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1 October 2012 SDA Newsletter This issue: Feature Article: Health Care Trilingual? 1 2 Registrar s Report.3 President's Report..3 Get to Know your Board...7 SDA Board Highlights. 7 SDA Member Updates 10 Dates to Remember Oct 1 Deadline for applying to write Fall CDRE Nov 3 CDRE The Saskatchewan Health Care System: Becoming Trilingual? Chelsea Haley, RD Hoshin Kanri, Kaizen, Jidoka, Heijunka, Kanban; You will likely hear these Japanese terms floating around health care in the months to come. This is because the province has recently signed a one year contract with John Black and Associates (JBA), renewable over the next 3 years, to help us transform the Saskatchewan Health Care system. JBA has had years of experience helping the Virginia Mason Medical Center in Seattle in their pursuit of becoming a high performing health care system. JBA first started working with Virginia Mason in 2001, helping them to apply Lean principles, traditionally used in manufacturing settings, to their health care system. JBA s methodology and plan for Saskatchewan is centered around two approaches: a new approach to strategic planning, and a new approach to management. The province has been working with JBA since last November to help us establish a new strategy planning system, known as Hoshin Kanri, or Strategy Deployment. JBA s methodology of focus and finish means that the province will act as one system versus our traditional history of working as 13 independent health regions. The province will collectively choose key areas of focus each fiscal year to reach established targets over five years. This level of collaboration and conversation among the regions and the Ministry of Health has never before been seen in the development of targets and strategies. Hoshin Kanri uses a method of successive checking of the strategies that are developed, through a process called Catchball. The strategies are first developed by the Provincial Leadership team (PLT) comprised of all of the regional CEOs, SCA, HQC, ehealth, 3S, the Deputy Minister of Health and 3 physician representatives then passed to the Vice President level of the organization through a facilitated 2 day session of catchball. This session provides the VP level with the opportunity to weigh in on the feasibility and practicality of the strategies proposed, and make recommendations and suggestions that then go back to the PLT for revision. This catchball session is designed to happen at every level of the organization, right down to the front line staff, with the rationale being that the people who are closest to the work have the best idea of how the work should be done, and the most accurate understanding of potential obstacles and barriers. This methodology is also designed to generate increased understanding, ownership, and commitment to the regional and provincial goals, by having the opportunity for all levels of the system to weigh in. The Health Plan ( released in March, was a result of the province s first efforts at Hoshin Kanri strategy planning. Each region and the system partners (Ministry of Health, SAHO, 3S Health, ehealth, HQC, SCA) have now begun their Diagnosis and Review session, a mid year review of improvement efforts to date that will help inform the Hoshin Kanri Strategy Development sessions for

2 Hoshin Kanri Strategy Deployment Model Senior Leaders in the province are currently undergoing Lean Leadership Certification (LLC), as the second part of the JBA transformation methodology. The certification process is completed over months and requires a significant time commitment from participants, spent both in learning the theory of lean principles, as well as handson experiential learning. The training is centered around the notion that leaders need to get out to the gemba, or the front line, where the work actually happens. You will likely be seeing much more of your Senior Leaders in the months to come, as they continue to practice their new leadership skills on the floor! CEOs, VPs, Directors, and members of the Kaizen Promotion Offices (KPO previously the Quality Improvement Departments) are first out of the gate in the first wave of LLC. The 5 year target for the healthcare system is to have 880, or 1% of the overall staff complement, certified in LLC. These certified lean leaders will then use lean tools such as Value Stream Mapping, Rapid Process Improvement Workshops (RPIW), 3P Events, and 5S throughout their organizations to help gain efficiencies and reduce waste in their processes, moving the province towards our shared vision for healthcare: The intent is that lean improvement methodologies will be widespread throughout the system. As a Dietitian, watch for an RPIW coming to your hospital or clinic soon! For more information about Saskatchewan s current journey with lean to date, visit For more information on outcomes achieved by Virginia Mason during their lean transformation, visit Saskatchewan s vision for healthcare 2

