Shared on behalf of Occupational Health and Safety

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In 2024 there were 871 incidents reported through the Incident Learning System. Of the 871 incidents, 283 were related to violence/harassment. This means that nearly 32% of all reported incidents involved violence or harassment towards our staff. Violence, in particular, is the single most reported incident type at Thunder Bay Regional Health Sciences Centre.

1. Scan Your Environment Continuously

• Observe patient behavior: Pay attention to patients’ non-verbal cues, such as tense body language, clenched fists, or agitated movements. These could signal that the person is becoming agitated or may escalate into aggression.

• Look for changes in tone or behavior: Watch for sudden shifts in a patient’s mood, like rapid speech, loud talking, or disoriented behavior, which may indicate distress or a potential violent outburst.

2. Know Your Patients’ Risk Factors

• Review patient history: Before interacting with a patient, check their records for any previous instances of violence, mental health issues, or substance abuse. These are risk factors for aggressive behavior.

• Watch for triggers: Certain triggers, like pain, frustration with treatment, or a history of mental health crises, can cause patients to act out. Stay informed about specific patient needs or risks.

3. Recognize Early Warning Signs of Aggression

• Behavioral signs: Increased agitation, pacing, clenched jaws or fists, and erratic movements often precede violence.

• Verbal cues: If a patient starts to use threatening language, shout, or make demands in an aggressive manner, this could indicate the situation is escalating.

• Tension in the room: A sudden shift in mood or atmosphere, like a calm environment becoming tense or quiet, should trigger heightened awareness of potential risk.

4. Position Yourself for Safety

• Exit routes: Always be aware of your nearest exit and the layout of the space. Position yourself near an exit when possible, so you have an escape route if needed.

• Personal Alarms: Ensure you are wearing your personal alarm on every shift and that it is in good working order.

• Keep a safe distance: Stay at least an arm’s length away from patients who may seem agitated. This reduces the risk of physical confrontation and gives you more time to react.

• Avoid being cornered: Try not to be placed in a position where you cannot quickly leave the area, especially when working with agitated patients.

5. Maintain Calm and Non-Threatening Body Language

• Avoid aggression in posture: Stand with an open posture and avoid crossing your arms or taking defensive stances. Keep your hands visible to show you are not a threat.

• Use a calm, soothing voice: Speak slowly and in a non-confrontational tone. Stay neutral and avoid raising your voice, which may escalate the situation.

• Eye contact: While maintaining eye contact can show that you are engaged, avoid staring, as this can be perceived as a challenge or threat.

6. Listen Actively

• Empathy: If a patient is upset, let them express themselves without interruption. Listen to their concerns and show empathy. Sometimes, simply feeling heard can de- escalate tension.

• Acknowledge their feelings: Use statements like, “I understand that you’re frustrated,” or “I can see that you’re in pain.” This can help calm the patient and open a line of communication.

7. Set Boundaries Early

• Assertive communication: If a patient starts to cross a line (e.g., using threatening language or becoming physically close in an aggressive manner), calmly and clearly set boundaries.

• Non-verbal cues: In addition to verbal boundaries, your body language should reflect calm authority and assertiveness. Keep your posture open but firm.

8. Stay Calm and Don’t Take It Personally

• Keep your emotions in check: If a patient becomes angry or hostile, stay calm and don’t let emotions drive your reactions. It’s important to separate the patient’s behavior from who you are as a person.

• Avoid reacting emotionally: If a patient is yelling or being verbally abusive, avoid responding with anger or frustration, as this can escalate the situation.

9. Work as a Team

• Alert colleagues early: If you notice a situation beginning to escalate, quietly notify a colleague or call for backup before things get out of control. Use the Hospital’s emergency codes to call for help if necessary.

• Team coordination: If you’re working with a team, ensure you’re all aware of the situation and prepared to act in unison if needed. Have a plan for managing a violent situation, including how to exit or contain it.

10. Know the Warning Signs of a Violent Outburst

• Physical cues: Look for clenched fists, rapid breathing, or a fixed gaze—these can indicate that someone is about to lash out.

• Verbal threats: Words like, “You better do what I say,” or “I’m going to hurt someone” are red flags. Take threats seriously, even if they seem like a bluff.

