Update on Horizon’s Critical Action Priorities Horizon has a plan to improve health care in New Brunswick. Our plan is focused on retention and recruitment efforts, in addition to improving the overall patient experience by addressing patient flow and access to services. Our four priority areas are: The power of working together for change Like the rest of Canada’s health care systems, our system in New Brunswick has been struggling, despite having well-intentioned, well-trained, and hardworking leaders, physicians and staff providing excellent care. There is no one action, change or person that will fix our system. It is going to take many people, with many ideas, changes, pilot projects, and attempts to make our system better. That is the approach we are taking. More than 70 projects have been initiated in eight hospitals, 31 community sites, and 17 departments. Millions of dollars have been invested in improvement changes. This report showcases the work that’s progressed in the last six months. Update on Horizon’s Critical Action PrioritiesView PDF ACCESS TO SERVICES Overview Focusing on barriers impacting access to health care services for our patients, with a special emphasis on emergency care, surgical services and addiction and mental health services Our accomplishments Hip replacement surgeries now being performed at Horizon’s Upper River Valley Hospital Following the successful launch of knee replacement surgeries, the surgical team at Horizon’s Upper River Valley Hospital (URVH) is now improving access for orthopedic surgery patients who have been waiting for a new hip. Total hip replacement surgeries are now being performed by Horizon surgeons and staff at URVH. Click here for details. New prenatal care program for pregnant individuals in the Fredericton area without a primary care provider Horizon is launching a new prenatal care program for pregnant individuals in Fredericton without a primary care provider. The Department of Obstetrics and Gynecology at Horizon’s Dr. Everett Chalmers Regional Hospital will provide access to an obstetrician for pregnant individuals in the Fredericton area without access to a primary care provider for the duration of their pregnancy. Learn more here. Horizon thoracic surgeons complete Canada-first fluoroscopic navigation bronchoscopy using Illumisite technology Thoracic surgeons at Horizon’s Saint John Regional Hospital have completed a landmark procedure using technology acquired through an innovative fundraising initiative led by the Saint John Regional Hospital Foundation. Dr. Brian Johnston and Dr. Crispin Russell recently performed successful fluoroscopy navigation bronchoscopies using the Illumisite platform, a first-of-its-kind achievement in Canadian medicine and a significant step forward for lung cancer care in New Brunswick. Click here to learn more. New partnership to significantly increase access to cataract surgeries in Miramichi region A new partnership between Horizon and a Miramichi-based ophthalmology clinic is tripling the number of cataract surgeries being completed on a weekly basis in the region. The agreement between Horizon and the Miramichi Cataract Surgical Center is dramatically enhancing access to cataract surgeries in the Miramichi region while increasing OR availability for other surgical procedures at Horizon’s Miramichi Regional Hospital (MRH). Click here to learn more. RHA community outreach teams collaborate to support shelter clients Outreach programs are being expanded to help shelter clients in Moncton and Saint John, thanks to collaboration from Vitalité and Horizon health networks. In Moncton, Vitalité’s Public Health and Addiction Mental Health services, Horizon’s Primary Health Care team, and the Salvus Clinic are coordinating their efforts to improve care for clients at shelters. Click here to learn more. Horizon surgery initiatives see an extra 115 patients receive hip or knee replacements over four-month period Over the last four months,115 additional orthopedic surgeries have been performed by Horizon health care teams, resulting in a 35 per cent reduction in the wait list for patients waiting longer than a year for a hip or knee replacement. These results are thanks to various process improvement initiatives, such as the high-intensity interval theatre (HIIT) initiative, which saw elective hip and knee surgeries performed outside of normal operating hours. Click here to learn more. New program improving quality of life, reducing need for surgery for osteoarthritis patients Horizon patients living with hip and/or knee osteoarthritis can now benefit from an internationally-recognized education and exercise program, which has already improved the quality of many participants and even allowed some to reconsider the need for surgery. Good Life with Osteoarthritis Denmark (GLA:D) Canada is an evidence-based program to treat and manage hip and/or knee osteoarthritis symptoms. It helps with managing and slowing the progression of osteoarthritis, improving patient outcomes (increasing function, decreasing pain) and reducing the need for total joint replacements and opioid use. Click here to learn more. Fredericton health centre increasing access to primary care Horizon’s Fredericton Downtown Community Health Centre has expanded its services to include same-day, self-referral appointments with nurse practitioners (NP), increasing access for primary care in the Fredericton area. Appointments will be made available for patients on Tuesday, Wednesday and Thursday. These are not walk-in appointments and must be booked by phone. Read more here. New after-hours psychiatry clinic making significant impact in connecting clients to mental health services A new initiative is dramatically enhancing access to psychiatry services for clients in the Moncton area, with dozens of patients – children/youth and adults – being removed from the waitlist and connected to the care they need in the right place, at the right time. Horizon psychiatrists Dr. Rozario Anthony and Dr. Syed Sadiq recently opened the doors to their clinic at 234 Reade St., located steps away from Horizon’s The Moncton Hospital. The clinic provides clients with far greater flexibility to attend appointments outside of traditional daytime hours of operation and will help further reduce the waitlist for mental health services in the Moncton area. Read more here. More patients receiving MRI appointments through optimization tactics More patients are receiving appointments, wait times have decreased and waitlists have been reduced, thanks to process improvement projects to optimize magnetic resonance imaging (MRI) services at Horizon. A pilot project at Horizon’s Miramichi Regional Hospital (MRH) has increased the number of patients seen in a week from 56 (2021) to 83 (2023) – an increase of almost 50 per cent — and decreased the average wait time between appointments to just under eight minutes, from 17 minutes. Read more here. New online tool will allow loved ones to see patient’s surgery status in real time Horizon, together with Service New Brunswick, is pleased to introduce a new online patient surgery tracker for patients who have planned elective surgeries at Horizon’s The Moncton Hospital (TMH) and Sackville Memorial Hospital (SMH). This pilot project will allow families of a patient undergoing elective surgery to view the patient’s surgery status (such as in pre-operative care, surgery or recovery, or ready for discharge) online in real time from any device. Read more. Total knee replacement surgeries now available in Waterville The surgical team at Horizon’s Upper River Valley Hospital (URVH) in Waterville is improving access for orthopedic surgery patients who have been waiting for new knees. Starting this week, total knee replacement surgeries will now be performed at URVH, many of which will be day surgeries. Once fully operational, up to eight knee surgeries per week could be completed by staff in Waterville. This program is estimated to serve an additional 360 knee replacement patients in one year, as well as reduce wait times and improve the patient experience. Read more. High-intensity interval theatre (HIIT) initiative to see Horizon complete up to 96 additional orthopaedic surgeries over next several months Members of Horizon Health Network (Horizon)’s Surgery Program are taking an innovative approach to performing surgeries on patients who have been waiting the longest for orthopaedic surgeries, which will improve access to surgical services and decrease the overall wait time for in-demand surgeries. Surgical teams in Fredericton, Miramichi, Moncton and Saint John will complete a “blitz” of up to 96 surgeries – primarily orthopaedic (hip and knee replacements) – on Saturdays in November, December, January and February. Typically, operating rooms (ORs) do not run planned surgeries on weekends. Click here for details. Horizon and Sussex community action group addresses ongoing health care challenges Horizon Health Network (Horizon), in partnership with community leaders in the Sussex area, have come together to find solutions to ensure accessible and sustainable health services in the Sussex area. The Sussex Health Centre (SHC) and Sussex and Area Action Group has been established and work is now underway – the group has held its initial meetings in September and October where the overall goals and objectives, team structure and roles and responsibilities were established. Read more here. Horizon’s Mobile Crisis Unit in Miramichi offering expanded hours of service Horizon wishes to inform the public that its Mobile Crisis Unit (MCU) in the Miramichi area is offering expanded hours of service to better meet the needs of clients by improving access and client experience for this important service. As of Nov. 1, Miramichi’s Mobile Crisis Unit has expanded its hours of service to respond to addiction and mental health crisis needs in the community from 8 a.m. to 8 p.m., seven days a week. Read more here. Horizon extends successful pilot to hire three more addictions and mental health social workers for emergency departments The addition of an addictions and mental health social worker in the Emergency Department (ED) at Horizon’s Dr. Everett Chalmers Regional Hospital has helped improve access to addiction and mental health services for over 1,900 patients since January as part of a pilot project. Based on this early success to offer additional support to these patients, Horizon is expanding the pilot project into three more emergency departments: three more social workers will join our addiction and mental health teams in Moncton, Saint John and Miramichi. These social workers will help ensure patients who come to our EDs with