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Found 66 results
  1. Content Article
    What, when, and how often you take your medications are what make up your medication routine. The routine can be confusing if you are taking two or more medications or you need to take medications at different times of the day. When possible, keeping your medication routine simple can help prevent mistakes with medications. This newsletter from SafeMedicationUse.ca shares ideas to help patients simplify and manage their medication routine.
  2. Content Article
    The Strengthening Medication Safety in Long-Term Care initiative, funded by the Ontario Ministry of Long-Term Care was established in partnership with the Institute for Safe Medication Practices (ISMP) Canada to address the medication safety-related recommendations in Justice Gillese’s Long-Term Care Homes Public Inquiry Report. The three-year initiative is designed to improve medication management processes, including those intended to deter and detect intentional and unintentional harm in long-term care homes across the province of Ontario. This bulletin provides an overview of the initiative and highlights selected examples of improvement projects completed in the first phase.
  3. Content Article
    This bulletin from the Canadian Institute for Health Information (CIHI) describes two new in-hospital infections indicators for Clostridium difficile (C. difficile) and Methicillin-Resistant Staphylococcus aureus (MRSA). It includes a table listing CIHI’s selected patient safety performance indicators and definitions.
  4. Content Article
    Historically, patient safety efforts have focused mostly on measuring and responding to harm. However, safety is much more than the absence of harm. Instead, patient safety includes looking at the whole system: its past, present and future in all its complexity. Healthcare Excellence Canada and Patients for Patient Safety Canada held many conversations with users of the health system, people who work in healthcare and safety scientists. The ideas collected suggest a new way of approaching patient safety – where everyone can contribute to creating safe conditions and where harm is more than physical. This discussion guide summarises what has been learned so far and captured in this key statement: Everyone contributes to patient safety. Together we must learn and act to create safer care and reduce all forms of healthcare harm.
  5. Content Article
    If you are throwing up, having diarrhoea, drinking less water and/or have a fever, you can become dehydrated. Being dehydrated means your body doesn't have enough fluids. When you're dehydrated, some medications used to treat certain health problems may cause unwanted side effects, such as harm to your kidneys. It is important to have a plan to prevent these side effects in case you should become sick and dehydrated. The authors of this guidance learned about a person who died in hospital as a result of side effects of taking a particular medication while dehydrated. They were taking a diabetes medication called empagliflozin and kept taking the same dose after becoming sick. This medication is helpful for people with diabetes, but it can cause serious side effects if it's taken when the person is dehydrated. This guidance offers advice on how to reduce the risk of side effects from your medications when you are sick and dehydrated.
  6. News Article
    On a Thursday in mid-August, the doors of a hospital's emergency department two hours west of Toronto were shut. A note posted on the front said the ER was closed for the day. It would reopen the following morning at 08:00, but close again for the evening. Patients who needed urgent care were asked to go to nearby hospitals - a 15- to 35-minute drive away. It was the ninth time since April that the Huron Public Healthcare Alliance - a network of four hospitals serving around 150,000 people in western Ontario - had to temporarily close or cut back hours at one of its emergency departments. Canada is one of the richest countries in the world. Its universal publicly funded healthcare system has been touted by progressive politicians in the US, the country's southern neighbour, who see it as a needed alternative to an American system where millions remain uninsured. But in recent months, Canada's system has been described by workers and hospital executives as being in a state of "crisis". That includes struggling emergency rooms. Toronto ER physician Dr Raghu Venugopal said he has seen stretchers lining the hallways, occupied by patients suffering from ailments like a broken hip or abdominal pains. On some days, those patients may wait anywhere from two to four days to be admitted to hospital, all while a team of two nurses tends to a total of 50 to 60 patients on the unit. Other patients are being examined in the waiting room because the lack of staff has forced parts of the ER to close, meaning there is limited space for doctors to see them privately. "We are in a standard-less void where anything goes, and it is shocking," Dr Venugopal said. Read full story Source: BBC News, 2 September 2022
