BBC celebrates Dr. Vera Peters, one of UHN's legendary radiation oncologists

Vera Peters
Dr. Vera Peters is remembered for her renowned work in breast cancer treatment during her time at Toronto General and Princess Margaret Hospitals. She was featured in a BBC documentary in October. (Photo: University of Toronto Archives)

The renowned British Broadcasting Corporation (BBC) is airing a documentary on one of UHN's most revered medical pioneers, Dr. Vera Peters. To listen to the documentary called, "A ground-breaking change to treating breast cancer," please go to BBC News (World Service) Witness History.

Dr. Peters, who started her career at Toronto General Hospital in the 1940s and worked at Princess Margaret Hospital until her retirement, is internationally acclaimed as a clinician who changed the management of Hodgkin's disease and breast cancer.

Dr. Peters (1911-1993) is renowned for her 1950 seminal discovery that Hodgkin's disease could be cured with radiation. Her approach of treatment tailored to the individual disease characteristics and minimizing treatment exposure became known as "the Toronto approach."

It took 30 years to win over the skeptics and go to the tailored treatment approach. She was an early advocate of breast-conserving surgery (lumpectomy) followed by radiation, which is as effective as radical mastectomy, in an era where disfiguring radical mastectomy prevailed.

Dr. Peters, who is also an inductee in the Canadian medical Hall of Fame, graduated in medicine from the University of Toronto in 1934. She married and had two children, and successfully balanced her professional and personal worlds in the day when women were not universally accepted as scientists.

Along the way, she was a remarkable role model who inspired and continues to inspire countless physicians.

Dr. Peters was appointed a Member of the Order of Canada in 1975 and an Officer of the Order of Canada in 1977. She received the Medal of the Centre Antoine Belere in Paris, France and was awarded the first R.M. Taylor Award in 1979. Also that year, she was the recipient of the Gold Medal from the American Society for Therapeutic Radiology and Oncology – the highest honour in the radiation oncology profession.

Concussion booklet aims to cut through the clutter

Canadian Concussion Centre Logo
New handbook developed by the Canadian Concussion Centre is "the most comprehensive booklet to date for post-concussion syndrome patients," says Toronto Western occupational therapist Heather Sloman. (Logo: UHN)

Over the last few years, there's been an increase in information and treatments claiming to help people suffering from concussion-related symptoms. With such an overwhelming number of options, how is a patient to know which therapies will be helpful and worthwhile?

A new handbook developed by Toronto Western Hospital's Canadian Concussion Centre – "Managing Post-Concussion Symptoms" – aims to make sense of it all.

Developed by an occupational therapy (OT) student Nicolette Gowan, under the supervision of TW OT Heather Sloman, the handbook provides a wealth of concussion information. Vetted by experts, the booklet not only helps patients better anticipate and understand their symptoms, but also directs them to existing therapies that can be helpful, tells them which ones to stay away from, and also provides questions patients can ask healthcare specialists to determine if the therapy offered is right for their recovery and that they have the right training.

"It's the most comprehensive booklet to date for post-concussion syndrome patients," Heather says. "It took us over 18 months to weed through all the information and condense it into a useful resource for our patients."

Currently available through the concussion clinics of Dr. Carmela Tartaglia and Dr. Charles Tator, the hope is to develop an official version for broader use with UHN Patient Education.

So far, feedback from patients has been positive.

"They really appreciate the acknowledgement of their collection of symptoms," says Heather.

Toronto Western ED team comes together to make the most of time and space

Pre-Post Lean
(Before and after) To make more efficient use of the Toronto Western Emergency Department's Resuscitation Room, the Lean Event team removed unnecessary counters and tidied the room’s required equipment and materials. Feedback from staff about the changes has been very positive. (Photos: UHN)

Time and space are important factors in Emergency Medicine and both need to be used as efficiently as possible.

That need was part of the driving force behind the Toronto Western Hospital (TW) Emergency Department's Lean (5S) Event to tackle their Resuscitation (RESUS) Room recently. Used to treat the most seriously ill and injured patients, the RESUS Room is a key area in any ED and contains the necessary equipment to deal with immediately life-threatening conditions.

"Emergency Department volumes have been increasing steadily and we need to squeeze every morsel of space that we have," says Nicole Harada, Patient Care Coordinator. "But improving the RESUS Room was also an issue identified by our staff as something we could address in order to improve our work flow."

A multidisciplinary team came together with seven registered nurses (RNs), two respiratory therapists (RTs), an emergency medicine physician, Patient Care Assistant and UHN volunteer all offering to address the space issues and discuss how to improve process and communication for RESUS cases.

"We use the RESUS room a lot, it really impacts how we work," says Cherie Aggabao, an RN in TW's ED who had never participated in a Lean Event before volunteering for this project. "I was motivated to help out because we know the RESUS space won't expand so it was up to us to make it more efficient."

The group tackled the most obvious issue first: space. Clutter was removed from the walls as were any supplies not specifically needed for the treatment room. Additional space was made by removing unnecessary counters and tidying the room's required equipment and materials.

The team then made improvements to their communication: the ED usually gets an alert from EMS to say that a case is on its way, meaning a team needs to be assembled. Calling a code RESUS in the past could cause disruption and overlap as everyone available would respond to help out. Now the charge nurse reaches out to specific people to fill the roster.

The process is still being refined with mock drills to come, but the space improvement has made a world of difference.

"Feedback has been great," Cherie says. "Not only because there is more room and the space is more organized, but staff also see change happening when they voice a concern, and that has gone a long way."

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