addiction or mental health concerns receive improved care and support in their recovery. Click here for additional details. Horizon introducing series of enhancements to Forensic Nurse Examiner services Horizon is introducing a series of strategic changes to its Forensic Nurse Examiner (FNE) program which will help ensure consistent access and improved care for survivors of sexual assault and intimate partner violence. These measures were identified as a result of an internal review of Horizon’s FNE program – formerly known as the Sexual Assault Nurse Examiner (SANE) program – services undertaken by the organization earlier this fall. Forensic Nurse Examiners provide specialized nursing services and trauma-informed care to victims of sexual violence, intimate partner violence, and maltreatment to any individual including men, women, teens, children, seniors and members of the LGBTQ community. Read more here. Expanded surgical services to launch at select community hospitals As part of our commitment to improving access to surgical services for our patients, we’re investing $6.4 million to expand surgical programs at our hospitals in Upper River Valley, Oromocto, Sackville and Sussex. This is an important and exciting investment in our facilities and staff, which will benefit patients throughout the province. Read more here. Surgery and Critical Care regional directors and medical leads Horizon is taking an important step toward improved management of Horizon-wide programs by adjusting the leadership and organizational structure of its clinical departments to improve collaboration and consistency across Horizon and the patient experience and outcomes. Two new regional positions have been created to co-lead Horizon’s Surgical department. Amy McCavour has been appointed as the Executive Regional Director, Co-Leader. She will be responsible for the operational planning, management, and leadership of the Surgical and Intensive Care department to ensure services/programs are developed, operated, and evaluated while maintaining efficient and effective resource utilization, patient/family satisfaction, and quality patient care that meets established standards and public expectations across all health zones. Read more about Amy here. Dr. Patricia Bryden has been appointed as the Executive Clinical/Academic Department Head, Co-Leader. She will oversee daily operations of the Surgical and Intensive Care department in all Horizon facilities relating to the quality of medical care, professional development, and medical staff issues, and will ensure compliance with Horizon Health Network By-laws and Medical Staff Rules and Regulations and accountability measures in accordance with the bylaws and all Horizon Health Network policies. Read more about Dr. Bryden here. PATIENT EXPERIENCE Overview Introducing initiatives focused on providing quality care experience for our patients Our accomplishments $155 million in renovations underway at Horizon’s Saint John Regional Hospital Construction work has begun on the first stage of a $155-million multi-year project to modernize and expand Horizon’s Saint John Regional Hospital. The multi-phase project will enhance care delivery by modernizing and expanding the hospital. Learn more here. Oncology nurses to help cancer patients navigate their care The provincial government announced today that a team of oncology nurses is in place tasked specifically to help patients navigate the complex system for cancer care. Through a partnership involving the provincial government and Horizon and Vitalité health networks, eight oncology nurse navigator positions have been created, covering each zone within both health authorities. Read more here. Celebrating successes of community collaboration in Tantramar A successful recruitment campaign highlighting the community, improved employee recruitment and engagement, and facility upgrades are just some of the early successes out of a collaboration between Horizon Health Network (Horizon) and the Rural Health Action Group (RHAG), a community-based organization formed to establish sustainable health service delivery for the Sackville, Memramcook and Tantramar area. Furthermore, an in-depth review of current health care services in the Sackville area, with an analysis of gaps and opportunities was completed by RHAG’s Service Design Working Group (SDWG), and the recommendations are being analyzed to create an outline for next steps. Click here for more information. $41 million invested to support accessible and quality health care The provincial government is investing $41 million in capital funding to support its health-care partners in their delivery of accessible and quality health care. The funding from the Department of Health is for equipment less than $100,000 and refurbishments and was provided earlier this year to Horizon Health Network, Vitalité Health Network, and Extra-Mural / Ambulance New Brunswick. Click here for all the details. Upgrades to Sackville Memorial Hospital Emergency Department complete Renovations to Horizon’s Sackville Memorial Hospital (SMH) Emergency Department (ED) have been completed, and the ED will re-open in its original space next week. The renovations include modernizing the ED and fixing damage from flooding that occurred in September 2022. Read more here. Update on recruitment and retention efforts, capital