  7. News Article
    The COVID-19 crisis has both divided and galvanised Canadians on healthcare. While the last three years have presented new challenges to healthcare systems across the country, the pandemic has also exacerbated existing challenges, most notably the high levels of errors and mistreatment documented in Canadian health care. According to a 2019 report from the Canadian Patient Safety Institute, Canada was already facing a public health crisis prior to the pandemic: a crisis of patient safety. As the report details, patient safety incidents are the third leading cause of death in Canada, following cancer and heart disease. Few studies calculate national data on this topic, but a 2013 report found that patient safety events resulted in just under 28,000 deaths. Many Canadians who have experienced these errors have shared their experiences with media in an effort to raise awareness and demand change. The impact of the COVID-19 pandemic has created a moment of dual crises. First, the pre-existing crisis of patient safety, and second, healthcare overall is now at a breaking point after three years of COVID-19, according to healthcare workers. Edmonton physician Dr. Darren Markland, for example, recently closed his kidney specialist practice after making a few "profound mistakes." In an interview with Global News, he explains he could no longer work at the current pace. He is not alone in this decision. Across the country, there have been waves of resignations in health care, leaving some areas struggling with a system that is "degrading, increasingly unsafe, and often without dignity." Read full story Source: MedicalXpress, 17 June 2022
  8. Content Article
    Hospital boards generally focus attention on measures to answer questions about risk, such as 'How safe are we now?' They are ultimately accountable for the quality of care delivered in hospitals, and data review is a key component of effective board governance. This editorial in BMJ Quality & Safety highlights the lack of guidance on the most effective format for presenting data to determine progress against key risks and targets. The authors argue that data must not be overly simplified and that charts prepared for boards should include monthly data points in graphic format over a longer period of time. This allows trends to be more visible and denotes whether an observed change is significant, helping hospital boards avoid erroneous conclusions tied to random variation.
  9. Content Article
    Questions have been raised as to whether medical masks offer similar protection against Covid-19 compared with N95 respirators. This study in The Annals of Internal Medicine aimed to determine whether medical masks are noninferior to N95 respirators in preventing Covid-19 in healthcare workers providing routine care. The authors of the study conducted a multicentre, randomised, noninferiority trial at 29 healthcare facilities in Canada, Israel, Pakistan and Egypt. The study found that among healthcare workers who provided routine care to patients with Covid-19, the overall estimates rule out a doubling in hazard of PCR–confirmed Covid-19 for medical masks when compared with N95 respirators.
  10. Content Article
    This Canadian study in the Journal of Patient Safety describes an initiative that introduced system-wide changes to practice and patient safety culture in a rapid time frame. it looks at the implementation of a 'zero harm' approach to eliminate preventable harm across a wide variety of clinical areas. In less than a year, the intervention increased patient safety incident reporting by 37% while decreasing falls with injury by 39%, pressure injury rates by 37% and central line–associated blood stream infections by 34%. 
  11. Content Article
    Social movement action for knowledge uptake and sustainability can be defined as individuals, groups, or organisations that, as voluntary and intrinsically motivated change agents, mobilise around a common cause to improve outcomes through knowledge uptake and sustainability. This article in the International Journal of Nursing Sciences shares a concept analysis of social movement aimed at advancing its application to evidence uptake and sustainability in healthcare. The authors concluded that social movement action can provide a lens through which to view implementation science. Collective action and collective identity–concepts less frequently canvassed in implementation science literature–can lend insight into grassroots approaches to uptake and sustainability. The concept analysis resulted in the development of the Social Movement Action Framework.
  12. Content Article
    The Canadian Academy of Health Sciences (CAHS) released its report on health human resources (HHR) in Canada. The report provides key findings designed to inform stakeholders (including governments). The report provides evidence-informed approaches to addressing the current challenges facing the Canadian health workforce.   The three overarching themes were identified: support and retention deployment and service delivery planning and development.
