HEALTH AND WELLNESS NEWS FOR YOU AND YOUR FAMILY
WINTER 2005
Fr
ee
What's Inside
Aboriginal Cultural Programs
at the Winnipeg Regional
Health Authority
Community Health
Advisory Councils
Soft Night Out:
A Medical Officer of Health
Experiences Life on the Streets
Don’t Hibernate. Participate.
Get “in motion"
Winter Wonderland
Walking Tips
A
Patient Safety:
What is Medication
Reconciliation?
ccording to the
2004 Canadian Adverse Events
Study, one out of nine adult hospital patients will
The Medication
potentially be given the wrong medication or medication
Reconciliation Project is one of six
dosage, and 24 per cent of preventable adverse events are related to
evidence-based system-wide national interventions being promoted and
medication error.
coordinated by the Canadian Patient Safety Institute as part of its Safer
Medication reconciliation is a system designed to prevent such errors.
Healthcare Now! Initiative.
It’s a process of collecting a patient’s current medications and
Other clinical interventions include the prevention of central-line
comparing them with the medications a physician might order during
and surgical site infections, the creation of Rapid Response Teams, the
admission, transfer or discharge. It allows the healthcare team to identify
prevention of Ventilator Associated Pneumonia, and the reliable use of
and address discrepancies and document any changes.
a set of medications shown to markedly increase a person’s chance of
But prescription medication isn’t the only concern.
survival after a heart attack.
According to a recent Health Canada survey, 71 per cent of Canadians
While several of these clinical interventions
regularly take natural health products such as
are
being piloted in Winnipeg hospitals, only
Patient Safety Tip
vitamins and minerals, herbal products and
medication reconciliation is a truly regional project.
homeopathic medicines. 29 per cent feel they
There are several reasons for this.
Always have a friend or family
are natural and safe or better than conventional
First, adverse drug events are some of the most
member with you at medical
medications (Baseline Natural Health Products
common adverse events in the healthcare system,
Survey Among Consumers, March 2005).
appointments to support you
especially in hospitals. The extent of the problem in
However, natural health products can have
community care settings and homes is not known,
emotionally and help you
potentially serious side effects, especially when
but it’s suspected to be a significant and largely
understand the information
combined with prescription drugs, over-thepreventable burden.
counter medicines, or other herbal products,
you’ve been given.
It’s hoped that a comprehensive program
and these products are also considered under
throughout the city and various levels of care will
medication reconciliation.
reduce adverse drug events and unnecessary costs
The Winnipeg Regional Health Authority is currently implementing a
and complications to individuals and the healthcare system as a whole—an
comprehensive 16 month medication reconciliation program that includes
important consideration in today’s resource-challenged healthcare system.
selected medical wards at six acute care hospitals, two primary care clinics
Another important benefit of the program is that it will shed light on
and two home care community areas.
communication patterns between healthcare workers and their patients,
The program will utilize a Rapid Cycle, or PDSA (Plan-Do-Study-Act)
and between one healthcare worker and another.
Improvement Model. Teams made up of nurses and pharmacists, with
Ultimately, medication reconciliation is another step towards a healthcare
input from doctors, patients, family members and risk managers, will test
culture that views errors as opportunities to learn.
a variety of innovations across the continuum of care. Actions that work
will be kept and expanded upon, and those that don’t will be studied to
If you would like more information about Patient Safety at the
WRHA, please contact Ryan Sidorchuk at 926-7164 or email at
understand why.
[email protected].
Aboriginal Cultural Programs
at the Winnipeg Regional Health Authority
As Canada’s indigenous people, Aboriginal people are defined under the Constitutional Act as First Nations, Inuit and Métis.
Historical and cultural factors have contributed to stereotypes about Aboriginal people that have resulted in inequities in several
areas, including access to health services and opportunities for employment. The Winnipeg Regional Health Authority has
enhanced access to existing cultural programs through ongoing communication and evaluation processes.
Diversity Enhances Care:
The Aboriginal Culture
Awareness Workshop
A
Spiritual and Cultural
Care: The Aboriginal
Traditional Wellness Clinic
W
s facilitator of the Aboriginal Culture Awareness Workshop,
hat does it mean to be healthy? To some, good health
Ivy Chaske is asked frequently why there are no awareness
simply means the absence of physical disease. To others,
workshops for other cultural groups.
emotional and spiritual well being are also a part of the
“In Winnipeg 14 per cent of the population is Aboriginal, and
equation.
the Aboriginal patient population in some areas of healthcare,
“Traditional Aboriginal cultures view human beings as
such as dialysis, can be as high as 90 per cent,” says Chaske. “Knowledge of spiritual beings,” says Sakoieta Widrick, Regional Spiritual and Cultural Care
Aboriginal culture helps workers to provide better care.”
