Welcome

New Employee Handbook

hsnsudbury.ca

A Message from the President & CEO

Globally recognized for patient-centred innovation

On behalf of the Board of Directors and Senior Management Team, I would like to congratulate and welcome you to Health Sciences North (HSN). As a member of the personnel, you play an important role in our health-care team and we value your contribution.

As a leader in the community, we are committed to providing the best quality patient care in a compassionate, collaborative and responsible manner.

Our personnel is our greatest asset and is the key to achieving and maintaining excellence in service that our patients have come to expect and continue to receive. As an organization, we are committed to creating a nurturing environment where people will feel fulfilled and grow.

Our quest to become one of the most advanced academic health sciences centres in Canada will have significant benefits for our staff, learners, patients and the communities we serve.

We are pleased that you have chosen to work at HSN and hope you have an enriching experience with us.

1 Welcome!

2 Table of Contents:

Occupational Health & Safety Policy Statement 4 Internal Responsibility System (IRS) 5 Joint Health & Safety Committee (JHSC) 6 Working Safe at HSN 7 Code of Conduct 8 Vision, Mission & Values 9 Welcome! The Hub 10 Policies & Procedures 12 Identification Policy 12 Influenza Immunization Policy 12 Dress Code 13 Smoke Free Property Policy 13 Want to Quit Smoking? 13 Control 14 HSN’s Social Media Policy 16 HSN Emergency Code Overview 18 Accident & Hazard Reporting 20 A Good Catch! 21 Musculoskeletal Disorder Prevention (MSD) 22 Freedom of Information & Protection of Privacy Act (FIPPA) 24 Privacy & Confidentiality 26 Information Technology (IT) 27 Volunteer Services 28 French Language Services 29 Corporate Communications 30 Health Sciences Library 31 HSN Parking 32 Organizational Development & Learning (ODL) 34 HSN Programs, Services & FAQs 35 HSN Programs & Services 38 RLHC Facility Maps 39

3 Occupational Health & Safety Policy Statement

Health Sciences North (HSN) is committed to providing and maintaining a safe and healthy work environment for our employees, physicians, patients, volunteers, visitors, contractors, sub-contractors and the general public through prevention. This commitment is documented in the organization’s Occupational Health and Safety Policy Statement. The Statement is the springboard to our Health & Safety Management System and is reviewed annually. It can be found on the Intranet and strategic locations with HSN workplaces. The Statement is:  HSN’s commitment to preventing occupational illness and injury in the workplace, including violence;  Recognizing senior management’s responsibility to implement and maintain a safe and healthy work environment;  Of responsibility to ensure that safe and healthy work conditions are maintained in his/her assigned work area;  A statement of responsibility to work in accordance with legislated standards and employer Safe Work Procedures/Practices.

Are you able to name two locations where you have seen our Health and Safety Policy Statement?

4 We are all responsible for Health & Safety!

The Occupational Health and Safety Act (OHSA) sets out the minimum standards for safe practices within workplaces and outlines roles and responsibilities for the workplace parties. The Ministry of Labour enforces the OHSA and regulations. The OHSA and internal health and safety (H&S) policies outline what specifically occurs at HSN. The specific roles and responsibilities of employees at any level of the organization are outlined in HSN’s Internal Responsibility System (IRS) policy. This policy is intended to outline the responsibilities of all HSN management and employees, and how they work together to make an efficient and effective Internal Responsibility System (IRS). The IRS is the underlying philosophy of occupational health and safety legislation in all Canadian jurisdictions. Its foundation is that everyone in the workplace—both employee and employer—is responsible for his or her own safety and for the safety of coworkers. Acts and regulations do not always impose or prescribe the specific steps to take for compliance. Instead, it holds employers responsible for determining such steps to ensure the health and safety of all employees. All designated workplace parties, including the CEO-President, Vice Presidents, Directors, Supervisors, Managers, Employees and contributory parties (Joint Health and Safety Committee, Unions, Occupational Health and Safety Services) have the obligation to know and comply with their health and safety roles and responsibilities. All workplace parties are directly responsible for health and safety as an essential part of their job—to review, understand and apply their specific accountabilities identified in the IRS policy.

Roles & Responsibilities at HSN Employer—Senior Leadership and applies to the HSN Officers, Chiefs and Vice Presidents. (OHSA Sec. 25, 26, 32) Supervisor—Management and applies to Directors, Managers, Supervisors, and Coordinators (OHSA Sec. 27, 32)

Worker—all employees (OHSA Sec. 28 and small piece in 32)

Employees have the following rights under the Act, 28(1):

 The right to know; Read and understand the IRS

 The right to participate; and Policy. Find HSN policies on

 The right to refuse work. the Hub or ask your supervisor for a copy.

5 Joint Health & Safety Committee (JHSC)

The Joint Health and Safety Committee (JHSC) is a consulting group that helps to excite or raise awareness of health and safety issues in the workplace; recognizes and identifies workplace risks; and develops recommendations for the employer to address these risks. To reach this goal the JHSC:

 Holds regular meetings;

 Conducts physical workplace inspections; and

 Makes written recommendations to the employer for the improvement of the health and safety of workers.

Members of the JHSC will also participate in Ministry of Labour (MOL) inspections, critical injury/fatality investigations and work refusals as directed by the Occupational Health and Safety Act (OHSA). The OHSA is enforced by the MOL.

It is important that the committee understand that the day-to-day health and safety functions and corrective actions to be taken in the workplace are the responsibility of the employer, supervisor and worker as outlined in the Internal Responsibility System (IRS) policy.

Everyone has the right to participate in the JHSC

Worker members of the JHSC represent ALL workers at HSN whereas management members represent all HSN management.

All employees should know who sits on the JHSC and feel comfortable to bring issues forward for discussion. Employees are to first address health and safety issues with their department management team as outlined by the IRS policy and the Employee Hazard/Incident/Accident reporting policy. If unsure about the process for reporting hazards and incidents, talk to your manager or the OHSS for guidance.