11. Use De-Escalation Techniques

• CPI (Crisis Prevention Intervention).

• Gentle Persuasive Approach.

12. Know Your Facility’s Protocols

• Code White ( https://informed.tbrhsc.net/getattachment/Policies/General-Manual/ Emergency-Plan/Code-White-Violent-or-Threatening-Person-(EMER-(1)/EMER-50- Code-White-Mar-01-2022.pdf
• Code Silver ( https://informed.tbrhsc.net/getattachment/Policies/General-Manual/ Emergency-Plan/Code-Silver-%E2%80%93-Active-Shooter-Armed-Intruder-(EMER/ EMER-190-Code-Silver-Active-Shooter-Armed-Intruder-Feb-6-2018.pdf )
• Code Purple ( https://informed.tbrhsc.net/getattachment/Policies/General-Manual/ Emergency-Plan/Code-Purple-%E2%80%93-Hostage-Taking-(EMER-130)/ EMER-130-Code-Purple_Hostage-Situation-Feb-6-2018.pdf )
• Workplace Violence Prevention Program ( https://informed.tbrhsc.net/ getattachment/Policies/General-Manual/Occupational-Health-and-Safety/ Workplace-Violence-Prevention-Program-(OHS-os-245)/OHS-os-245-Workplace- Violence-Prevention-Program-Apr-2024.pdf )
• Contacting Security – contact through switchboard or dial 6509 for security office

13. Report Incidents and Concerns

• Document threats or violence: Always report any incidents of violence, threats, or suspicious behavior to your supervisor, so the situation can be addressed and preventive measures put in place.

• Follow up: If you’ve observed a concerning situation, check in later to ensure it’s being properly addressed, and keep open communication with your team about ongoing risks. By staying aware of the environment, anticipating potential risks, and responding to aggression appropriately, you can help prevent violence before it escalates.

We’re excited to share that A+ Employee Travel Perks is offering TBRHSC exclusive discounts on all hotels, car rentals, entertainment and vacation rentals! Savings may exceed 50%, and will average 10-20% below market.

Book today: https://localhospitality.com/aplus-c.html

To view the full Affinity List please visit: https://informed.tbrhsc.net/departments/human-resources/employee-recognition/affinity-program

Shared on behalf of Ryan Sears, Code Grey – Air Exclusion Executive Sponsor

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As we begin to encounter the effects of wildfire season in our region, it is important that we review and follow our Code Grey – Air Exclusion Policy. 

To date, Environment Canada has issued one special air quality statement for the Thunder Bay area related to smoke plumes from active wildfires this season. These fires put particles and gases into the air that can be harmful to human health. When this occurs, people may experience symptoms such as increased coughing, throat irritation, headaches, or shortness of breath. Our Air Exclusion Policy aims to reduce this risk to the internal environment and mitigate or reduce these associated impacts. 

With Ontario’s legislated fire season running from April 1 to October 31 annually, leadership will continue to monitor air quality alerts and adjust our Hospital’s response as required. 

Please take a moment to complete the Recommended Actions below. 

Recommended Actions

• Review the Code Grey – Air Exclusion (Button Down) policy and associated refresher Safety Huddle (attached). Familiarize yourself with the policy and related procedures.

• Visit the Air Quality Health Index for information on how to reduce your health risk along with current and forecasted Air Quality Health Index (AQHI) values.

We’re excited to share that SoftMoc has updated their process for accessing exclusive employee deals on footwear!

Employees can access these savings by:

1. Clicking on this link: https://www.softmoc.com/ca/GetMyCorporateReward.aspx?company=thunderbayregionalhealthsciencescentre&c=825×7110251633
2. Click on the Corporate Rewards Link
3. Create your account or login
4. Click “Corporate Rewards”
5. Click “Generate Code”

Happy Shoe Shopping!

To view the full Affinity List please visit: https://informed.tbrhsc.net/departments/human-resources/employee-recognition/affinity-program

June is National Indigenous History Month. It’s a time for all Canadians to honour the rich history, heritage, and incredible diversity of Indigenous Peoples who have called this land home since time immemorial.