Coordinator. “So when we as Elders work with patients we start with the
Universal participation is encouraged in the two-day staff workshop that
spirit. Then we address emotions and finally the physical body.”
examines contemporary, historical and cultural factors that contribute to
Spiritual and Cultural Care Services are delivered through the Winnipeg
stereotypes about Aboriginal people. Participants learn about facts and
Regional Health Authority’s Aboriginal Health Services program, and
fallacies associated with Aboriginal people and how values and perceptions
Widrick stresses that services are not an alternative to the current system,
influence behaviour.
but an enhancement.
“The depth of the information really surprised me,” says Sandy Tataryn, a
“As Aboriginal people we’ve carried certain cultural traditions with us
public health nurse. “It could easily be a week long.”
since we were created,” he says. “The Spiritual and Cultural Care program
One of the most powerful tools of the Workshop is Sleeping Children
allows us to bring those traditions forward into the modern world to help
Awake, a video
balance the Western
exploring the past
medical model.”
According to the 2002 Romanow Report on the Future of Health Care in
and present day
Established in
impact of the
Canada, “...more needs to be done to provide appropriate training for non- 2002, the Aboriginal
residential school
Traditional Wellness
Aboriginal health care providers so they are in a better position to meet
system on Aboriginal
Clinic at the Health
the health needs of Aboriginal communities.”
people.
Sciences Centre gives
“It can be difficult
Aboriginal and nonfor some people to
Aboriginal people the
watch,” says Chaske. “But the residential school system had a major impact
opportunity to seek healing using this traditional healing approach.
on Aboriginal people, and it’s a big piece of our shared history that many
Kathy Bird is one of the Clinic’s traditional healers. She says the role of
Canadians don’t know about.”
the healer is often misunderstood.
Tataryn, who attended the workshop on a blustery Tuesday in November,
“Traditional healers don’t actually heal anyone: the medicines and the
was moved.
Creator do,” she says. “The role of the healer is to communicate with the
“I can see why it’s an integral part of the Workshop,” she says. “Watching Creator.”
that film, you feel the heartache. You develop a sensitivity to the
It’s traditional for a person seeking healing to present the healer with
devastation residential schools created. It makes you more compassionate.”
tobacco, and Bird says the tobacco is accepted on behalf of the Creator.
After the film, participants are invited to take part in a sharing ceremony,
“The healer then receives direction about what the patient needs to do
and many find the experience moving.
to get well from the Creator, whether it’s a sweat, a fast, a sun dance, or
“Aboriginal spirituality has so many profound, beautiful elements to it,”
medicines,” she says.
say Tom Janzic, a nurse with the Crisis Stabilization Unit. “This experience
People seem to be responding well.
has given me so much energy and reinforced my own spirituality.”
“I think the numbers indicate the reaction has been positive,” says
Chaske says it’s this kind of participant involvement that makes the
Patricia Frain, Director of the Spiritual Care Department at HSC. “The
Workshop successful.
Clinic’s caseload has doubled since 2002, and runs twice a month to
“The participants make it work,” she says. “We learn from each other, and accommodate the increased demand.”
it makes healthcare better for everyone,” she says.
Widrick says services such as the Aboriginal Traditional Wellness Clinic are
the key to improving health in Aboriginal people.
“We have the tools and the means to get ourselves healthy again,” he
says. “We just need to open some doors to allow those tools and means
into the healthcare system.”
Your Say in Healthcare:
Community Health
Advisory Councils
A
s snow piles up outside the Victoria Hospital, tales of
treacherous driving conditions get worse with each new
arrival. It took one person two hours to get here from
downtown.
Nevertheless, the mood is jovial as the small group of people
gathering in the brown panelled boardroom shake off the snow and settle
down to work.
So what brings these brave souls out on a stormy Winnipeg night in
November? They’re all volunteers on one of the Winnipeg Regional Health
Authority’s Community Health Advisory Councils.
“Being a member of a Council gives you as a community member
the opportunity to have a positive impact on healthcare,” says Kathleen
Clouston, a member of the St. Boniface/St. Vital Council. “It has a snowball
effect: we do something small and positive, and it helps to make a lot of
big, positive changes.”
Community Health Advisory Councils provide input and ideas about
health issues to the Board of the WRHA. There are six councils representing
community areas including Downtown/Point Douglas, River East/Transcona,
River Heights/Fort Garry, St. Boniface/St. Vital and St. James Assiniboia/
Assiniboine South.