Members have additional health and safety training. If interested in participating on the JHSC tell your manager, union and/or the Occupational Health and Safety Services (OHSS) department at ext. 1010.

Posted on the intranet you will find JHSC information including:  Current list of JHSC members  Schedule of physical workplace inspections at HSN Want to read more  JHSC meeting minutes  Ministry of Labour Orders and Field Reports on the JHSC?

 MOL’s A Guide to the JHSC/H&S Representatives Visit: www.labour.gov.on.ca

6 Working Safe At HSN

Gloves protect your hands from germs and help reduce the spread of germs. However, since hand contamination may still occur due to leaks in the gloves or improper removal, the use of gloves cannot be considered to be a substitute for hand hygiene. Hand hygiene must be performed after glove removal.

Masks cover your mouth and nose.  A surgical mask helps stop germs in your nose and mouth from spreading. It can also keep you from breathing in some germs.  A special respiratory mask (N95 respirator) forms a tight seal around your nose and mouth. It may be needed so that you do not breathe in small germs like tuberculosis bacteria. Remember! All staff must complete N95 mask fit testing every 2 years!

Eye protection includes face shields and goggles. These protect the mucous membranes in your eyes from blood and other bodily fluids. If these fluids make contact with the eyes, germs in the fluid can enter the body through the mucous membranes. Prescription glasses are NOT considered proper eye protection.

Clothing includes gowns, aprons, head covering, and shoe covers.  These are often used to protect you and the patient.  They are also used to protect you when you work with bodily fluids.

Removal of PPE The process of taking off your PPE is just as important as wearing your PPE! The process of personal protective equipment removal requires adherence to the following process to prevent recontamination: 1. Remove gloves and discard using a glove-to-glove/skin-to-skin technique. 2. Remove gown. Discard in linen hamper in a manner that minimizes air disturbance. 3. Perform hand hygiene. 4. Remove mask and discard. 5. Perform hand hygiene.

Soiled linen and waste must be disposed of in designated bags and handled using standard precautions to prevent personal contamination and transfer to other patients. DO NOT DISPOSED OF SHARPS IN LINEN OR WASTE BAGS.

Sharps Injury Prevention  Recapping of a used sharp is an unsafe practice that leads to a multitude of preventable sharps related injuries  Sharps are to be disposed of immediately and only in the labeled puncture- proof containers If you find a sharps hazard, report it and take steps to eliminate it!

7 Code of Conduct

HSN is committed to providing a safe, healthy and supportive working environment by treating our employees, medical and credentialed professional staff and clients with respect, fairness and sensitivity. Violence in the workplace can have devastating effects on the quality of life for our employees and on the productivity of the organization.

In keeping with the living nature of this mission, the following Pledge has been developed as a further affirmation of our code and behaviors, and as a guide to the mutual relationships that characterize the HSN culture. The concept of the Pledge emphasizes that this is a commitment that flows not just one way but among many people. All members of HSN will acknowledge and sign the Pledge.

In an effort to promote a culture of safety, wherever possible, the same reporting process as an Employee Hazard/Incident/Accident Report and forms are being utilized. The goal is to reinforce existing processes making it easier for individuals to remember ‘what’ to do ‘when’ to do it, and ‘how’ to follow-up. Based on this, issues relating to the Code of Conduct follow the general steps and requirements set out in the Hospital’s Employee Hazard/Incident/Accident Reporting Policy.

Principles of Conduct Dignity Reliability Fairness Trust Professionalism

8 Our Vision, Mission & Values

Our Vision Globally recognized for patient-centred innovation

Our Mission Improve the health of northerners by working with our partners to advance quality care, education, research and health promotion

We Value Excellence Respect Accountability Engagement

9 10 The Hub

11 Policies & Procedures

Policies and procedures form the bedrock of a health organization’s success. Employees, physicians, medical learners, students, volunteers, vendors, and contract workers depend on policies and procedures to establish standards on how various processes must be conducted – from processing payments, to protecting patient information, to meeting healthcare compliance regulations, to admitting patients, to conducting surgical procedures. From time to time, you may need to reference policies and related documents. These can be found on the Hub under ‘Policies and Procedures’. Here you can use the search feature found on the left hand side to search for documents you need.

Identification: Staff are expected to wear/display an HSN issued identification badge at all times. To obtain a hospital ID badge please visit Human Resources at the Kirkwood Site – Cottage 1 to have one made. You will require valid identification to receive a badge (i.e. driver’s license and/or health card). HR is open Monday-Friday from 0800-1600 hours and you can reach them at (705) 523-7100 x3990 to book an appointment.

Influenza Immunization: For the safety of its employees and patients, HSN has put in place a protocol which requires employees to choose to either maintain an annual influenza immunization as per HSN policy or to wear an isolation/procedure mask when they are working in patient care areas or providing patient care services during

12 Dress Code: Appropriate professional clothing, including footwear, is required at all times. Program and department specific dress codes may also be in effect. If you are unsure, please ask your supervisor for clarification.

Smoke Free Property Policy: Health Sciences North (HSN) strives to provide a healthy environment for patients, visitors and all who work at HSN. This includes healthy behaviours, such as not smoking. HSN is 100 percent smoke free and prohibits smoking on all HSN owned properties inclusive of personal vehicles parked on HSN property. HSN properties include the Ramsey Lake Health Centre and the Sudbury Outpatient Centre. Smokers must leave hospital property to smoke.

HSN Smoke Free Property Maps

Want to quit smoking?

Staff interested in quitting smoking should call Human Resources at extension 3390 for information for all employees, their spouses and dependent children. These individuals each quality for a $500 lifetime benefit towards prescription and over-the- counter smoking cessation aids.

For further information on HSN’s smoke- free grounds, please refer to HSN’s Smoke -Free Policy located on the Hub.