  13. Content Article
    The Learning Together Evaluation framework for Patient and Public Engagement (PPE) in research is an adaptable tool which can be used to plan and to evaluate patient engagement before, during and at the end of a project. The Learning Together Framework can be used in multiple ways with the purpose of mutual learning and understanding by all partners. It is rooted in seven guiding principles of patient engagement defined by the patient-oriented research community: Relationship building Co-building Equity, diversity and inclusion Support and barrier removal Transparency Sustainability Transformation
  14. Content Article
    This study in Brain, Behaviour & Immunity - Health aimed to examine associations between symptomatic Covid-19 history, neurocognitive function and psychiatric symptoms. The authors used cognitive task performance, functional brain imaging and a prospective population survey to conduct the study. Converging findings from laboratory and population survey data support the conclusion that symptomatic Covid-19 infection is associated with task-related, functional imaging and self-reported indices of cognitive dysfunction as well as psychiatric symptoms. In some cases, these findings appear to be more amplified among women than men, and among older women than younger.
  15. Content Article
    This systematic review in the British Journal of Surgery aimed to describe types of cognitive bias in surgery, their impact on surgical performance and patient outcomes, their source, and the mitigation strategies used to reduce their effect. The authors concluded that cognitive biases have a negative impact on surgical performance and patient outcomes across all points of surgical care. This review highlights the scarcity of research investigating the sources that give rise to cognitive biases in surgery and the mitigation strategies that target these factors.
  16. Content Article
    This systematic review in BMJ Open synthesised evidence on the impacts of insufficient sleep and fatigue on health and performance of physicians in independent practice, as well as on patient safety. The authors also assessed the effectiveness of interventions targeting insufficient sleep and fatigue. The authors found that fatigue and insufficient sleep may be associated with negative physician health outcomes, but concluded that current evidence is inadequate to inform practice recommendations.
  17. News Article
    Greg Price died of complications after testicular cancer surgery, but a review of his case found missed faxes, follow-ups and botched data-sharing ultimately cost the vibrant 31-year-old Alberta man his life. All the missteps in his case meant it took 407 days from his first complaint for Price — an engineer, pilot, and athlete — to be diagnosed with cancer. He died three months after his doctor said he should see a specialist, and while he was being passed between multiple doctors, his health data often was not. Now, his sister, Teri Price, says too little has changed in medical information-sharing in the decade since her brother's death. This, despite a review of his case — the 2013 Alberta Continuity of Patient Care Study — that recommended life-saving changes to the healthcare system to avoid more experiences like his. So, she's fighting to improve the system that she says not only failed her brother, but keeps failing to change. Price says that Canadians assume that their health information is shared between doctors to keep them safe and studied to improve the system, but often, it's not. And medical front-line staff in Canada say problems persist when it comes to sharing everything from patient information to aggregate medical and staffing data. "Information tends to be broken up between the services that patients attend," said Ewan Affleck, a doctor in the Northwest Territories who has spent his career fighting for better data access, and a member of the expert advisory arm of the Pan-Canadian Health Data Strategy Group. "The cohesion and use of health data in Canada is legislated to fail." Read full story Source: CBC News, 17 November 2022
  18. Content Article
    Focused practice is an approach to primary care where a family doctor or GP chooses one or more specific clinical areas as a major part-time or full-time component of their practice. In recent years, there has been a global increase in focused practice and a decline in offering a comprehensive scope of practice in primary care. This Canadian study in the British Journal of General Practice looked at factors influencing family doctors' decisions to work in focused practice. The authors of the study concluded that: both early-career and resident family doctors unanimously saw focused practice as a way to avoid the burnout or exhaustion they associated with comprehensive practice in the current structure of the healthcare system. more research is needed to understand the implications of family physician choices of focused practice within the physician workforce.