3 Registrar s Report: Lana Moore RD In late August I had the privilege of attending the Preceptor Workshop in Saskatoon. It was a great opportunity to re connect with SDA members, often whom I only get to know electronically. That day I sat beside a current dietetic intern who was brimming with excitement to start her internship and enter into the dietetics profession. In the following weeks, I received Donna Wiebe s reflections on her career in her Honorary Lifetime Affiliate submission, Chelsea Haley s feature article on Hoshin Kanri and Tammy Ives s description of upcoming continuing education opportunities offered by Dietitians of Canada. In reading the articles and looking at all of the upcoming learning opportunities, I was struck by the amount of change that we as dietitians experience in our professional lives over the course of our careers. Not only changes in the science of nutrition, but also changes in the world around us (technology, medications, education strategies, organizational philosophies). When we finish our academic and practical training, we write the Canadian Dietetic Registration Exam to demonstrate our competence. Being a dietitian is about more than just demonstrating our competence on exam day it is also about a commitment to continuing our competence over the course of our professional lives. Just as Donna reflected on the changes she was witness to over the course of her professional career, I wonder what will change over the course of the career for the intern whom I sat beside at the workshop. Maybe someday we will look back and chuckle at some of our current practices and laugh in the same way we do at the thought of tablets and urine testing for diabetes management described by Donna. It is exciting to be part of the profession that is continually evolving. President s Report: Charlotte Pilat Burns, RD I started in the role of President of SDA at the end of June and I am very excited to work with the fantastic group of Board members that we have this year. I have enjoyed my experiences as a member of the Discipline committee, MAL of Discipline and President Elect with SDA so far and look forward to the next two years in this role. I know I have lots to learn as the new President but I feel that we are in a good position as an Association thanks to the hard work of the previous Board and the outstanding SDA staff members. Some of the work ahead of us in this upcoming year is the implementation of the new Integrated Competencies and the development of the Scope of Practice for Dietitians. If you have any questions or comments, please feel free to contact me at [email protected].

4 Honorary Lifetime Affiliate Donna Wiebe I attended the University of Saskatchewan, graduating in 1973 with a Bachelor of Science in Home Economics (B.S.H.Ec.) majoring in Dietetics and Nutrition. I was fortunate to obtain an integrated dietetic internship at the Royal Alexandra Hospital in Edmonton, meaning that I was able to complete 4 months of the internship during the summer between third and fourth year of university, then return for the remaining 8 months of internship following graduation. Even as an intern, I had a special interest in working with people with diabetes and I had the opportunity to facilitate the group class about healthy eating for people with diabetes. I chose to spend the one week in an area of our own choice at the Diabetes Education Centre at the University of Alberta Hospital. At that time, the program offered a four day group class where clients learned about food restrictions and urine sugar testing. What an opportunity it was for me to meet and observe the workings of famous diabetes specialists such as Dr. Gordon Brown! My internship opportunities inspired me to become passionate about working with people with diabetes. I completed internship in January 1974, and was awarded a threemonth maternity leave dietitian position at the Royal Alexandra Hospital. After the completion of my internship and short work term, I returned to my home in Aberdeen to get married and to begin to seek employment in Saskatchewan. I found a posting for a therapeutic dietitian position at the Moose Jaw Union Hospital. I applied by sending off a letter describing my qualifications and suitability for the job. When the personnel director phoned me to set up an interview time, to my delight, he also offered to set up an interview for a job for my husband, who is a pharmacist. Following the interviews, we were both offered and accepted the positions. At that time, Moose Jaw Union Hospital was an acute care facility with 228 beds. My position was a busy position that provided dietitian service to both inpatients and outpatients. Since I had a special interest in diabetes diet counseling, I developed a program to include a weekly class on an introduction to the diabetes diet for both inpatients and outpatients. Outpatient referrals from local physicians grew by leaps and bounds. I was invited to participate in an evening diabetes education program sponsored by the local VON team that fall. I also was approached to assume the role of nutrition consultant for the local branch of the Canadian Diabetes Association, a volunteer position which I held until my retirement. In 1986, a second dietitian was hired and I chose to take the newly created position as outpatient dietitian at the Patient Education Centre (PEC). A registered nurse joined me, and we became a strong team as educators for both the Cardiac Rehabilitation Program and the Diabetes Education Program. In addition, through the PEC, I offered therapeutic diet counseling and a weight management program. Over time, the PEC grew in its capacity and additional nurse and dietitian positions were added. How rewarding it was to have clients return for follow up visits to report to us that they felt better and had improved blood sugar results. The more I became involved with diabetes education, the more passionate I became for working with people with diabetes. Over time, our scope became more diverse with the addition of a renal unit at our hospital. 4