13 Infection Control How infection spreads:

Three (3) elements are required: 1) A source of infectious microorganisms; 2) A susceptible host; and 3) A means of transmission for the microorganism.

Unfortunately, healthcare facilities have several sources of infectious micro-organisms, including;  People can harbor a variety of microorganisms such as bacteria, viruses, parasites, yeast and fungi.  Contaminated objects can also be sources of infection such as bedpans, floors, medical equipment, laundry, tables….etc. To be transmitted, microorganisms must enter the host’s body. This may be done via: Inhalation Break in the host’s skin Contaminated needle or other sharp object Mouth, eyes, nose or other openings into the body

How to Wash your Hands

14 Elements of Routine Practices:

Risk Assessment Administrative Controls Barrier Equipment (PPE) Gloves  Perform an assessment before  Maintain staff education and each interaction to determine ongoing training  Whenever contact with mucous required interventions to membranes, non-intact skin, prevent exposure to self and  Just Clean Your Hands (4 blood/body fluid, secretions/ other patients. Moments for Hand Hygiene) excretions, contaminated equipment or surfaces is Understand and follow policies   Routine Practices anticipated. and use control measures.  Respiratory Etiquette (stay  Perform hand hygiene after Understand your risks of  home when sick, cover your glove removal exposure i.e. will there be cough, 2 meter separation) exposure to blood and body Healthy workplace,  Do not wash or re-use gloves fluid during the procedure/ immunization interaction? (compliance with Gowns hygiene, confusion, invasive  Worn to protect the mucous procedure) membranes of the nose, mouth  When procedure is likely to and eyes during procedures/ generate splashes or sprays or  Do I need protection from activities that generate splashes contact with infectious material. patient’s symptoms? (FRI, rash) or sprays of body fluid, or within 2 meters of a coughing  Should be worn only when patient. Environmental Controls providing care for patients  Change mask if wet  Is there appropriate bed  Never re-use spacing (private rooms, toilet  Clean eye protection between facilities, cohorting of patients  Not to be worn as warm-up patient use with like illness)? jackets  Do not re-use or hang around  Is there cleaning of patient care  Do not go from patient to neck equipment following every use? patient Is there ventilation (HVAC) for  Proper, up to date fit-testing  Masks / Respirators and Eye special environments (OR, negative pressure, fume hood)? Protection

 Worn to protect the mucous How to Handrub membranes of the nose, mouth and eyes during procedures/ activities that generate splashes or sprays of body fluid, or within 2 meters of a coughing patient.

 Change mask if wet

 Clean eye protection between patient use

 Do not re-use or hang around neck

 Proper, up to date fit-testing

15 HSN’s Social Media Policy

Who does the policy affect? All HSN employees, physicians, medical learners, students, volunteers and contractors on-duty and off-duty.

Why does HSN need a Social Media Policy? HSN recognizes that social media is a valuable tool in communication. As we become more active online, responsible use of social media will ensure the protection of privacy, confidentiality, reputation and dignity of our patients, ourselves and our organization.

What constitutes “Social Media”? Any facility for online publication and commentary including, but not limited to: blogs, reviews, Twitter, Facebook, LinkedIn, Pinterest, YouTube, etc.

Should I stop using social media? No, in fact, the opposite is true. HSN encourages you to connect with our organization online through Facebook, Twitter, LinkedIn, YouTube and Pinterest, all the while ensuring you are abiding by the policy. Social Media use is permitted on your own personal device on your own time as long as your behaviour does not interfere with your responsibilities at HSN, and if applicable, to your profession.

Know that even with privacy settings, your comments have the potential to be made public. Assume that anyone could read your posts: managers, co-workers, patients, the public, the media, etc. Always think before you post.

How do I abide by the policy and continue to use social media? Read the Social Media Policy in full on the HSN Intranet and abide by the Terms & Conditions.

 Do not disclose names, personal health information or circumstances of patients, their families, and your colleagues. Doing so is a breach of the PHIPA.

 Do not post photos, videos, or audio of patients, guests or their families.

 Posting photos, videos, or audio of staff/colleagues requires verbal consent from those individuals.

 Where your connection to HSN is apparent, make it clear that you are representing yourself, not HSN.

 Treat an online conversation with the same confidentiality as an in-person conversation and do not discuss incidents that have occurred in the workplace.

16 HSN’s Social Media Policy

What if I want to use social media on behalf of HSN? Please contact Corporate Communications to determine usage needs. If approved, you will obtain training and a copy of HSN’s “Guidelines for Official Participation in Social Media”.

What are the consequences of not abiding by this policy? HSN staff, whether on-duty or off-duty, who are found to be acting on social media in a manner that is inconsistent with this policy or with other HSN policies may be required to correct, edit or remove a post or statement and may be subject to disciplinary action up to and including termination of employment or affiliation with HSN and, in more serious cases, the organization may pursue legal action as appropriate.

Find HSN’s full Social Media Policy on the Hub!

Key Points:

 Social media is changing the way we live and work  It’s changing the way that patients and communities access health information  It gives all of us a voice in healthcare and with that voice comes responsibility  This policy is here to protect and guide you in your work

For further questions regarding HSN’s Social Media Policy, contact Sarah Wendorf, Social Media & Web Specialist, at ext.3212.