  19. Content Article
    In this video of a plenary session from the Guidelines International Network (GIN) Conference on 26 October 2021, James McCormack, Professor at the Faculty of Pharmaceutical Science, University of British Columbia, discusses issues with clinical practice guidelines and ways to overcome them.
  20. Content Article
    This study in BMJ Quality & Safety examines how much electronic differential diagnostic support (EDS) systems improve diagnostic accuracy, and whether EDS should be used early or late in the diagnostic process. Using a volunteer sample of medical students and doctors at six Canadian medical schools, the authors compared the rate of correct diagnosis when EDS was used early and late in the diagnostic process. The study found that EDS increased the number of diagnostic hypotheses and the likelihood of correct diagnosis, and that these effects persisted whether EDS was used early or late in the diagnostic process.
  21. Content Article
    This article by Lauren McGIll in The Walrus looks at how design changes to the trauma bay at St Michael's Hospital in Toronto are saving lives. Lack of intentional design in hospitals, new technologies and a culture that celebrates adaptability all contribute to what the author describes as "a piecemeal approach" to emergency medicine workspaces. The outcome of this is ultimately higher mortality rates as staff do not have an optimum working environment. The article describes a research project set up in 2015 by doctors Christopher Hicks and Andrew Petrosoniak, which aimed to identify and remove latent hazards and obstacles that cost trauma staff time in emergency situations. They redesigned the trauma bay at St Michael's hospital as a result of their findings, and early reports are that dramatic rescues have been possible thanks to the new layout. Petrosoniak says, “You cannot remove the stress of someone dying in front of you, but we can remove the stress of not being able to find equipment.” Further reading Trauma Resuscitation Using in situ Simulation Team Training (TRUST) study: latent safety threat evaluation using framework analysis and video review (BMJ Quality & Safety) Study protocol for a framework analysis using video review to identify latent safety threats: trauma resuscitation using in situ simulation team training (TRUST) (BMJ Open) Stress Testing the Resuscitation Room: Latent Threats to Patient Safety Identified During Interprofessional In Situ Simulation in a Canadian Academic Emergency Department (AEM Education and Training) Health professionals' experience of teamwork education in acute hospital settings: a systematic review of qualitative literature (JBI Evidence Synthesis)
  22. Content Article
    This editorial in BMJ Quality & Safety suggests that individual doctors' conduct, performance and responsibility are important factors in improving patient safety. The authors argue that although a 'systems approach' is important, it is necessary to examine the role of individuals within those systems. They highlight recent research that points to small numbers of individual doctors who contribute repeatedly to patient dissatisfaction and harm, and to difficult working environments for other staff. They suggest that identifying and intervening with these individuals plays a role in the wider systems approach to patient safety. They also highlight an urgent need for further research into identifying and responding to problematic clinicians.
  23. Content Article
    After an investigation of an event, it’s important to touch base with the healthcare team and everyone involved so they can get some closure. This is an important part of the healing process that we have neglected too often. Alberta Health Services provide tips on how to support staff involved in adverse events.
  24. Content Article
    IMAGINE Citizens is an Alberta-based network of people and community-oriented partners that offers us, as health citizens, collaboration pathways to deliver person-centred healthcare. Their vision is a health system intentionally designed in partnership between citizens and other stakeholders to achieve the best possible experiences and outcomes for all Albertans in Canada.
  25. Content Article
    In North America, although pharmacists are obligated to ensure prescribed medications are appropriate, information about a patient’s reason for use is not a required component of a legal prescription. The benefits of prescribers including the reason for use on prescriptions is evident in the current literature. However, it is not standard practice to share this information with pharmacists.The aim of this study was to characterise the research on how including the reason for use on a prescription impacts pharmacists.The results suggest that including the reason for use on a prescription can help the pharmacist catch more errors, reduce the need to contact prescribers, support patient counseling, impact communication, and improve patient safety. Reasons that may prevent prescribers from adding the reason for use information are concerns about workflow and patient privacy.
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