5 In 2006, as I retired from my position with the Patient Education Centre and the Moose Jaw Union Hospital, it was a joy for me to leave my position to two very competent young dietitians who were sharing a dietitian position at the time. This meant that they were both able to move into full time positions and I was able to retire confident that they would carry on the good work that we had done together. Although I had officially retired, when a clinical dietitian position became vacant at Valley View Centre, a facility in Moose Jaw which houses both mentally and physically challenged persons, I decided to apply. I was soon writing my first ever resume and was offered the position. This was a great opportunity for me to learn more about dysphagia management and to take up the challenge of providing ongoing nutritious meals to residents with varied and unique nutritional challenges. I served in this capacity for two years when I decided to permanently retire from my profession. This was a difficult decision, and with the help and guidance of our SDA Registrar Lana Moore, I felt privileged to become an honorary lifetime affiliate of SDA. As I reflect back, I realize how fortunate I was to have an exciting and rewarding career in dietetics. It is also interesting to reflect back and realize how much diabetes management has changed over the thirty years during my career. In the 1970 s, the diet for control of diabetes was one of restriction. Clients were taught to measure foods using food scales for protein foods, measuring cups and spoons for other foods, and to keep the diet consistent from day to day, in order to match as closely as possible to the insulin peaks. There was no flexibility..no sleeping in even after a big night out, no blood glucose meters, and no human insulins. Clients collected their urine in a cup and did tests in test tubes using a pill in 10 drops of urine. Depending on the color that their urine changed to, determined whether it was negative, meaning they had no sugar in their urine, or high, meaning they were in danger. There was absolutely no way to tell what their blood sugar was except by how they felt. Over the years, there were many new developments the field of diabetes. With carbohydrate counting, blood glucose monitors, human insulins, new medications, insulin pens, insulin pumps, people with diabetes can be much more flexible with nutrition and their lifestyles. One of my clients summed it up well when he said I wish I had returned to you for updated diabetes diet information sooner. You have so much good news to tell me. What I remember from twenty years ago is that the dietitian at that time told me to eat only half a banana. I thought she was crazy. Life is so much better now for a person with diabetes than it was in the 1970 s! I would like to thank Lana for the opportunity to provide this submission for the SDA newsletter. Reflecting upon my career in dietetics has been very gratifying to me. I so appreciate being able to share my experiences and I hope that my enthusiasm inspires someone to become a professional dietitian or to take a similar career path. Nutrition Day survey will take place on Thursday November 8, 2012 What is Nutrition Day? Nutrition Day is an international 1 day cross sectional audit that collects information to: help Hospitals and Long Term Care improve how they identify patients who may be at risk of malnutrition increase awareness of the prevalence of malnutrition through patient monitoring and benchmarking It was established in 2006 to draw attention to the under recognized problem of malnutrition, with Canadian facilities participating since Visit nutritionday.org for more information or contact Luiza Kent Smith at [email protected]

