictions and Mental Health services.

These partnerships exist with educational institutions, nursing homes, First Nations communities, all levels of government, the YMCA, police and Corrections Canada, to name a few. Strong linkages are also prevalent with community organizations such as the Heart and Stroke Foundation and other community groups that are committed to improve the health of their communities.

Businesses also provide valuable support through their generous donations to Horizon’s Hospital Foundations. This support is critical to the enhancement of patient-care services throughout the network.

As Horizon evolves as an organization it will continue to engage its community partners and strengthen its relationships to Lead for a Healthy Tomorrow.

Partnerships

Community partnerships contribute to Horizon’s success.


Partnerships with educational institutions key to recruitment of health-care professionals

Horizons’s well developed partnerships with educational institutions foster research activities and assist with recruitment of human resources. Horizon’s recruitment team has a mandate to find the right person at the right time for the right job. This team strives to promote Horizon as an employer of choice, and educate individuals on the diverse selection of career opportunities available in health care. Recruitment team members actively engage students during their learning years, both in secondary and post-secondary education.

As building relationships with educational institutions is vital to the recruitment efforts of Horizon, the organization has partnered with 32 universities, 24 colleges, and 16 academies to offer placements and internships to students interested in exploring all of what Horizon has to offer.

Along with building long-lasting relationships with numerous universities and colleges, the recruitment team also participates in job fairs and class presentations across Canada and Maine to engage professionals from hard to recruit disciplines.Recruitment of medical professionals is also a priority. In September, Horizon welcomed the first group of medical students to the Dalhousie Medicine New Brunswick distributed education program located in Saint John. The program will be delivered in Fredericton, Miramichi, Moncton, Saint John and Waterville.

All of these initiatives help Horizon promote the value of careers in health care and recruit talented people to come to work as part of a highly talented and dedicated team of professionals.

Volunteers, Foundation, Auxiliaries and Alumnae are vital to Horizon’s success

Currently, there are more than 3,500 Volunteers, Auxiliaries and Alumnae within Horizon who give freely of their time and talents to assist in the delivery of quality patient care.

The volunteers of Horizon are a vital part of the organization. With 12 hospitals and more than 100 medical facilities, clinics and offices that deliver a full range of acute care and community-based health services, their contributions are extremely important to the overall success of the organization.

Additionally, 20 Foundations, as well as 19 Auxiliaries and Alumnae, raise millions of dollars each year to benefit the needs of Horizon’s facilities and programs.

Their continuous and unwavering support is vital to the organization and the staff of Horizon is extremely grateful for their generous and continued commitment to improve and enhance patient care.


Students enrolled in the first class of the Dalhousie Medicine New Brunswick Program


Contact Us

Please visit our website at www.HorizonNB.ca or email us [email protected] Pleasant Street, Miramichi, New Brunswick E1V 1Y3 • Telephone: (506) 623-5500

Published by Horizon Health Network.

The Accreditation Report is available on Horizon’s website www.HorizonNB.ca

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