Issues the councils examine are determined by the goals set out in the
WRHA’s strategic plan. Past issues have included factors that impact the
health of children and seniors and health service delivery and coordination.
Members volunteer for three-year terms and each Council meets four
times per year. Councils have between 11 and 15 members, and Council
Coordinator Colleen Schneider says the groups are representative of
individual communities.
“We look at the demographics of an area and try to bring together a
sampling of that community,” she says. “We look for a range of people.”
Couston says one of the most fulfilling aspects of being a member of a
Council is seeing your recommendations come to life.
“The most important feedback we’ve received is that so many different
areas have used our work to implement policy and improve health,” she
says.
Over the past several years, recommendations from the Councils have
played a part in several big initiatives within the WRHA, including the
development of a comprehensive phone listing in the phone book and an
Internet tool called Encompass, which allows users to search the WRHA
Web site for health information.
The Councils have also been influential outside of the WRHA.
At a seniors planning session last spring priority issued identified by the
Councils were used to address issues impacting seniors, and the CHAC Child
Health Report provided the framework of community priority issues for the
Healthy Schools Initiative currently underway.
According to Clouston, the Councils work because they help people to
help themselves.
“When it comes to healthcare, people need to be their own best
advocates,” she says. “To do that they need information. The Councils
highlight gaps where more information is needed.”
And Clouston says you don’t need any special skills to participate.
“You just need to have an interest in health, be open-minded, and have
good communication skills,” she says. “And you need to be able to say ‘I
don’t know’ sometimes.”
The WRHA is currently recruiting CHAC members for terms beginning
in September 2006. For more information, please contact Colleen
Schneider at 926-8073.
A Medical Officer of
Health Experiences
Life on the Streets
T
here were over ten of us,
including a First Nations’ leader,
a senior administrator of the
Winnipeg Regional Health
Authority, a provincial MLA,
and a handful of reporters. We met at the
Agape Table food bank at Broadway and
Osborne at noon to begin our Hard Night
Out experience.
It’s an event organized by the Harm
Reduction Network of Manitoba in which
politicians, policy makers and media are
Pierre Plourde
challenged to spend a night out on the
street with a homeless person.
My field guides, Norman and Shirley, had been instructed to treat me like
an egg.
“Don’t bring him back cracked, hard-boiled or scrambled,” they were told.
“And don’t lose him.”
Shirley promised to get me back in one piece.
So it was that I found myself heading out onto the streets of Winnipeg in
near zero temperatures with nothing in my pockets and my welfare in the
hands of two homeless people—one an ex-con, the other covered in scars
from years of physical abuse in a previous relationship. Both were addicted
to crack. For my security, a spotter with a cell phone accompanied us.
What followed was an experience I will never forget.
Over the course of the next 18 hours we walked nearly 30 kilometres.
Shirley’s steady limp betrayed her damaged arthritic joints, but she didn’t
complain once.
Norman quickly established himself as the leader of our group. Having
been homeless since he was 12, he knew all the tricks of the trade. He was
intelligent and savvy, navigating the back lanes of Winnipeg with stealth
and precision, and offering me a street survival education that was second
to none. As he put it, “If you know what you’re doing, you can feed
yourself in a city like Winnipeg without any money.”
Indeed, we ate more than enough hopping from one drop-in centre to
the next throughout the day. I was surprised by the good food available in
dumpsters. Our carefully timed visits yielded freshly discarded produce that
hadn’t been disturbed and was therefore relatively uncontaminated and
intact.
We filled several plastic bags with groceries for our evening dinner.
Unfortunately, however, shelter is not as easy to find on the streets of
Winnipeg as free food. Norman and Shirley wanted to find me comfortable
shelter for the night, but they also wanted me to see the less desirable
options.
Our first visit was to a park along the river where crack users hang out at
night next to a campfire. Next, we visited a bridge where glue sniffers park
themselves on old mattresses year round. But Shirley felt these places were
too dangerous and cold for a Medical Officer of Health.
So we made our way to the shelters in downtown Winnipeg, places like
Jack’s and the Main Street Project. I would have considered spending the
night at the Main Street Project, but we hadn’t panhandled that day and
didn’t have $11 to get in.
So there we were at 6 pm with no place to sleep for the night.
We set off to look for outdoor shelter in one of the many corners under
stairwells and behind fences where Norman had spent nights in the past.
Then Norman remembered an old friend who might be able to put us up;
Donny, a lonely 64-year-old living in a mice infested apartment in the West
End.