upgrades at Horizon’s Sackville Memorial Hospital Horizon Health Network (Horizon) is making progress in its efforts to recruit and retain frontline health care workers at Horizon’s Sackville Memorial Hospital (SMH), while also moving forward with key infrastructure upgrades at this facility. “We know that our health care system and our local communities are at their best when we all take ownership of these challenges and work hand-in-hand to address them openly, transparently and collaboratively,” said Margaret Melanson, Horizon’s interim President and CEO. Click here to read the news release. Pilot project of social workers in Emergency Departments benefitting patients, reducing social admissions A pilot project that sees social workers intervene with patients in emergency departments (ED) is helping prevent social admissions, reduce emergency department visits and strengthening early co-ordination of social determinants of health to decrease the length of stay for admitted patients. This pilot project started at Horizon’s Saint John Regional Hospital in January 2022. The program was also introduced at The Moncton Hospital and Miramichi Regional Hospital in spring 2022 and the Dr. Everett Chalmers Regional Hospital in Fredericton in summer 2022. Learn more here. Improving patient experience by adding staff to monitor and support patients in the ED wait rooms While you wait to be triaged and seen in the ED, you may be introduced to our newest care team members who work exclusively in hospital waiting rooms in Fredericton, Miramichi, Moncton, and Saint John. They may be a licenced practical nurse (LPN), a personal care attendant with specialized training (PCA 2), or a nursing student who is eager to help on the frontline. After introducing themselves to you, they may: Check your vital signs; Ensure you are comfortable i.e., bring you a blanket if you are cold, or water if you are thirsty; Report any concerns to the triage nurse or ED staff; and Monitor the well-being of others who are waiting in the ED. Read more about this program here. PATIENT FLOW Overview Streamlining the way patients move into, through and out of our hospitals Our accomplishments Virtual consultations now available for patients seeking urgent mental health care in Horizon Emergency Departments Patients with mental distress who present to a Horizon Emergency Department (ED) can now connect virtually with an addiction and mental health team and or a psychiatrist. Virtual care consultations are now available 24 hours a day, seven days a week, as an alternative option to in-person sessions. Click here for details. Improving patient flow with a smile Patient flow and access to services are two key areas Horizon has committed to improving, along with retention and recruitment and improving patient experience. The Physician Assistants (PA) at Horizon’s Dr. Everett Chalmers Regional Hospital in Fredericton are doing just that in the Emergency Department, which is why we are adding a third PA to support this ongoing effort. PAs assess patients, order tests or review results with the patient, prescribe medications and help implement a recovery plan. We are able to do this with the help of Ryan Bennett and Kevin the two PAs at the DECRH. Read more here. RETENTION & RECRUITMENT Overview Implementing initiatives to retain valuable health care workers paired with an aggressive recruitment strategy Our accomplishments Horizon reports significant recruitment gains in 2022-23; hundreds more staff providing care throughout health care system Horizon successfully recruited nearly 2,400 employees during the 2022-23 fiscal year, representing a net gain of 550 more health care professionals who are providing safe and quality care for patients, increasing access to services, and supporting our current workforce. From April 1, 2022 to March 31, 2023, a total of 528 registered nurses (RNs), 337 licenced practical nurses (LPNs) and 523 personal care attendants (PCAs) were recruited to Horizon, in addition to hundreds of additional support staff and allied health professionals. Read more here. Nurse Practitioners Now Included in Horizon Referral Reward Horizon has expanded the Horizon Referral Reward to include Nurse Practitioners. New Brunswick residents, along with Horizon staff and physicians, can now refer an eligible Registered Nurse (RNCA) or Nurse Practitioner (RNCD) to work for Horizon and receive a $1,000 Horizon Referral Reward. There is no limit to how many candidates one individual can refer. And right now, for a limited time, if a Registered Nurse is successfully referred to work in one of Horizon’s Critical Care Units or Emergency Departments, the reward will be DOUBLED. That’s $2,000! Read more here. Horizon employees step up to help co-worker be with family when she needed it most Tosin Abioye has been working at Horizon’s Saint John Regional Hospital for six months. In December, her family had a medical emergency. Thanks to a generous donation from her coworkers in the Palliative Care Unit, Tosin was able to take some time off and spend it with her family during this critical time. The team collectively donated 150 hours of vacation time so Tosin could be with her family. Learn more here. Horizon partners with ThriveNB to help our newly recruited Internationally Educated Nurses settle into their communities Akhila and her