17 HSN Emergency Codes Overview TO CALL OR CANCEL ANY CODE DIAL x5555 Provide Switchboard with: → Code Being Called (i.e. Code White, Code Blue, etc.) → Building/Tower of Code (i.e. SOC or RLHC Centre Tower, etc.) → Location/Department of Code (i.e. Level 2, , etc.) → Room Number/Room Name (i.e. Patient room #, Cafeteria, etc.) TO CALL SECURITY Emergent Threats (crime in progress, violence, etc.) DIAL x5555 or 911 Non-Emergent Threats (falls, suspicious activity, etc.) DIAL x3205 (Main Security Desk—RLHC) or DIAL x0 (have Switchboard page Security) Report Complete Complete Code to Staff Staff Pool Search Code-Specific Responsibilities Pool? Roster? Map? AMBER If missing from your area: Dial Dial x5555 and Call 911 Missing Provide Switchboard with a description of the missing child/youth Child/Youth Complete the Meditech missing patient report Child All Staff: x5555 Abduction Secure elevator and floor exits—no one permitted to leave building (full lock down) BLACK If you receive the bomb threat: for Dial x5555 Bomb Threat Phone: Complete the Bomb Threat Checklist Mail/Hard Copy: Do not handle document ALL Email: Do not remove from screen BLUE Called for anyone 30 days or older Code Blue Team will respond If in your area: Adult/Child Codes Dial x5555 Cardiac Arrest → For children call “Code Blue—Child” or Medical Provide assistance consistent with your level of knowledge, skill, and Emergency ability If not in your area and you are NOT a Code Blue Team member: Do not respond (no action required) BROWN If in your area, follow S P I L L: Safely evacuate In-facility Prevent spread of fumes Hazardous Spill Initiate notification (dial x5555) Leave electrical alone (i.e. light switches) Locate MSDS (ensure cleanup of spill in accordance with proper pro- cedures) If not in your area: Avoid spill area GREEN Dial x5555 Code Green Alert: Evacuation Report to Staff Pool (if not already there) Wait for further instructions Code Green Confirmed: Initiate your department/unit evacuation procedures in accordance with instructions from Senior Administration GREY Dial x5555 All Staff: External Air Ensure all windows and exterior doors are closed Exclusion Ensure all accessible ventilation outlets are sealed Ensure no one enters or leaves the building

This is a quick reference sheet only. To view the complete Emergency Response Procedures for each code, go to Emergency Preparedness on the Hub.

18 HSN Emergency Codes Overview

Report to Complete Complete Code Staff Staff Pool Search Code-Specific Responsibilities Pool? Roster? Map? ORANGE Dial x5555 External disaster impacts the hospital, causing patient surge Disaster All staff: Return to work area Await instructions from Manager/Supervisor ORANGE CBRN Dial x5555 External CBRN disaster impacts the hospital (patient surge with CBRN Disaster exposure) Chemical/Biological/ All staff: Radiological/Nuclear Return to work area Await instructions from Manager/Supervisor PINK Called for anyone zero (0) to one (1) month old or any NICU patient Advanced Resuscitation Team will respond Neonatal If in your area: Cardiac Arrest or Dial x5555 Medical Emergency Provide assistance consistent with your level of knowledge, skill, and ability If not in your area and you are NOT an Advanced Resuscitation Team member: Do not respond (no action required) PURPLE Hostage Taking IN DEVELOPMENT RED If in your building: Report to Staff Pool and remain there until Code is cancelled or Fire instructed otherwise

If you discover fire, R E A C T: Remove occupants Enclose area (close doors) Activate alarm (pull station) Call x5555 (give exact location of fire) Try to extinguish fire only if safe to do so SILVER All Staff: Call 911 Weapons Threat/ Do not attend the scene Active Shooter Evacuate yourself, patients, and visitors if possible If evacuation not possible, hide If in a locked down unit, remain there and hide If in immediate danger from shooter, attempt to disrupt or incapacitate shooter WHITE Code White Response Team will respond. If in your area: Violent/Behavioural Dial x5555 Situation Respond to scene Assist/support the threatened person If not in your area and you are NOT a Code White Team member: Do not respond (no action required) YELLOW If missing from your area: Dial x5555 Adult Missing Person Provide Switchboard with a description of the missing individual Complete the Meditech missing patient report

This is a quick reference only. To view the complete Emergency Response Procedures for each code, go to Emergency Preparedness on the Hub.

19 Accident & Hazard Reporting

Sometimes accidents happen or there was the potential to cause injury. It’s important to know that all work related incidents must be reported.

Step 1 If you identify a hazard you can’t correct on your own or get hurt / sick as a result of your work duties, you must report to your manager immediately.

Step 2 Your manager will complete the YELLOW Supervisor/Manager’s report with you as soon as possible in accordance with the law and HSN policy.  If your manager is not available, you must complete a BLUE Employee Report. Fax a copy to OHSS and ensure your manager gets a copy. *The BLUE form does not replace the YELLOW form; it is the same as a verbal report and it triggers the process described above.  If the work-related injury specific to overexertion/ strain (MSDs) came on over time (no specific accident), you will be asked to complete a PINK Gradual Onset Report in addition to the YELLOW Report.  If there are witnesses to the accident, your manager will ask you to ensure that GREEN Witness Statements are completed by them and returned to him/her.

Step 3 If you require (or may require) medical attention, you must take a PINK envelope. The pink envelope contains a cover letter to the physician and a WSIB Functional Abilities Form (FAF). If you see a health professional, the completed FAF must be returned to your manager before your next scheduled shift. The health professional will charge the WSIB directly for completion of the form so you will not be asked to pay. The form asks for functional information only – what you can and cannot do as a result of the injury.

Step 4 Before your manager finishes the reporting process with you, s/he should remind you that: HSN will provide modified duties at no wage loss; You must discuss modified duties with your doctor; The WSIB may not pay wage loss benefits if they agree that the work offered you was suitable (even if you are authorized off work); and The FAF must be completed and returned to him/her as soon as possible (preferably before your next scheduled shift).

Step 5 When the YELLOW form is complete, your manager will review it with you OR allow you to read it over; both you and the manager need to sign and date the form.

Step 6 The manager will fax the report to the OHSS before the end of the shift (or within 24 hours at the latest) and give you a copy. 20 A Good Catch!