It’s important to acknowledge Canada’s past and its ongoing impact of colonization, racism, and stereotypes that contribute to health inequities for Indigenous Peoples within the current Canadian healthcare system. We pay tribute to the Survivors of Indian Residential Schools, Indian Day Schools, the 60’s scoop, and missing and murdered Indigenous women, girls, two-spirited, and gender diverse peoples.

Our Hospital is committed to actions to support the Truth and Reconciliation Commission’s 94 Calls to Action. We encourage everyone to learn and reflect on the vibrant cultures, languages, and traditions of Indigenous Peoples across Turtle Island.

This week’s events:

NAN community building display

Thunder Bay Regional Health Sciences Centre has partnered with Nishnawbe Aski Nation (NAN) to showcase a community building panel display on site. This project, developed by the NAN Education Department, was funded by the Ontario Ministry of Education in response to the Seven Youth Inquest in 2016, and is aimed to address racism experienced by students in Thunder Bay schools.

The purpose of the display is to combat myths and misunderstandings that lead to racism and to provide an opportunity for respectful dialogue about Treaty relationships. The display aims to encourage truthful and respectful discussions while discouraging false and derogatory statements about Indigenous Peoples.

The panels will be on display across from Seasons Gift Shop until Friday, June 6.

Lunch & Learn (June 4)

Join Annette Klement, Cultural Safety Educator, for a Lunch and Learn on the Medicine Wheel. This session will provide a basic overview of what the Medicine Wheel represents, as well as how to use it to connect and support your patient’s care. Lunch will be provided. Click here for more information.

To learn more, click here.
Canadian Museum for Human Rights: Indigenous History and Human Rights
The Canadian Encyclopedia: The Indian Act – A Summary
Historica Canada: Residential Schools in Canada
Indigenous Corporate Training: Truth and Reconciliation Calls to Action
CBC Books: 25 books that highlight beauty of Indigenous literature

Check out the poster below to see what events TBRHSC will host throughout the month.

Celebrate Canadian Environmental week by joining the Active Commute Challenge! By walking, biking, taking transit, or carpooling, you’ll help reduce emissions and contribute to a healthier, more sustainable Thunder Bay.

Over 40% of our city’s greenhouse gas emissions come from transportation. Every sustainable commute makes a difference.

About 90% of people in Thunder Bay produce greenhouse gases (GHGs) just getting to and from work. This happens because driving burns fuel, releasing greenhouse gases such as carbon dioxide, methane, and nitrous oxide. These invisible and odorless gases accumulate in the atmosphere and trap heat—ultimately contributing to climate change.

The good news? Small changes help. Walking, biking, or even carpooling just a few times a week cuts down your emissions—and it adds up fast. Join the Active Commute Challenge today!

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Did you know that Thunder Bay Regional Health Sciences Centre (TBRHSC) participates in the co-operative education placement program?

Co-operative education (also known as high school co-op) provides secondary school students with an immersive learning experience in a safe, culturally responsive environment. The co-operative education program aligns with our Staff Experience strategic pillar and our mission as an academic health sciences centre, allowing students to learn about TBRHSC and to apply their skills and interests in different areas of the Hospital. Placements have been offered in a variety of areas of the Hospital including Medical Device Reprocessing, Intensive Care Unit, Cancer Center, Cafeteria, Professional Practise, Nutrition & Food Services, Surgical Inpatient & Neurosurgery, Hemodialysis, Patient Portering, Housekeeping and the Operating Room. Students are able to engage in unique learning opportunities that are not only memorable, but allow them to gain practical, hands on work experience that enhances their resume. In addition, the program can help students decide on a post-secondary career path, and may find themselves working at TBRHSC in the future!

Each student has a direct supervisor in their placement area, available to support them and answer any questions.

Here is what our supervisors have to say about the co-operative education experience:

Jodi Lewicki, Manager, Medical Device Reprocessing Department

“Abby chose MDRD as her choice for a co-op placement and because of her outstanding interview we chose her! She has a positive attitude that is contagious. Her interest in Medical Device Reprocessing and all that we do here was welcome and invigorating to the staff that worked with her. She was enthusiastic in all tasks assigned to her ranging from standard administration to the critical steps involved in Sterile Processing such as Decontamination, Assembly, Packaging, Sterilizing and Distribution of sterile instruments/sets to the O.R. and clinics. She said her experience as a co-op student in MDRD makes her more excited to enter the nursing program and potentially coming back to the TBRHSC as an employee.”