6 SDA Continuing Competence Program Audit Observations Each year 5% of the SDA Membership is selected to participate in the continuing competence program audit. The audits are completed in the Spring of each year and it is intended to evaluate the member on their compliance with the continuing competence program. Members are asked (among other things) to submit their self assessment, completed learning plan and supporting evidence. Please retain your continuing competence documentation for five years as auditors can ask for previous years documentation upon request. One of the issues that arose this year is that some of the goals were written as job tasks or business plans rather than goals to increase knowledge or skills in a specific area. When goals are written as job tasks, evaluations do not show evidence that those activities had an impact on practice or competence. Learning should increase knowledge in a specific area and have an impact on practice. So, revisit your learning plan and ask yourself if your goals for this year are job tasks or competency goals. If you need to make a change, contact the registrar and she can assist you. Examples: Job tasks (NOT APPROPRIATE don t demonstrate learning or increase in knowledge): To give 3 presentations. To revise the department policy manual To attend a (specific) conference. Competency goals (APPROPRIATE, demonstrate learning or increase in knowledge in specific area): To improve my presentation skills. To update skills in writing effective policies. To increase my knowledge in (specific area). Congratulations to SDA Member and Board Past President Natasha Haskey on being selected to receive a 2012 Young Alumni Achievement Award from the University of Saskatchewan. The Alumni Achievement Awards recognize graduates of the University of Saskatchewan for excellence, leadership, and innovation in their achievements and contributions to the social, cultural, and economic well being of society, which positively reflect on the University of Saskatchewan and the Alumni Association. Natasha s was nominated by Adriene Danyilw who wrote in her submission essay, in her short career to date as a Registered Dietitian (Natasha) has contributed immensely to the well being of this province. Her leadership, innovative spirit, and natural abilities as a mentor make her an outstanding model University of Saskatchewan alumnus, and one very deserving of an Achievement Award. Her calm, humble, caring, hard working and professional attributes have touched, and will continue to benefit countless patients and families, as well as colleagues, U of S students, and fellow 6 U of S alumni.

7 June 26, 2012 (AGM) Presentation of Annual Report for 2012 Re appointment of Andrea Banadyga to MAL of Professional Standards, Natasha Haskey completed her term as SDA President and Charlotte Pilat Burns appointed as new SDA President. July 18, 2012 (Teleconference) Finance update and re investment of GIC Discussion regarding the PDEP meeting in June and update on PDEP competencies and accreditation September 15, 2012 (Saskatoon) SDA Board Highlights Finance update, review of updated Financial policies, re investment of GIC Review of proposals for website upgrade (Member s Only) The next SDA Board meeting is scheduled for Nov. 17, Get to know your SDA Board! Seshni Naidoo MAL of Discipline Seshni received her Bachelor of Science in Nutrition from the University of Saskatchewan in Since then, she has also completed both a Business Administration Certificate and a Executive Business Administration Certificate from the Edwards School of Business at the University of Saskatchewan. Seshni has primarily practiced as a Manager of Food Services in the long term care environment since convocation. She currently works in the Saskatoon Health Region as a Regional Food Service Dietitian. Seshni Naidoo MAL Legislation Some of her interests include traveling, reading, cooking and experimenting in the kitchen. Seshni and her husband welcomed their son, Nikhil, in October 2011.She has two pet bearded dragons Sam and Marley that she loves spending time with. Seshni is looking forward to being involved in SDA and working with her fellow Dietitians.