21 Musculoskeletal Disorder Prevention (MSD) What is an MSD? Musculoskeletal Disorders (MSDs) are injuries and disorders of Examples include: muscles, nerves, tendons, ligaments, cartilage, and bones.  Back Strain/Sprain  Carpal Tunnel Syndrome MSDs result mainly from exposure to risk factors (or ‘hazards’) related to primarily force, posture and time.  Epicondylitis—Lateral/Medial  Bursitis MSDs can be the result of a one-time event or develop over  Tendonitis time. At HSN, MSDs are reported and tracked as “Overexertion/ Strain”.  Trigger Finger

What causes MSDs?

Know the hazards! High force demands = increased MSD risk

Force refers to the amount of effort made by the muscles, and the amount of pressure on body parts as a result of different job demands. All work tasks require workers to use their muscles to exert some level of force. However, when a task requires them to exert a level of force that is too high for any particular muscle, it can damage the muscle or the related tendons, joints and other soft tissue.

Force-related MSD hazards can be present when lifting, pushing, pulling, carrying, gripping, using tools.

Awkward or static postures = increased MSD risk

Posture is another name for the position of various parts of the body during any activity. For most joints, a good or “neutral” posture means that the joints are being used near the middle of their full range of motion. The farther a joint moves towards either end of its range of motion, or the farther away from the neutral posture, the more awkward or poor the posture becomes and the more strain is put on the muscles, tendons and ligaments around the joint. For example, when arms are fully stretched out, the elbow and shoulder joints are at the end of their range of motion. If the worker pulls or lifts repeatedly in this position, there is a higher risk of injury.

Posture-related MSD hazards can be present when bending, twisting, reaching, kneeling.

Repetitive movements/actions = increased MSD risk

The risk of developing an MSD increases when the same parts of the body are used repeatedly, with few breaks or chances to rest. Highly repetitive tasks can lead to fatigue, tissue damage, and, eventually, pain and discomfort. This can occur even if the level of force is low and the work postures are not very awkward.

Repetition-related MSD hazards can be present when doing the same thing over and over again, with little time for rest.

When MSD hazards are present, report them to your supervisor and talk about ways to reduce your risk of developing MSDs 22 Musculoskeletal Disorder Musculoskeletal Disorder Prevention (MSD) Prevention (MSD) Computer Workstations  Fully support your feet on the floor or a footrest  Your knees are level with or slightly below the hip joints  Top of monitor (or screen) no higher than eye level  No leaning forward to view the monitor  The keyboard and monitor are directly in front  The keyboard and mouse are at approximately the same height as your elbows  The mouse should be positioned at the same level as and as close as possible to the keyboard  Placing the mouse on your non-dominant side is an option to reduce the demands to your dominant side  Upper arms remain relaxed at sides  When your fingers are on the home row keys, your hand, wrist and forearm should be in a straight line  Change position frequently, for example, take a short 30 second micro-break for every 15 minutes of work and get up at least once each hour to move about

Violence Prevention

Violence can present itself in many forms, including physical harassment (e.g., hitting, shoving, pushing or kicking), verbal abuse (e.g., swearing, insulting or condescending language), and sexual abuse (e.g., any unwanted comment, gesture, sound or action of a sexual nature) that causes an individual to feel degraded, uncomfortable, and threatened or unsafe. At no time and under any circumstances is violence acceptable at HSN. Would you know what to do if you were faced with an aggressive or violent individual? It is imperative that you know your responsibilities in this situation. The primary focus of all Code White interventions is the care, welfare, safety, security and dignity of patients, visitors and co-workers. Talk to your supervisor and be prepared.

Needle Stick Injuries The Hospital has a Blood and Body Fluid Surveillance Program in place and promotes sharps and needle stick safety and prevention of these types of injuries. Safety engineered (needleless) intravenous systems and safety engineered needles have been implemented at HSN. All health care workers have a responsibility to handle sharps/needles with care. Employees who handle and dispose of sharps must follow the Sharps Handling and Disposal Policy/Procedures at all times. This document can be found on the intranet at the Occupational Health and Safety community. Report all sharps-related injuries or hazards promptly. Should an employee experience a sharps/needle stick injury, the surveillance program ensures that appropriate follow-up (i.e. lab work, counselling, education) is provided by the Occupational Health Nurse (or Emergency physician – after hours).

23 Freedom of Information & Protection of Privacy Act (FIPPA)

Frequently Asked Questions about FIPPA:

Why were brought under FIPPA? To increase transparency and accountability in our hospitals. Ontario was the only Canadian province in which hospitals were not covered by FOI legislation.

Who can make an FOI request? Individuals and organizations (ie. media, union, political parties, public etc). Anyone in the world can make an FOI request at HSN.

Does the hospital have a certain time period in which to respond to an FOI request? Yes, within 30 calendar days, unless there are special circumstances.

What is a record? Information that is recorded or that can be made into a record, whether in print, audio or electronic form (eg. emails, policies and procedures, handwritten and personal notes, assessment tools, expense claims/accounts, minutes of meetings, agendas etc.)

What records are not covered by the Act?  Personal Health Information  Abortion services  Certain labour relations, employment and placement matters  Research records

What is personal information (PI)? PI is information (factual or subjective) about an identifiable individual. It includes details such as name, address, gender, age, education, employment history etc.

Is any personal Information considered public? Yes, business contact information, including name, title, business address, business telephone number etc. is not considered personal information.

Can anyone obtain access to my personal information under FIPPA?

No, only you can obtain access to your own personal information. Contact Us: Patient Confidentiality: FOI Office It’s everybody’s job – Not everybody’s business Ext. 3999 [email protected]

24 Freedom of Information & Protection of Privacy Act (FIPPA)

Effective January 1, 2012, hospitals came under the provisions of FIPPA

1) Applies to records in the care and custody of hospitals on or after January 1, 2007.

2) Does not apply to personal health information in the custody or control of hospitals.

3) Personal health information is subject to the Personal Health Information Protection Act (PHIPA).

THE PURPOSES OF FIPPA 1) To provide a right of access to information in the custody or under the control of institutions such as hospitals; and

2) To protect the privacy of individuals with respect to personal information about themselves in the custody or under the control of institutions.