Debbie Baca, Dietary Aide, Nutrition and Food Services

“Having Lauryn as a Co-Op student has been an absolute pleasure. Lauryn’s hard work ethic was so refreshing. She showed a lot of initiative, always finishing her tasks and finding other jobs that needed to be done all on her own. She has never needed directions or guidance. Lauryn was always busy working, never standing around. Lauryn would be an asset to any employer. There are countless positives I could mention about Lauryn; her kindness, positivity, work ethic and her independence in seeking out work especially stood out. If I had to sum Lauren up in one word it would be IMPRESSIVE. I enjoyed working with Lauryn very much and I am hoping she will return as a summer student.”

Edith Hart, Manager, Critical Care and Respiratory Services

“Addison and Katie were the second semester high school co-op students who joined the ICU team. They are both going into nursing in the fall so this was a great introduction to the hospital for them. In the ICU they were able to pair up with staff including nurses, respiratory therapists, physiotherapists, pharmacists, and infection control practitioners. They were responsible for restocking supplies, and observed several critical care therapies including chest tube insertions, insertion of endotracheal tubes for life support, bedside hemodialysis, and bronchoscopes.”

Ashley Dell, Manager, Housekeeping, Laundry/Linen & Portering

“Payton has been an outstanding addition to our department. She is a quick learner who takes direction extremely well and consistently shows a strong work ethic. With a positive attitude and a smile that brightens the workplace, Payton naturally fits into the Housekeeping team. She keeps herself busy at all times and demonstrates great initiative by taking on tasks independently without needing to be asked. Her energy, enthusiasm, and dedication make her a true asset to our department.

Mikaela has quickly distinguished herself as a valuable member to our Portering Department. As a co-op student she demonstrates an impressive ability to learn new tasks rapidly and is always eager to take on responsibilities independently. Her proactive attitude and strong work ethic have allowed her to seamlessly fit into the Porter role, where she consistently contributes to the team’s success. Mikaela’s enthusiasm and reliability make her a standout addition to our team.”

Katherine Tuomi, Manager, Diagnostic Imaging

“Abby has been a great addition to Diagnostic imaging. During her co-op placement, she has helped many patients find their way to each modality waiting room, and even out to the exit! It is very helpful to have extra hands to help make the patient experience that much better. She has been able to gain knowledge of the many modalities within Diagnostic Imaging. We hope this helps her decisions on what to pursue in future education. She was a pleasure to work with during her placement.”

Participating in a co-op placement at TBRHSC can help students see the possibilities that the future can bring and it assists us in developing our future workforce. Students create community connections while observing the value of education, and of being engaged, compassionate members of the community.

Each semester the high schools receive a list of the available co-operative education placements. To learn more about future high school co-op placement opportunities contact the Human Resources Department.

Shared on behalf of Craig Kozlowski, Director, Corporate Patient Flow (Executive Sponsor)

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The Hospital’s Code Green (EMER-90) policy has been revised.

Actions required:

1. Read this memo and review the updated Code Green – Evacuation Plan (EMER-90) policy and sub plan template to familiarize yourself with important process changes.
2. Managers to ensure that the updated policy is added to their area’s emergency binder and that all workers review the attached policy.
3. Areas are to update their sub plans (see template attached) by June 20, 2025 (ensure you recycle previous versions of the policy/sub plan). Please submit a copy to yolanda.karpowich@tbh.net.

Policy changes:

• Additional focus on Code Green – STAT: formatted to stress that an impacted unit is empowered to activate and clear a STAT; does not require Senior Leader on Call approval.
• “Appendix 5 – Important Phone Numbers” has been removed as these numbers may change and/or should be captured in applicable departmental sub plans.
• “Appendix 8 – Code Green Patient Tracking Form” has been removed from the policy and converted into an official form CS-1118.
• Expanded definitions section.
• Revised response algorithm in the appendices.

Sub Plan changes:

• “Staff Meeting Area” definition updated to Muster Point and Headcount method added; matching Code Red – Fire (EMER-30).
• Streamlined instructions, particularly for non-patient care areas, to remove redundancies and non-applicable actions.
• Additional instructions and examples provided in the comments to aid in timely updating.