8 The Saskatchewan Dietitians Association (SDA) and Dietitians of Canada (DC) recently piloted a primary health service Ask A Dietitian that provided free access to a dietitian for all residents of Saskatchewan, including health professionals and other front line providers. The pilot project provided the opportunity to trial the service and obtain feedback from residents, health professionals and other front line providers. The pilot was conducted to answer the question of whether Ask A Dietitian would be an effective way to provide access to reliable nutrition information to help residents make informed choices related to their family and their own health. For the short time the service was available it was received very well by the public, health professionals and other front line providers with 100% stating they found this service useful and 93% saying they would definitely use the service again. Based on this information we are recommending the following: Continue Ask A Dietitian service year round with Registered Dietitians or at minimum conduct a longer pilot for 1 to 3 years. Ensure that the service is based on the patient first philosophy and primary health concept by offering the service for free to residents and building relationships with health professionals and other front line providers. Explore opportunities to link with services such as Saskatchewan HealthLine or other organizations. Promote the service to rural and remote areas of Saskatchewan. This includes working and connecting with health professionals and front line providers in these locations, as the residents may not have access to a phone or internet. Extend Ask A Dietitian hours to exceed those of the pilot project to make the service more user friendly. Obtain a license to use the Call Center PEN (CCPEN) Database. Provide various forms of connecting with Ask A Dietitian through phone, , and reaching out to targeted audiences through social media. Budget for promotion of the service and follow up expenses such as mail outs. Have systems in place to address language barriers and hearing impairments, similar to that of other call centers. Ensure ongoing collection of data to monitor service utilization and quality. DC and SDA continue their advocacy efforts to establish the Ask A Dietitian service as a long term program. Copies of the final report to the Minister of Health, Minister of Rural and Remote Health, Opposition Health Critic, Chief Medical Health Officer, Health Quality Council, 3 S Health and the CEOs of the regional health authority. View the Executive Summary/Report at the addresses below and pass along to those who you feel might be interested and/or able to aid our advocacy efforts

9 SDA Thanks Roseann Nasser A sincere thank you to Roseann Nasser who has resigned from her role as SDA Representative to the Alliance of Canadian Dietetic Regulatory Bodies. Roseann has been a part of the SDA Board for many years and has held the positions of MAL of Discipline, President, Past President and SDA Representative to the Alliance. In her role as Alliance Rep she has given countless hours to teleconferences and national meetings that required travel and time away from her work and family. Roseann has long held a vision for new and different way for the stakeholders in the profession to work together and this vision was key in the development of the Partnership for Dietetic Education and Practice (PDEP) group. Roseann is a humble leader who holds a lot of the history of the SDA Board and whom was key in building the foundation to allow SDA to develop into a regulatory body. Her calm and collaborative perspective have been great assets to SDA Board. InterD 5 workshop November 16 social & November 17 workshop Saskatoon, SK Do you work in an interdisciplinary setting? Are you interesting in making your collaborations more effective? Register at The conference is planned by the College of Physicians and Surgeons, Saskatchewan Registered Nurses Association and the College of Pharmacists of Saskatchewan, but is intended for all health professionals interested in collaborative health care teams. Learn how to: Overcome obstacles and proactively engage other health care professionals in providing a more coordinated approach to care. Enhance patient safety in the hospital and outpatient settings through a structured approach to hand offs and transitions. Adopt interdisciplinary care management practices that improve access to services while increasing your capacity to handle heavy patient loads. Use tools and communications techniques collaboratively to ensure patients are effectively engaged as managers of their own health condition. Design and develop collaborative care solutions that will have a significant impact on your day to day practices

10 SDA Member Updates Welcome to the following members who have transferred from other provinces: Robin Miller Farewell to the following who resigned from SDA: Courtney Bodnar Congratulations to those who passed the CDRE in May 2012 and became full practicing members: Kristen Bueckert Stephanie Hill Welcome to the members with Restricted Licenses who will write the CDRE in November 2012: Jennifer Baker Erin Bowers Megan Boschman Lacey Miller Jayme Nicholls Garrett Neil Noura Sheikhalzoor Are you a great writer? Have an eye for grammar and/or editing? If so, please consider joining SDA s Communication Committee! The Committee is currently seeking members who would be interested in working on the content for the Members Only website upgrade as well as contribute to the editorial team for the quarterly SDA Newsletter. For questions or further details, please contact Lana Moore: [email protected] 10 Saskatchewan Dietitians Association # th Ave, Regina, SK S4R 1C2E. [email protected] P. (306) F. (306)