FIPPA establishes a right for every person to access information held by hospitals and provides a formal process for people to exercise that right by submitting a Freedom of Information (FOI) request.

HOW TO MAKE AN FOI REQUEST Anyone can make an FOI request. The request must have the following:

1) The request must be in writing either by letter or completing the Information Access/ Correction Request Form located on the HSN website (www.hsnsudbury.ca).

2) The request must provide sufficient detail so as to enable the hospital to identify the records being requested.

3) The request must be accompanied by the $5.00 application fee.

PROCESSING OF FOI REQUESTS AT HSN * 1) FOI Office receives all formal FOI requests and opens a file for tracking purposes; 2) FOI Coordinator sends acknowledgment to requester that request has been received;

3) FOI Coordinator may contact the requester to clarify/ narrow the request;

4) FOI Office contacts Department Leads to locate the records that are responsive to the request;

5) FOI Coordinator reviews the records to determine extend to which information will be disclosed;

6) FOI Coordinator notifies the affected parties; 7) FOI Coordinator makes the decision to grant or deny access within 30 calendar days of receipt of the request;

8) FOI Coordinator notifies the requester of the decision; and

9) FOI Office documents the decision.

* These are the general steps taken however there are numerous additional steps depending on the complexity of each request. 25 Privacy & Confidentiality Personal Health Information (PHI)

The hospital has policies and procedures that tell you how to collect, disclose, access and dispose of personal health information. Personal health information (PHI) is any kind of “identifying information” about a person. These policies follow the set of laws that have been put in place by the Ontario Personal Health Information Protection Act (PHIPA). Even if your job here at HSN does not require that you handle PHI, or provide care directly to patient/clients, you have a responsibility to keep what you learn while on the job here private.

You need to know that:  Look up your own PHI in the computer or the paper record. There is a procedure you must  If collecting PHI is part of your job, you may follow if you want to see your own PHI. collect only the information that is needed to provide health care, e.g. Social Insurance What is the “circle of care”? Numbers are not needed to provide health care. The circle of care refers to health care  If releasing PHI is part of your job, you can share professionals, students and volunteers, who are PHI with another organization only if the patient/ permitted to collect, use, disclose or handle PHI client has agreed, e.g. the patient/client has for the purpose of providing direct health care. signed a written release for an insurance These are people who need to see the information company. because they provide care/service to the patient.

 Everyone must always follow the policies for For example, keeping both paper and electronic health  In a physician’s office, the circle of care includes: records safe, e.g. you must keep files and the physician, the nurse, a specialist or other storage rooms locked at all times and protect health care provider referred by the physician logins and passwords. and any other health care professional selected  Everyone must always follow the policies for by the patient, such as a pharmacist or disposing of PHI safely, e.g. you must shred physiotherapist; paper records and destroy diskettes, instead of  In a hospital, the circle of care includes: the throwing them in the trash or reusing them. attending physician and the health care team  If a patient/client or family member asks to see (e.g., residents, nurses, technicians, clinical their own PHI, you must direct him or her to the clerks and employees assigned to the patient) HIS department. who have direct responsibilities of providing care to the individual. Do not: What is a privacy breach?  Tell your friends and family members about people that you see here and the care that they A breach of privacy can be: may be receiving.  Reading the record of a hospital patient/client, if  Discuss the personal details of a patient/client you are not involved in providing care to that with other staff members who are not providing person. care to that patient/client.  Losing PHI, whether you lose paper records or  Talk about the personal details of a patient/ diskettes or information that is stored in a client with other staff members who are laptop computer which is then stolen. providing care to that patient/client in areas Information accessed through the Internet by where you may be overheard, e.g. hallways, unauthorized people or paper records that are cafeterias, or elevators. left in the cafeteria or any other public place would be other examples.  Look up the health information of a patient/ client unless you are directly involved in  Talking about PHI in a public place, both inside providing care tot hat patient/client, e.g. this and outside of the hospital, with people who are means information in Meditech and/or any paper not part of the circle of care. records, and it does mean even for members of your own family. 26 Information Technology (IT) Username & Passwords Your Supervisor/Manager will provide you with your username and temporary password. The first time you log on you will need to change your temporary password. All information must remain within HSN. No documents are to be taken home (either hard copy or electronic version).

The Hub (Intranet) The Hub (internal website) is accessible only via HSN computers. You can access the Hub from an HSN computer you have been granted access to by either opening Internet Explorer (the Intranet is the default homepage) or by visiting https://intra.hsn.share/.

IT Service Desk Should you have any technical problems with your computer, please call x3332 ( Service Desk) and have your computer name handy (this is labelled in bright orange on your system). You can also submit your request electronically by visiting the IT Service Desk Request link on the intranet on the Toolbox page or by emailing [email protected]

Self Help You can find self help folders and documents on the Information Technology Intranet Page to guide you through most common technical issues. Go to https://intra.hsn.share/programs-services/ information-technology/service-desk-desktop-support 27

Volunteer Services How We Can Help

The role of Volunteer Services is to promote meaningful volunteer opportunities.

We match volunteer skills; interests and availability to the needs of your service and ensure they are appropriately prepared to assist you.

We work with staff to design suitable assignments, decide the qualifications for the position, support staff in their supervisory role, and mediate during times of conflict.

We promote the use of volunteers throughout the organization and help to create and customize unique volunteer opportunities to address your department’s needs.

Our Volunteers Volunteers actively support staff, patients and their families at our three sites, assisting in specific programs and services and enabling the hospital to make the most of its resources.

Volunteers come from all walks of life. They are secondary school, University and College students interested in the health care field. Volunteers are skilled professionals investigating a career change or heading into retirement after a career. Today’s volunteers offer experience, skill and their time.

Help Support Your Volunteer Program Building relationships is the key to successful volunteer placements. Recognize volunteers through your support, include them in discussions, and respect the time they donate to help you.

