It’s been a wonderful year at SickKids! Here’s why…
SickKids topping the charts as a great place to work
SickKids was once again named one of Canada’s Top 100 Employers and one of Greater Toronto's Top Employers by Mediacorp Canada Inc. We were also named a Top Employer for Canadians Over 40. SickKids was recognized for investing in our staff through ongoing training and development and helping staff prepare for the future through retirement education sessions. Community involvement, both locally and globally, and our commitment to creating a healthy work environment through our robust wellness program were also noted as reasons for selection.
A few days after that award, SickKids was named one of Canada’s Top 40 Research Hospitals by Research Infosource Inc. SickKids earned second place on the annual Top 40 list for overall research spending, a jump from third place last year. SickKids also ranked first for institution intensity (research spending as a percentage of total hospital spending) and second for researcher intensity (research spending per researcher) in the medium-sized hospital tier. This recognition is a testament to the outstanding work of our researchers and their success in competing for grants.
Earlier in the year, Forbes recognized SickKids as one of Canada’s Best Employers for 2016. The list, which consists of the top 250 employers across 25 industries in Canada, was created based on feedback from more than 8,000 Canadian workers. These individuals were asked to determine, on a scale of zero to 10, how likely they were to recommend their employer to someone else.
Excited to join the SickKids team? Check our career listings.
Picking up steam on our journey to eliminating preventable harm
Since March 2015, the Caring Safely initiative has come to embody SickKids’ commitment to patient and staff safety. We are building significant momentum and beginning to see the impact of our staff’s determination, creativity and resourcefulness as we implement new processes and training to improve safety and reduce preventable harm. We have worked together in many new ways including developing a more robust, timely, and transparent serious safety event review process, as well as implementing an all-staff education curriculum and standardized care bundles to prevent hospital-acquired conditions. As we approach the end of the year, we are pleased to report that 4,000 staff have been trained in the error prevention curriculum.
We are embracing collaboration, locally and internationally. By working with the Children’s Hospitals Solutions for Patient Safety, a collaborative of North American paediatric hospitals that is working towards the shared goal of eliminating preventable harm, we are able to learn from organizations that share our goal, some of whom began their safety journeys years ago. In the past year, two of our peer paediatric hospitals in Canada, the Children’s Hospital of Eastern Ontario and the IWK Health Centre, have joined in the collaborative and have looked to us to guide the first steps of implementation. The success and enthusiasm of our peers, and our increasing partnership with patients and families, gives us confidence we can collectively achieve our goal of eliminating preventable harm.
Reducing unnecessary tests and treatments
Unnecessary tests and treatments do not add value to care. In some cases they can potentially expose patients to harm, they can lead to even more testing to investigate false positives, and often they can contribute to a patient's stress levels. These tests and treatments also put an increased strain on the resources of our health-care system.
In early 2016, SickKids announced its participation in Choosing Wisely Canada, a campaign to help clinicians and patients engage in conversations about unnecessary tests and treatments to help make smart and effective choices that will ensure high-quality care. As part of the campaign, national medical specialty societies have developed lists of "Five Things Clinicians and Patients Should Question." As a paediatric health centre that cares for children with highly complex and specialized medical conditions, SickKids has created its own initial recommended list of tests and treatments that our staff should aim to restrict to those patients who would likely benefit from them.
By implementing these recommendations, SickKids will be able to improve the quality of clinical care and build on the excellent care experience we already deliver to our patients and families.
Test identifies child’s one in a million disease
While the merits of whole genome testing, a laboratory process that looks at a person’s entire DNA sequence at one time rather than just parts of it, have been recognized by researchers, it has yet to become a standard practice for clinicians looking for a diagnosis. When investigating a potential genetic condition in a child, the current standard-of-care genetic test is chromosome microarray analysis, which only looks at copy number changes in genes and misses smaller genetic changes.
A study led by the Centre for Genetic Medicine at SickKids compared standard genetic testing to whole genome sequencing in 100 patient cases at SickKids and found that whole genome sequencing identified genetic variants that could help with diagnosis in more than one-third of the patients. This represented a four-fold increase compared to the diagnostic rate using the standard chromosome microarray analysis, which only found genetic variants in eight per cent of the cases. In one of the cases, whole genome sequencing revealed that the patient had a very rare condition called pantothenate kinase-associated neurodegeneration (PKAN) -- the incidence is literally one in a million.
The results of this study indicate that whole genome sequencing can and should be used at the first-tier genetic test in individuals with developmental delay and/or congenital abnormalities to help doctors determine prognosis, guide treatment or begin appropriate surveillance and prevention programs.
Emergency preparedness: ready to spring into action
This year was a significant one in terms of emergency preparedness at SickKids. Although they are challenging to carry out, particularly with a busy hospital to run, exercises simulating the emergency are critical to ensuring that we are able to react nimbly and effectively in the case of any real emergency.
In August, SickKids held an evacuation exercise. A mock fire triggered the call to evacuate and staff safely ushered patients (dolls, stuffed toys and mannequins) from one unit to another, making sure all patients had proper identification bands, their medical charts, any required medical equipment and medications. At the Operating Room desk, staff members waited for additional instructions or announcements. A public call centre was established so families and the public – played by volunteers -- could contact SickKids for information. In the Emergency Measures Command Centre, leaders representing departments from across the organization were busy coordinating the hospital-wide emergency response.
