spotlight on p&g

spotlight on P&G

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Issue 5 - Fall 2008Welcome to the fifth edition of Spotlight on P & G,

a newsletter for staff in Sunnybrook’s Perinatal and Gynaecology Program.

You’ll find updates on M-Wing construction as well as news of interest to P & G staff.

If you have any suggestions for future content, please drop a line to sandeep.deol@sunnybrook.ca or call 416.967.8554.

Sunnybrook’s Early Fetal Ultrasound Centre the First of Its Kind

A new service at Sunnybrook Health Sciences Centre is striving to ensure that pregnant women have the option to detect possible fetal problems earlier in their pregnancy.

The Toronto Centre for Early Fetal Ultrasound at the Perinatal and Gynaecology Department of Sunnybrook is the first of its kind in Canada performing early stage fetal targeted ultrasound examination in order to detect potential fetal conditions such as structural anomalies – which are complications that may occur with the development of the fetal skull, brain, spine, abdominal wall, limbs, stomach and bladder – and to also detect chromosomal disorders, such as Down’s syndrome.

“Our aim is to get ultrasounds for pregnant women done sooner, so that women have more possibilities and testing options,” says Dr. Ori Nevo, a Maternal Fetal Medicine specialist and lead physician at Sunnybrook’s Toronto Centre for Early Fetal Ultrasound. “We have the same equipment as everyone else, but the performance and interpretation of the scan requires a different level of expertise that we can offer at an earlier stage in a woman’s pregnancy.”

Congenital anomalies, which are defects present in a baby since birth, are relatively common, occurring in two to three per cent of low-risk pregnancies. In Canada, the first targeted ultrasound for detection of anomalies is traditionally performed at 18-20 weeks. The Toronto Centre for Early Fetal Ultrasound performs ultrasound screening six to eight weeks earlier, at 12-15 weeks.

“The women we are seeing are either at risk for fetal anomalies or are obese, and in that case, the later ultrasound may be of limited resolution,” says Dr. Nevo, who is also an assistant professor in Obstetrics and Gynaecology at the University of Toronto. “However, ideally, any pregnant woman would benefit from early fetal ultrasound examination.”

Ayelet Lahat, 28, of Toronto, who visited the Centre recently, went directly to Dr. Nevo for her second pregnancy’s ultrasound screening after she was referred to Dr. Nevo for ultrasound during her first pregnancy by her doctor in Israel.

“I knew everything would be fine, because I’m an optimistic person,” Ms. Lahat says. “I feel more comfortable now, knowing that everything really

is okay. It is so important to catch issues early, especially in a pregnancy. The Toronto Centre for Early Fetal Ultrasound has experienced and trained professionals and I knew I would be in good hands.”

Currently, Dr. Nevo is the lead and only physician performing ultrasound scans within the Toronto Centre for Early Fetal Ultrasound. Until construction of Sunnybrook’s new Perinatal & Gynaecology unit is completed in 2010, the Centre’s services are located at 76 Grenville Street, Toronto, Ontario.

Dr. Ori Nevo, a Maternal Fetal Medicine s p e c ia l i s t a nd l e a d phys ic i a n a t Sunnybrook’s Toronto Centre for Early Fetal Ultrasound.

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New Parking Garage at Sunnybrook

M-Wing Construction Update: Cranes Soon Coming Down

The cranes that have become a fixture of the Sunnybrook landscape will soon be coming down. The east crane will be removed in early November and the west crane will remain until late December, 2008. Although the sight of the tower cranes on our campus has been a thrill, this is an exciting step because it indicates that we are getting closer to a finished product.

The concrete structure of the expansion is finished and steel has been installed for the mechanical penthouse. Roofing, exterior cladding, window installation and exterior brickwork are well underway. Installation of the new bridges and structure connecting areas on the east and west of the galleria is underway, and lobby connections will soon start between the existing building and the new structure at all floor levels.

Construction crews have been busy on work within the building as well. Rough-ins for all major mechanical and electrical services are underway on the fourth and fifth floors, which is where the state-of-the-art Neonatal Intensive Care Unit (NICU), Ambulatory Care & Obstetrics, Neonatal Follow-up Clinic, and program support space will be. The fifth floor will house the Birthing Suites, the High Risk

Area for expectant mothers, Combined Care, the Operative Delivery area, Breast Feeding Clinic, and other support areas. Partitioning is well underway on these floors and the form of the new facilities continues to take shape.

R o u g h - i n w o r k on the s i x th and seventh f loors i s well advanced with many of the major systems nearing completion as well. This includes temporary heating and lighting, sprinkler and standpipe, utility risers and life safety systems.

December wil l mark the halfway point for the job. By the end of 2008, the connection between the existing M-Wing and the expansion will be complete and the roof spanning the galleria will be installed. The crew will also work to get the building closed in and weather-tight by the end of the year. Efforts will continue to energize permanent power and

heating systems in the shell by the end of the year so that it can run through the winter. While the large tower cranes are departing, you can rest assured it will be a beehive of activity on the inside of the site.