Volunteers have the expectation that their placement will be interesting and challenging. They believe in our cause and like you, are dedicated to the care of our patients. Support and stimulate your volunteer by mentoring them. The more they know, the more they can help. Like you, volunteers want to be challenged.

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Corporate Communications

The Corporate Communications Department of HSN serves as the liaison between the organization and its internal and external audiences. Corporate Communications works with all programs and services as well as the public to coordinate communications in a timely and efficient manner, and to enhance the activities of the organization through effective communications, while raising awareness of our many programs and services.

Communication Responsibilities:

· Intranet/Internet · Dialogue – monthly employee newsletter · Social Media & Web · Visual Standards · Management Forum – held monthly for HSN management · Communication Binders – available in each program/service area; houses important information for staff · Bulletin Boards/Display Cases – located in cafeteria and elevators · News releases & Public Service Announcements · Board Talk - corporate communiqué

Media/Public Relations & Social Media:

Department is the first point of contact for all media-related activities. Any media contact, whether initiated by the media or by a program, service, or staff member of the hospital, must be coordinated through the Communications Department. This includes interviews, photography or video/audio recording. Communications also invites “good news” stories and encourages staff to contact the Media/Public Relations Officer if they identify a noteworthy initiative or event within their program or service area. For your reference, the HSN has a Media Contact Policy is on the Intranet under HSN Policies and Procedures, Corporate Communications. The Communications Department also provides and maintains HSN’s social and web identity. HSN is currently on Facebook, Twitter, YouTube, LinkedIn and Pinterest, HSN also has a Social Media Policy that applies to all employees, physicians, medical learners, students, volunteers and contractors whether on-duty and off-duty. Any questions, whether regarding social media, media requests or community engagements should be directed through the communications department.

Check out Corporate Communication on the Hub: https://intra.hsn.share/programs-services/communications-subsite

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Health Sciences Library

Library Services: North Tower, Level 1 in hallway across from chapel Monday to Friday (0830 – 1630)

Patient Library – Main Lobby, Northeast Cancer Centre Monday to Friday (0900 – 1300)

Services: Literature Searches The Evidence Pyramid Document Delivery Tables of Contents Purchasing Training Sessions Patient Libraries  Northeast Cancer Centre  Children’s Treatment Centre  Sudbury Outpatient Centre  Voices for Women

Research: Catalogue Journals Databases Evidence based medicine resources

Contact us Tools: [email protected] Internet Access 705-523-7100 ext. 3375 (Health Sciences) ext. 2351 (Patient) Wireless Access Computers Visit our Website Meeting Rooms/OTN studio Mobile Education Laboratory (laptops) www.hsnsudbury.ca/PortalEn/library/

31 HSN Parking Paid Parking Cards

Ramsey Lake Health Centre and Centennial Drive cards are to be requested in person from the Finance Payment Office in Room 1200, South Tower, during regular business hours. Please note that the machines only take change. Alternatively, parking tokens may be purchased ($6 each).  Ramsey Lake Health Centre Card (P1 & P2, P8) $80.00/month, $36.92/pay  Centennial Drive Card $50.00/month, $23.08/pay

Sudbury Outpatient Centre and Sudbury Mental Health & Addictions Centre – Cedar Street cards are to be requested in person from the Payroll Office at the Sudbury Outpatient Centre.  Sudbury Outpatient Centre, Regent $80.00/month, $36.92/pay  Sudbury Mental Health & Addictions Centre, Cedar Street $36.83/month, $17.00/pay

Sudbury Mental Health & Addiction Centre – Kirkwood are to be requested in person from Switchboard at Kirkwood.  Sudbury Mental Health & Addictions Centre, Kirkwood Site $38.00/month, $17.54/pay

32 33 Organizational Development & Learning

Go to our site to access information on:

 WHMIS Training

 Student Placements  CPR (Level C) HCP Training

 French Language Training  Orientation

 Non-Violent Crisis Intervention Training  Education Portal

Educational Services:

To Access the Education Portal onsite:

1. Log onto an HSN computer using your username and password. 2. Access the HSN Intranet by opening Internet Explorer. 3. Click on “Education” from the front main menu at the top of the page. 4. Open the Portal by clicking on the “Education Portal” icon.

To Access the Education Portal offsite:

Visit: https://secure.hsnsudbury.ca/Education/ You are required to use your HSN computer login information to sign in.

You must complete your WHMIS training every three (3) years. Follow these easy steps to access the “a WHMIS Hero” Self-Learning Package (SLP):  Go to Education Portal  Select Self Learning tab  Select **Health & Safety (All Staff)** in the pull down menu  Select a WHMIS hero

34 HSN Programs, Services & FAQ’s

Violence Intervention Prevention Program (VIPP) A 24-hour service at HSN. It provides emergency health care and psychosocial support for victims of acute and . The team is comprised of specially trained registered nurses and social workers. Offers prompt, confidential, individualized care and treatment in both official languages.

What is Domestic Violence?

Any form of violence between current or former partners in an intimate relationship. It may include physical, emotional, financial, sexual and spiritual abuse. It can happen to women or men regardless of sexual orientation, economic background, ethnicity, religion or age.

What is Sexual Assault?

Any form of sexual activity with another person without their consent. Victims can be female or male and include persons of all ages, from young children to senior citizens.

How to access the Program?

Through the emergency department or switchboard a physician’s referral or by calling the VIPP Program directly.

What will happen at the hospital?

The Emergency Department staff will triage and medically treat any injuries requiring immediate attention such as fractures or cuts. A forensic nurse will meet the patient in a quiet, private area and provide her/him with treatment options. Patient Services Provided by the VIPP Program

 Risk assessment and safety planning  Physical assessment and medical follow-up  Forensic documentation and collection of evidence  Forensic photography  Assessment and treatment options for of the risks of  Assessment and treatment options for HIV and other sexually transmitted .  Referrals and follow-up with program counselors, community agencies and shelters  Mandated reporting to Children’s Aid Society  Facilitate police disclosure if requested and courtroom support  Provide expert Courtroom testimony *All services offered by the VIPP program are confidential and optional.