The exercise was a success, helping to identify processes that are working well and those that need improvement.
In addition to the mock drill, SickKids staff members who could be called to the Emergency Measures Command Centre during a real emergency all received training this year on the latest incident management best practices.
Systems and analytics: integrated, smarter and more efficient
Across SickKids, from clinical areas to administrative offices to research labs, new business systems and processes introduced this year are changing the way we work and providing greater insight into our operations.
A major finance and human resources systems modernization project went live, automating many paper-based processes and integrating formerly disparate systems, helping to improve efficiency and the timeliness and quality of information shared across the hospital. This is just the start of our journey to better integrate, analyze and report data and information. Earlier this year, SickKids introduced an interactive business intelligence platform that is helping to transform data analysis and reporting. Leaders across SickKids are now able to analyze key measures such as average length of stay, patient volumes, emergency wait times and more. This deeper insight into our patient population and operations is already leading to more informed, accurate and meaningful decision-making, enabling SickKids to further improve program efficiency and effectiveness.
Excellence in teaching and learning – at home and abroad
Each day SickKids strives to provide better care than the day before, a pursuit of excellence that depends on learning, the critical link between new knowledge and its application in the care of a sick child.
In 2016, the SickKids Learning Institute celebrated the graduation of the inaugural class of the SickKids Teaching Scholars Program, which included 21 graduates representing paediatrics, nursing and professional services. A second class is now completing the 10-month program, created to enhance teaching expertise among health-care professionals whose focus is child health.
To provide effective patient care, we must use knowledge generated from research and create effective changes in health policy and/or practice. This process of moving knowledge into action is referred to as knowledge translation. The Knowledge Translation (KT) Team within the SickKids Learning Institute supports health science researchers and clinicians with various KT initiatives, including teaching a comprehensive and successful Scientist Knowledge Translation Training (SKTT) course. This fall, SickKids launched SKTT Australia in Melbourne, Sydney and Perth, with the intention of expanding our reach to address a worldwide need for professional development in knowledge translation.
Surveillance approach to detecting tumours yields remarkable results
A cancer surveillance system dubbed the “Toronto Protocol” is being touted as the next best thing to finding a cure to an inherited cancer disorder called Li-Fraumeni syndrome. Patients with Li-Fraumeni carry a substantially higher lifetime risk of developing cancers such as bone cancer, leukemia and breast cancer.
Research led by SickKids shows that children and adults with this inherited cancer susceptibility can benefit significantly from the Toronto Protocol, which helps detect tumours early, enables quicker treatment and improves overall survival. The protocol involves a combination of tests which are available at virtually every hospital, including blood work, ultrasound of the abdomen and pelvis every three to four months, and annual MRIs of the whole body and brain. The new research observed more patients over a longer period of time and yielded remarkable results: the five-year survival rate was 89 per cent for people who underwent surveillance compared to only 60 per cent for those who did not undergo surveillance.
Not only does this data support the use of genetic testing in at-risk individuals, it also raises the awareness of the importance and value of surveillance strategies for early tumour detection, not only in the context of patients with Li-Fraumeni syndrome, but also for those with other cancer-susceptibility syndromes.
Improving the health of children worldwide
Our reach and positive contributions extend the world over.
The SickKids Centre for Global Child Health was involved throughout the year in supporting the United Nations’ Global Strategy for Women’s, Children’s and Adolescents’ Health, as part of the Sustainable Development Goals (2015-2030). The centre contributed to major international reports on early childhood development, stillbirths, adolescent health and other pressing global child health issues.
The centre has also been working with Canadian partners to improve the lives of children and their families in resource-poor environments, where the largest number of deaths to children under five occurs. In collaboration with local health systems partners, the centre launched the first paediatric haematology/oncology nursing education program in the Caribbean and expanded specialized paediatric nursing education to the northern regions of Ghana.
SickKids International (SKI) continued its collaborations with health-care institutions, governments and organizations around the world to help create sustainable, high-quality paediatric care by providing training and expert advisory consultation.
The SKI team is leading our efforts in South Africa, where we are working with the Nelson Mandela Children’s Hospital in Johannesburg, a new hospital which will be the fifth on the African continent and an important addition to Southern African health care. Our participation in the project has been made possible through a federal grant and philanthropic donations.
SKI is also working with the Chinese government, which has made improving paediatric services within the country a priority. In March, SKI began a five-year project with Shenzhen Children's Hospital to teach the skills needed to develop new protocols and improve paediatric cancer care. This builds on work already underway at Tianjin Economic-Technological Development Area International Cardiovascular Hospital, where a SickKids team is providing paediatric cardiac assessment education, as well as helping nurses, pharmacists and other hospital staff to upgrade their existing skills and learn new ones.
Bold and fierce: SickKids VS
This year's SickKids brand campaign, SickKids VS the greatest challenges in child health, has garnered a lot of attention since launching in October. The various campaign elements represent a bold shift in tone of voice, highlighting the fierce side of our patients, families and staff, and the fight that occurs on behalf of our patients at the hospital each day.
Real staff, real parents and real patients adds a special component to the final product. More than 500 staff members helped out either in front of the camera or behind the scenes and approximately 50 patient families agreed to be filmed.
That’s a wrap on 2016! Thanks to all our staff, volunteers, patients, families, community partners and supporters for everything you do to help us along our journey. Happy New Year from everyone at SickKids!