Process Reminders:

• Code Green – Evacuation instructions apply to the Hospital building (980 Oliver Rd) only. For external buildings see Emergency Planning & Response to External Buildings (EMER-200).
• Code Green sub plans provide important department specific instructions to supplement the policy that must be reviewed annually by the department manager.

 If you have any questions, please reach out to Mēsha Richard, Lead, Emergency Preparedness (ext. 6552 or mesha.richard@tbh.net).

Hello, Boozhoo, Bonjour.

It’s hard to believe May is already behind us. The pace across our Hospital and Health Research Institute has been brisk — and filled with meaningful progress.

I’d like to begin with an update on the Ontario budget as it impacts the way we do business here. This past month, we saw the budget released as many in the health care sector across the province waited to see what was in it for hospitals. The budget announced a $1.1 billion increase to hospital funding, but most hospitals — including ours — this will be a reset year with the focus being on the creation of a hospital sector stabilization plan. While we are expected to receive up to a 3% base funding adjustment – with the potential to receive an additional 1%, without the clarity of our actual funding allocation, we remain unclear as to the impact of any adjustment. As such, we anticipate that hospitals will remain short of the estimated $2.2 billion needed across the province just to keep pace with inflation, rising service volumes, and labor costs. Like many hospitals, we’re facing serious financial pressures, yet we continue to move forward with major initiatives like the Cardiovascular Surgery Program, our Electronic Health Record upgrade, and ongoing infrastructure improvements. This is a testament to your resilience and your commitment to providing exceptional care — despite the headwinds. Thank you for continuing to deliver excellence, every day. I can assure you that I will continue to make our case to decision-makers as I did last week in Toronto. The communities and region we serve have unique and distinct challenges that other parts of the province don’t face — a message I continue to put in front of the Ministry and our elected representatives at every opportunity.

Shifting gears, I would like to offer a huge thank you to everyone who participated in this year’s Spring Up to Clean Up. Your efforts make a real difference, not just in how our grounds look, but in how they feel. A tidy, welcoming environment reflects the pride we take in the care we provide. Let’s all continue to do our part in keeping our shared spaces clean and safe.

Please mark your calendars — the Staff Appreciation BBQ is coming! On Wednesday, June 12 from 11:00 a.m. to 2:00 p.m., we’ll gather in the courtyard to celebrate you. This is a moment to recognize how your work supports Strategic Plan 2026 and brings our vision — Exceptional care, every patient, every time — to life. This is the third year of the four-year plan, and I am tremendously pleased with all the progress that you have all contributed to. I hope to see many of you there to celebrate.

Meanwhile, facility upgrades are well underway. There is lots to report on as we move forward with various construction and upgrades throughout our Hospital. Thank you to everyone who provided feedback on patient room finishes and design. These upgrades are more than cosmetic —they’re about creating a brighter, more healing space for patients, families, and staff. Your patience during this work is deeply appreciated.

Starting June 9, we’ll be inviting you to take part in the Health Standards Organization (HSO) Global Workforce Survey. This anonymous survey is a vital part of our accreditation process and gives us valuable insights into workplace safety and culture. Please keep an eye on your inbox — it’s your chance to tell us what’s working and where we can do better. Your voice matters.

TBRHSC is looking ahead to National Indigenous History Month. June offers us an important opportunity to celebrate and learn from the histories, cultures, and contributions of First Nations, Inuit, and Métis peoples. I encourage you to take part in events and conversations throughout the month and to reflect on how we can each support culturally safe, inclusive care.

The Staff Advisory Committee continues to strengthen our organization. Thanks to this group’s thoughtful input, we’ve made tangible improvements that benefit both staff and patients. If you have ideas or concerns to share, I encourage you to reach out to the committee anytime at TBRHSC.StaffAdvisoryCommittee@tbh.net.

Finally, a few signs of spring are finally all around us. I hope you’re finding time to recharge — whether that’s with family, friends, or a four-legged companion.

As always, I welcome your thoughts on this blog or anything else on your mind. Reach me anytime at rhonda.ellacott@tbh.net.