Occupational Health & Safety

Prevention Intervention Safety and Wellness Disability Management

 Pre-placement health reviews  Accident reporting to WSIB  Respiratory Mask Fitting  STD/LTD Management  Disease prevention through immunization  Early and safe return to work programs  Legislative compliance through the development and  Accommodation strategies enforcement of safety policies and programs  Statistical reporting and trend analysis  Workplace Hazard Assessment  Support and assistance to management and staff regard-  Resource for the JHSC ing disability related issues  Wellness promotion  Absenteeism support

Occupational Health & Safety on the Hub:

https://intra.hsn.share/programs-services/occupational-health-and-safety 35

Translation Services

Ministry funded translation service is provided to health care agencies for materials that are destined to patients or to the public, such as forms, educational material, pamphlets, public web site, etc.

These services are coordinated from the HSN FLS office and provide translated material to over 50 HSN Programs, Services & FAQ’s

Employee Assistance Program Your Employee Assistance Program (EAP) is a confidential and voluntary support service that can help you solve all kinds of problems and challengers in your life.

You and your immediate family members (as defined in your employee benefit plan) can receive support over the telephone, in person, online, and through a variety of issue-based health and wellness resources. For each concern you are experiencing, you can receive a series of sessions. You can also take advantage of online tools to help man- age personal well-being.

You’ll get practical, relevant support, fast and in a way that is most suited to your preferences, learning approach and lifestyle. Caring professionals can help you select a support option that works best for you.

Is the Service Confidential?

Yes. Your EAP is completely confidential within the limits of the law. No one, including your employer, will ever know that you have used the service unless you choose to tell them.

How Much Will It Cost?

There is no cost to your EAP, if you need more specialized or long-term support, your EAP will help you select an appropriate specialist or service that can provide assistance. While fees for these additional services are your respon- sibility, some may be covered by your provincial or organizational health plan.

How do I access the Employee Assistance Program (EAP)? You can call the Morneau Shepell toll-free EAP line (available 24 hours a day, 365 days a year) 1-800-268-5211 (English) 1-800-363-3872 (Français) for general assistance or to arrange for an appointment with a counsellor. You can also visit the Morneau Shepell website at www.fgiworldmembers.com. (Username: srh Password: srh044)

Patient Representatives The Patient Representative role started in the late 1960’s in the United States. In Canada, it evolved in the late 1980’s. At HSN the position was created in 1999. Currently a large network of Patient Representatives in Ontario.

Purpose of the Patient Representative Role  Be Responsive  Understand varying situations and viewpoints  Centralize  Look for trends  Find solutions  Assist in reducing complaints

Who provides feedback? Patients, Family, Friends, Employees & medical staff, Community partners, External organizations

Patient Representative Role in Conflict Resolution

 Receives and handles complaints from start to finish  Develops an action plan that will facilitate resolution  Develops and provides closure documents  Investigate/follow-up with any of the following individuals to enable effective resolution of complaints:  patients  family members  hospital staff  physicians/Chief of Staff  HSN management  Representatives from external organizations 36 HSN Programs, Services & FAQ’s HSN Foundation

Health Sciences North Foundation is a registered charity and the fundraising partner of the hospital. Thanks to the donations of grateful patients and other members of the community, as well companies and other foundations, we are able to purchase vital medical equipment and fund capital construction projects at the hospital. Our hospital cannot rely on government funding alone to meet its needs. The support of our donors helps bridge the gap in funding to ensure that patients have access to modern equipment and facilities.

How Funds Are Raised Funds are raised through special events, fund raisers and the many donors who support the Foundation. Some of these donors include individuals who have made a gift in honour of a caregiver, or in memory of a loved one. Others are through HSN staff members who donate through payroll deductions—thank you for your support!

Our Accomplishments Our accomplishments are your accomplishments as they symbolize a community coming together to ensure the future of health care in and northeastern Ontario. Some of our past accomplishments:  Construction of the one site hospital  New Catheterization Lab  MRI Breast Coil  Dialysis Machines  And much, more more!

How You Can Help You can help your hospital Foundation by becoming an ambassador and educating fellow staff members, patients and the general public about Health Sciences North Foundation.

How to contact us: Our office is open Monday to Friday from 8 a.m. to 4 p.m. and is located in the main lobby of the Ramsey Lake Health Centre (beside the Gift Shop). We invite you to stop by during these times to meet our staff and learn more about your Foundation. If you have any questions about how the Foundation works, or how we can be of assistance to you and your department, please give us a call or send us an email. Mary Lou Hussak Executive Director 705-523-1733 (HSN x7133) [email protected]

RLHC Cafeteria Rock Garden Cafe

There is a variety of food hot and cold food available including a salad bar, sandwiches, soup, hot breakfasts, panini and pizza station, pasta and stir-fry station, hot and cold beverages including Starbucks and Seattle’s Best Coffee, stews and

chilli, etc.

Located on Level 2 of the South Tower

Hours of Operation Monday to Friday: 7am to 6pm Weekends and most holidays: 10 am to 2 pm

Find out what’s cooking at the Rock Garden Café today: http://menu.marekhospitality.ca/HSN/

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HSN Programs & Services & Programs HSN

38 RLHC Facility Maps

Staff Locker Rooms There are two locker room locations in the Centre Tower:

 Level 0

 Level 1 Staff Entrances Staff who wish to use a locker while on placement must bring their own lock to secure their belongings. Staff can enter through the Main and South entrances. The South entrance You must remove items and locks at the end of your shift prior to leaving. will be open from 0500 – 2100. After Security will be monitoring for compliance with lock and content removal so that the hours entry must be accessed through hospital can maintain maximum flexibility of lockers and adhere to infection control security. protocols.

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