family moved from India to Sackville, NB, in October. Moving to a new country is never easy, but thanks to the new partnership between Horizon and ThriveNB, Akhila’s move was seamless. ThriveNB is an organization with the goal of helping newcomers settle in the province. Horizon has officially partnered with them to help internationally educated nurses (IENs) settle in our province. Learn more here. Horizon’s pledge to nursing students and grads: Guaranteed employment Horizon’s Student Nurse Advancement Pledge (SNAP) provides nursing students with a seamless transition from student to nurse. Guaranteed employment is offered to all BScN/BN and Practical Nursing students and grads from any recognized college or university across Canada. Horizon will support nursing students through numerous career paths in a variety of specialty areas and settings. Click here for details. Bravo! – Showing employees we care September is Employee Appreciation Month and we’ve been showing our appreciation to staff at employee appreciation events across the province. Through our Bravo! program, patients and their families can share stories about an employee who went above and beyond to make a difference. Learn more here. Horizon Nurse Recruitment Dashboard We are committed to keeping our staff, physicians, volunteers, and the public informed of our nurse recruitment progress. One way we are doing this is by showing how many nursing staff have been hired in Horizon facilities. We are doing this by publishing the Horizon Nurse Recruitment Dashboard. It provides a snapshot of how many nurses (Registered Nurses, Licensed Practical Nurses and Patient Care Attendants) have been recruited thus far in our fiscal year from April 1, 2022 to March 31, 2023 and where they came from – whether it was New Brunswick, other provinces, or outside of Canada. The numbers are updated daily and show progress toward our nurse recruitment targets. For additional information, visit our website and read our latest accomplishments. Employees Health, Wellness and Safety Initiatives Employee Health Wellness & Safety has evolved into a department with multiple focuses: Injury Prevention, Occupational Health & Safety, Employee Health and Employee Wellness. We recently launched three new initiatives to support our employees through the summer surge in COVID-19 cases: an employee greeter program at our four large regional hospitals that have see an increase in outbreak units, on-site COVID-19 booster clinics and an enhanced outdoor seating project. Read more about these initiatives here. Nursing Recruitment Since April 1, Horizon talent acquisition specialists have successfully recruited and onboarded 255 Registered Nurses (RNs), 159 Licensed Practical Nurses (LPNs) and 275 Patient Care Attendants (PCAs), in addition to hundreds of allied health professionals and support service workers across several fields of expertise. Learn more here. Horizon Referral Reward Program Horizon is actively recruiting nurses, physicians and other health care workers to work in New Brunswick, and you can help. If you are a New Brunswick resident, or a Horizon staff member or physician and want to spread the word about Horizon career opportunities, this is your chance to be rewarded – in dollars! Your reward depends on the eligible position that is successfully referred. Learn more about the Horizon Referral Reward Program here. Read more! May 5, 2023 “Small things can make a big difference”: Horizon physiotherapists and occupational therapists help hospitalized patients get home faster From left to right, physiotherapist Justin Saulnier, occupational therapist Michelle Goguen, and Tara Mann, manager of Physiotherapy Services for Horizon’s Moncton area. Tara Mann, a Horizon physiotherapist, … February 17, 2023 “I have accomplished so much since I completed the GLA:D program” Meet Joyce, a former participant of Horizon’s Good Life with Osteoarthritis in Denmark (GLA:D) program. After learning about it from a physiotherapist, Joyce attended … February 8, 2023 New online tool will allow loved ones to see patient’s surgery status in real time All New Brunswickers deserve accessible and quality health care and a positive patient experience, and this initiative is one example of how Horizon is … September 28, 2022 Improving patient flow with a smile Physician Assistants (PAs) play a crucial role in patient care at Horizon’s Dr. Everett Chalmers Regional Hospital (DECRH) in Fredericton. They work as part … September 22, 2022 Pilot project of social workers in emergency departments proving to have tremendous benefits to patients The social work in emergency department pilot project at Horizon’s Saint John Regional Hospital has been a success thanks to the coordination and teamwork … September 9, 2022 An exceptional patient experience, every step of the way By Peter Moore, a grateful loved one If you know someone who works in the health care system, feel free to share this with your … Explore more Horizon Stories We want to hear from you! Horizon Health Network is committed to involving people affected by the decisions it makes. Whether you are a staff, physician or volunteer, or a patient, client or family member, or member of the public – we want to hear from you in a way that is meaningful to YOU. Visit our Let’s Talk Horizon platform for all current engagement projects.