Donny, although grumpy on the surface, turned out to have a heart of
gold. He let us squat in his small one bedroom flat for the night and gave
us free reign of his kitchen. We filled his vintage refrigerator with fruits and
vegetables, and Shirley cooked pork chops and hard-boiled two dozen eggs
for protein, all from the dumpster. Then we feasted on coleslaw and buns
in addition to what we had prepared. We were stuffed by the end of the
evening. The dumpsters had been good to us that day.
We finally got to sleep around 2 am, and were up again at 5 am to get
to Siloam Mission for breakfast at 6 am. Bacon and eggs sure tasted good
after the brisk one-hour walk. But it’s not the type of breakfast that’s
normally available for the homeless: this was a special breakfast for us
“Hard Night Outers”.
After saying our good byes and thanks, we parted ways and went back to
our own lives. I left my winter coat with Shirley, as I knew she could make
good use of it in minus 30 degree weather. She felt good about bringing
back her “egg” safe and sound, but Norman felt a little chagrined that I
had only experienced what he called a “Soft Night Out”. He feared I would
go back and tell my friends and colleagues that street life isn’t so bad after
all.
Well, don’t worry Norman.
I know it was only made easy because you sheltered me from the hell you
were probably too ashamed or afraid to reveal to me for my own sake and
safety. And I only had to do it for one night. You were right when you
said I would have to spend at least one week with you to find out what it’s
really like. You are stuck doing it all year round.
Norman and Shirley, thank you for the “Soft Night Out”. Even though it
could have been harder, I got the picture.
One of my most memorable encounters that day was with a businessman
we approached in front of the office building where I work. He refused to
talk to us, even after I reluctantly revealed who I was and what I was doing
on the streets that night. He just wasn’t interested in confronting poverty
and pain.
This “egg” walked home that morning realizing his house is only a ten
minute walk from Donny’s apartment, but a world away.
Pierre Plourde is a Medical Officer of Health with the Winnipeg
Regional Health Authority.
Don’t Hibernate. Participate.
Get “in motion”.
Winter Wear
Selecting the right outdoor gear is essential
to enjoying and safely participating in winter
activities. When dressing for cold weather,
experts suggest that people wear at least three
loose fitting layers that help pull body moisture
away from the body and trap warm air against
the body.
First layer: The base layer worn closest
to the skin should be a lightweight synthetic
material (such as polypropylene) that is
designed to pull or “wick” perspiration away
from the skin.
Second layer: The mid-layer should be a
warm insulating layer that traps warm air and
draws moisture away from your body. Fleece
and wool make for an excellent second layer.
Cotton should be avoided because when it gets
wet, it stays wet.
Third layer: The outer layer should be
windproof. There are many types of windproof
clothing including hats, pants, jackets and
pullovers. The outer layer should be able to
trap heat, remain breathable and shield from
wind and water.
Be prepared to shed some layers of clothing
as your muscles heat up. Also, extra care
should be taken to protect the head, face,
neck, hands and feet during cold weather.
• A toque is an ideal choice to help maintain
body heat, as up to 50 per cent of that
heat can escape through the head.
• A mask or neck warmer worn over the
mouth can help keep the air you breathe
warm and moist.
• Mittens with a windproof shell provide
more warmth than gloves.
• Roomy boots, skates and shoes with
warm wool or acrylic blend socks are
recommended. Ensure winter shoes are not
so tight as that can restrict blood flow and
increase risk of frostbite. Boot and shoe
treads made of neoprene and rubber are
essential for safety and balance in slick, icy
conditions.
A
s the mercury plunges and the snow
piles high, our first instinct may be
to retreat into our homes, cozy up
on the couch in front of our TV’s
and hibernate until the first day of
spring.
But is this good for you? The answer is no,
because being active year-round is essential
for good health. By getting 30-60 minutes
of moderate physical activity every day, you’ll
enjoy increased energy, endurance, flexibility
and strength. Other benefits include improved
mood, sleep patterns and brain function, as well
as weight maintenance. However, the benefits
gained through regular physical activity in the
spring, summer and fall can fade fast if regular
physical activity stops in the winter.
Winnipeg in motion recognizes that winter
can be a challenging time to stick to your
physical activity routine. And holiday parties
and treats can sabotage your personal healthy
living plan. However, with a little knowledge,
preparation and ingenuity, you can stay “in
motion” during the holidays and throughout the
winter, and enjoy better health as a result.
Outdoor activities...