The M -Wing p ro je c t has be en consistently tracking on budget and on schedule from the beginning. The project is expected to be complete in mid-2010 with the Perinatal and Gynaecology fit-out consuming the last year of construction. - Barry McLellan, President and CEO

In addition to the M-Wing construction, planning for a third

parking garage at the Sunnybrook campus is also underway.

This parking garage is to be located immediately to the east

of the Creche Child Daycare Centre. It is anticipated that the

new parking garage will be able to accommodate parking for

approximately 670 vehicles and is expected to be complete

at approximately the same time the M-Wing expansion is

completed in mid-2010.

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Retirement

Shirley Bennett from 6E

New Staff

Birthing Unit

Hilary ShackletonLynn CastroJennie AronssonAngel BenderHeather HarrisMaren HaywardAdele PageKarla WestburyShirin KabiriMaria Houshyar

Maternal & NewbornJennifer McDougallKaroline WypychLaura Jeffers

High Risk Pregnancy UnitKristina Bozicevic

Feeding PreparationMarlene Delgado

Department of Newborn & Developmental PediatricsMartina Esdaile

Gynaecology Surgery Unit

Pam Spanogiannopoulos

NICU

Gretchen Kramer Kanwal Mirza Ken Abbott Seul Yoo

Staff Notes

A Transition Steering Committee was developed in the late spring of 2008 to help guide Perinatal and Gynaecology staff members in their upcoming move from 76 Grenville to Sunnybrook’s Bayview campus. The Transition Committee’s purpose is to facilitate and ensure a safe and seamless transition of the Program into the new space in M-Wing at Sunnybrook. Within this committee, there are five sub-committees that will

act in the same capacity but with a focus on specific aspects of the move. The sub-committee categories are: staffing, communication, processes, equipment, and memor ies and celebration. Committee meetings will commence this fall and representation from all units is required. If you would like more information, please contact Monica Nicholson or El izabeth MacMillan-York.

Transition Steering Committee Aims to

Ensure Smooth Move

In conjunction with Organizational Development, the Transition Committee has organized change workshops to assist and provide staff with tools to help them cope with the transition of the Perinatal and Gynaecology program to Sunnybrook’s Bayview campus. Workshop activities include staff tours of Sunnybrook and of the construction site. To date, five workshops have been held and more are scheduled to follow. Additional dates will be added to the

schedule for those staff members that have not had a chance to participate. All staff suggestions and concerns are noted and are reviewed.

A preliminary report suggests that the majority of staff members are finding the change workshop beneficial. On a scale of one to six (where one is poor and six is excellent), participants in four change workshops gave the sessions an average score of five.

Change Workshops Proving Beneficial for

Perinatal and Gynaecology Staff

Perinatal and Gynaecology staff prepare to tour their new home!

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Perinatal and

Gynaecology

Program Hosts

Planning Retreat

In June, 2008, the Per inatal and

Gynaecology program hosted a planning

retreat to begin discussions about a

number of outstanding priority issues

that require further planning to ensure

a smooth and seamless transition and

integration at Sunnybrook’s Bayview

campus site. The planning retreat

included over 70 participants from across

Sunnybrook’s programs, professional

services and administration. Early

discussion of these issues yielded a

number of tasks, proposed timelines

and mechanisms.

Recent Events

Through lectures and interactive discussions between the audience and experts, participants at the 2008 Pregnancy and Birth – Current Clinical Issues conference in September learned about research-based approaches to a variety of important and commonly encountered aspects of prenatal,

intrapartum and postpartum care.

The event was presented by The Centre for Mother, Infant and Child Research, a unit of the Sunnybrook Research Institute. The conference hosted numerous experts across Canada, who spoke about the latest trends and research in maternal care:

Charmaine Roye - •CMA on Collaborative Care

Suzanne Tough - Collaborative •Care: How to Move Forward with Integration

Lee Saxell - South Community •Birth Program

Anne Biringer - Primary Care of •the Low Risk Woman: Who is the Appropriate Care Provider?

Kellie Murphy - Antenatal •Corticosteroids

Deborah Money - Perinatal •Infection in Pregnancy

Hani Akoury - Induction •Augmentation

Denice Feig - Metformin and •the Management of Diabetes in Pregnancy

Diane de Camps Meschino - •Antenatal Depression

Robyn Stremler - The Crying •Baby

The following key priority areas were

identified for immediate attention in

preparing for the move:

Critical care support 1.

Enhancing low risk Obstetrics 2.

Facilitating full Gynaecology 3.

relocation

Determining impact on 4.

clinical services

Integration of support 5.

services

Human resources planning 6.

Preparing people: 7.

professional development,

education and training

Integrating cultures and 8.

change management

Annual Pregnancy and Birth Conference

Presents the Changing Face of Canadian

Maternity Care

Nursing staff from the Birthing Unit and High Risk Pregnancy Unit began a critical care course at George Brown College in Toronto this September. Nursing staff members introduced this course in anticipation of the Perinatal and Gynaecology program’s move to Sunnybrook’s Bayview campus, where staff will be caring for pregnant women

who may also have co-morbidities. In the process of completing this course, staff will be carrying out the clinical portion of their studies on D4 at the Bayview campus, where relationships are being developed with staff members who will be caring for some of the program’s patients in the future.

Perinatal & Gynaecology Nurses

Embark on Critical Care Course