Stanton Territorial Health Authority: Kay Lewis, CEO

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Providing healthcare in a large geographic region where the population is sparse presents unique difficulties, but for healthcare professionals there are a number of benefits, as well. Not only was Kay Lewis, CEO of Stanton Territorial Health Authority since December 2008, drawn by the opportunity to see and experience a part of Canada she had never seen before, she was drawn to a service area where she felt her work would really make a difference.

Stanton Territorial Hospital provides emergency referral services for nearly 450,000 square miles, a quarter of the geography of Canada, with a population of approximately 40,000 in the Northwest Territories. An additional 10,000 residents are served in the western region of Nunavut, the newest and geographically largest territory in Canada. Almost 20,000 of the total population served by the Stanton Territorial Health Authority are in the capital city of Yellowknife, where the Authority makes its home. Yellowknife lies about 250 miles south of the Arctic Circle. “Most of these very small communities don’t even have road access,” says Lewis. “There is no ground ambulance service; there are Medevac support teams taking patients in and out.”

Lewis oversees 450 staff members who are supporting thirty-three community health centers throughout the region. As well as the 100-bed acute care hospital, Stanton Territorial Health Authority also oversees a number of Specialists Clinics, the Stanton Ophthalmology Clinic, the Mental Health Clinic, and the Health Promotion and Protection branch, which oversees water quality, the tobacco act, and food safety issues for all of the Northwest Territories.

Caring People Providing Excellent and Culturally Relevant Health Services

There are eleven official languages in the Northwest Territories and five of those are widely spoken within the city of Yellowknife, “so you have to be very sensitive to the culture,” says Lewis. Stanton Territorial Health Authority provides aboriginal support services in the hospital as well as interpreters for patient care on the floors.

“I really think our success is defined by our people who are delivering the services and the high quality of our staff,” says Lewis. Serving such a sparse and diverse population gives the physicians and other healthcare professionals the opportunity to gain experience in a variety of practice areas. “You can certainly look forward to broadening your scope and level of expertise,” says Lewis.

Specialists are available in nearly every area of medicine, but where there is a shortage or when the volume of patients in a particular health niche is simply not great enough to justify a specialist, there are arrangements in place to use specialists from elsewhere, mainly Alberta. Doctors from outside the region, for instance, currently provide urology, neurology, and rheumatology services. Specialists travel between the larger regional centers allowing smaller communities to have access to their expertise and specialty care. “Our specialists truly function as consultants,” says Lewis. “The primary care is done by hospitalists.” A solid foundation of teamwork between the specialists and the general practitioners helps to assure that all patient needs are met.

Emergency services are linked with regional and provincial partners in order to assess patients and determine the level of care needed. The department also acts as a territorial hub for urgent patient transport and Medevacs. When necessary, the emergency department physicians provide telemedicine services to remote clinics and nursing stations.

Moving Quality of Care Forward

The Stanton Territorial Hospital has only been open since 1988, but Lewis says changes in care provisions, in particular ambulatory care, have already required the development of a plan to improve emergency room services and ambulatory care.

In March of 2009, the hospital began the transition from film to digital imaging. This digital imaging picture archiving and communication system (DI/PACS) represents a $5.9 million investment on the part of Canada Health Infoway and the government of the Northwest Territories.

“Certainly the challenge is to make sure we can use technology to enhance service delivery. I think given our small size, we have done quite well to keep pace with other hospitals.” “We have components of the electronic medical health record on site at this point in time,” says Lewis. There are also plans to move forward to a full EMR in the near future.

Successful Initiatives

Lewis is pleased with the progress of a number of areas of healthcare in the Northwest Territories. “We’ve done very well with chronic disease management from a diabetes perspective,” she says. “We also have programs related to patient and staff safety. Because we have staff coming and going, there is a lot of support and orientation for new staff as well as professional development opportunities for all levels of staff.” The Ophthalmic Medical Technologist Training Program, for instance, has been highly successful and Lewis sees it as a potential model for other training programs. Highly trained technicians support the ophthalmologist to serve a broader population and needs for ophthalmology care.

Open communication and truthful discourse about the business of healthcare and the challenges within are important to Lewis as the leader of the Stanton Territorial Health Authority. The organization will begin a marketing campaign in the near future that will help communicate the goals of the health authority to the public. An image of a human hand, in all its shapes and forms, will be the vehicle for conveying the message, “Your health is priority one”.

“We are very proud of our achievements,” says Lewis. “We have built a very strong territorial referral hospital with quality practitioners and are proud of the level of professional practice we have here and the overall commitment to quality care in this organization. We pride ourselves on providing a very high quality of care.”

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