For those who enjoy the great outdoors, there
are many excellent and inexpensive opportunities
to add some variety to your family’s winter
physical activity routine. There are many
locations where families can walk, jog, ski, skate,
snowboard, snowshoe or go tobogganing. The
City of Winnipeg operates a number of skating
rinks and toboggan hills throughout the city,
some of which provide heated washrooms and
warming shelters. The City of Winnipeg also
maintains cross-country ski and walking trails. To
obtain rink, hill and trail information, visit www.
winnipeg.ca/publicworks/parks/winterindex.asp.
And parents should note that preschool and
school aged children reported in a recent survey
that tobogganing and other winter activities were
fifth in popularity out of all activities, regardless
of the season.
Indoor activities...
If you would rather enjoy the winter wonders
viewing them through the warm side of a
window, check out the nearest community,
leisure or fitness centre for some indoor physical
activity options.
• Many facilities
offer programs and exercise
equipment designed to suit your
specific needs. Some facilities offer fitness
memberships that allow you to use the
facilities only during the winter months.
• Several local community clubs have walking
clubs that walk indoors at local schools and
malls. It’s a great way to socialize and get
your daily dose of activity too!
• Winter is a great time to take up a new
indoor sport or try a new activity. Sport
Manitoba’s website (www.sportmanitoba.ca)
can help link you to a wide array of indoor
leagues and sports, with everything from
archery to wrestling.
• Treadmills, steppers and other home exercise
equipment can make a great companion
to your favourite sitcom, drama or news
broadcast. Using this exercise equipment
several times a day, even for as little as 10
minutes at a time, is a good start towards
improved health.
• You can also work towards your daily dose
of physical activity at home by replacing
commercial breaks with “in motion” breaks.
Stand up, march on the spot, do a few wall
push-ups, climb the stairs, or play with the
dog. Including more lifestyle activity in each
day is a great way to maintain mobility and
improve your health.
• Check out the City of Winnipeg Leisure
Guide for opportunities to become more
active in your community area (www.
winnipeg.ca/cms/leisure/).
As a reminder, if you are new to activity or
have been inactive for a long time, be sure to
speak with a health professional before starting
any new exercise program. Whatever the
weather, be sure to make physical activity a part
of each day.
Physical Activity.
It’s good for your health.
Do it for life!
Winter Wonderland
Walking Tips
I
n a recent survey, walking was reported as the most popular yearround activity for adults. That should not be a surprise, as walking
is one of the easiest, least expensive and safest ways to build more
activity into every day.
Personal walking programs can be done inside or out. As long as
you plan ahead and dress for weather conditions, cold weather should
not prevent you from starting a walking program. If you prefer warmer
surroundings, walking at malls, schools and even in the hallways in your
apartment are excellent ways to add steps to your daily routine.
Walking outdoors in the winter can be challenging, but with proper
preparation, you can enjoy the many wonders that winter has to offer. Use
the following tips to help you discover new routes and safely navigate the
snow, ice and cold:
• Take shorter steps, walk flat-footed and bend your body slightly
forward, keeping your weight over the centre of your feet. If you slip
and begin to fall backward, make sure that you bend your back and
head forward to protect your head from hitting the ground.
• Before heading outdoors, plan your route, check the local weather
forecast and dress accordingly.
• Winter days are short, so know when sunset is. If out after dark, be
sure to wear bright and reflective clothing for safety.
• Recruit a walking partner for pleasure and safety. If a friend can’t
make it that day make sure that family or friends know where you’re
going.
• Wear shoes and boots that provide good traction. For added traction,
slip-on walking and jogging winter treads are available at specialty
shoe stores.
• Carry identification and personal medical information at all times. If
possible, carry a cell phone.
• For safety, use a pair of trekking poles with a carbide tip (crosscountry ski poles will do). This will help to maintain balance and will
also provide an upper body workout.
If winter walking seems like a good idea to you, whether indoors or out,
visit www.winnipeginmotion.ca/walkingworkout/ and sign up for your own
personalized walking program. Once you sign up, Winnipeg in motion
will provide you with motivational tips, a walking chart to monitor your
progress and other suggestions that will help you add years to your life and
life to your years.
www.wrha.mb.ca
TO FIND OUT MORE
ABOUT THE WINNIPEG
REGIONAL HEALTH
AUTHORITY,
log onto our website:
www.wrha.mb.ca. You’ll find information
about how we care, where you can find care,
opportunities to work in health care, how
we’re improving and innovating in the field of
health care, as well as the latest health care
news.
Looking for a specific site or service? Click
on the Encompass database under “Finding
Care” on the WRHA Web site to search the online health services directory.
is produced by the Winnipeg Regional Health
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