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Canadian Patient Safety Institute

Safe care....accepting no less​

The Canadian Patient Safety Institute (CPSI) has over 10-years of experience in safety leadership and implementing programs to enhance safety in every part of the healthcare continuum.​

SHIFT to Safety

 

Improving patient care safety and quality in Canada requires everyone’s involvement—SHIFT to Safety gives you the tools and resources you need to keep patients safe, whether you are a member of the public, a provider, or a leader.


 

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Patient Safety Power Play – 2017 in review33311Patient Safety Power Plays It's that time of year again . . . how 2017 has flown by.... but that tends to happen when you love what you do and the people with whom you get to do it. Given that the year is winding down, this is the perfect opportunity to revisit my Canadian Patient Safety Institute 2017 checklist. Continually raising the bar for quality improvement and advancing the patient safety agenda? Check!Unprecedented collaboration with patients and partners? Check!A brand new bold strategic plan and a bright future for patient safety in Canada? Check! Here's a quick look at what made 2017 another smashing success and why the CPSI is better positioned than ever to continue working with the healthcare system to make care saferRelease of "The Case for Investing in Patient Safety" report (Left to right) Robert Vandervelde, CPSI, Michael Higgins, Alberta Prime TimeThe most recent data available on harm in healthcare, this report details the threats as well as the significantly higher healthcare costs that result from patient safety incidents.Joint Position Statement on the use of a Safe Surgical Checklist With the support of Alberta Health Services (AHS), the Canadian Anesthesiologists' Society (CAS), and the Operating Room Nurses Association of Canada (ORNAC), CPSI released a joint position statement calling for the widespread use of a surgical safety checklist in operating rooms across Canada.A Consortium Celebration After years of collaboration, members of the National Patient Safety Consortium gathered one more time to celebrate the fruits of our labour. See for yourself what passion for patient safety means to this incredible group.Federal Health Ministers making patient safety a priority Both former Health Minister Jane Philpott, and current Health Minister Ginette Petitpas Taylor were involved in a pair of our biggest events of the year STOP! Clean Your Hands Day and Canadian Patient Safety Week. We thank the office of the Health Minister for the ongoing support of, and interest in patient safety.#SuperSHIFTERS and #SHIFTtalks seriesWhen we launched SHIFT to Safety, we made it a goal to profile the best and brightest people and organizations that embodied what SHIFT to Safety is all about understanding HOW to improve culture, teamwork and quality. Each month, read a brand-new installment of the #SuperSHIFTERS and #SHIFTtalks series.WHO Collaborating Centre (From left to right) Dr. Jonas Gonseth-Garcia, Advisor, Quality in Health Systems and Services, Pan-American Health Organization/World Health Organization, Helen Haskell, Co-chair, WHO Patients for Patient Safety Advisory Group, and Chris Power, CEO, Canadian Patient Safety Institute. The World Health Organization has officially designated CPSI as a WHO Collaborating Centre for Patient Safety and Patient Engagement to carry out activities in support of WHO programs internationally. We're thrilled with this designation and the WHO's belief in our abilities. We look forward to representing Canada on the global stage! Of course, this is but the tip of the iceberg. Our website is bursting at the seams with patient safety and quality improvement opportunities. What about you? What are your highlights of the year? What will you remember about 2017 and what has you excited for 2018? As always you can connect with me directly at cpower@cpsi-icsp.ca or on Twitter @ChrisPowerCPSI. Yours in patient safety, Chris Power CEO, Canadian Patient Safety Institute12/7/2017 7:00:00 AMIt's that time of year again . . . how 2017 has flown by.... but that tends to happen when you love what you do and the people with whom you get to12/7/2017 11:08:21 PM205http://www.patientsafetyinstitute.ca/en/NewsAlerts/News/Pages/Forms/AllItems.aspxhtmlFalseaspx
#SHIFTTalks Teamwork is where it’s at33300SHIFT Talks When I started at the Health Quality Council of Alberta (HQCA) in 2015, my director handed me a giant binder – 3 inches, D-ring – it was huge. I admit, I was somewhat overwhelmed. My first thought was, "do you want me to read that whole thing?" The binder held information about a project involving TeamSTEPPS – a healthcare teamwork training program that provides a standard team-based approach to patient care. TeamSTEPPS is delivered by the Agency for Healthcare Research and Quality (AHRQ) out of the United States. Despite the initially feeling overwhelmed, my second gut reaction was yes, I'm up for the challenge! I went through the binder and searched the AHRQ website to try and get my head around what this TeamSTEPPS stuff was all about. I quickly realized that despite not knowing the "TeamSTEPPS" brand, I had been using the tools taught in the TeamSTEPPS program for years. My first exposure to TeamSTEPPS was back when I took an Emergency Medical Responder course (about a million years ago), and they introduced us to SBAR (Situation Background Assessment Recommendation), a standardized, mnemonic, communication tool that allows a quick, concise transfer of information from one healthcare practitioner to another. At the time, I did not fully recognize how important this was. I was young, and quite frankly, very naïve. As my career progressed, I started to recognize the power of this fundamental gem that I was taught so long ago. I noticed the silos among healthcare professions. Nurses speak "nurse," lab techs speak "lab tech," doctors speak "doctor" . . . you get the idea. The problem is that communication between professions is hindered; we are not all speaking the same language. And the REAL problem is that this is dangerous for patients. Communication is only ONE of the teamwork skills that TeamSTEPPS addresses. Leadership, situational monitoring and mutual support are all equally important to successful teamwork and positive patient outcomes. Fast forward to 2016. I received an email from our executive director drawing our attention to the work that the Canadian Patient Safety Institute (CPSI) had begun in TeamSTEPPS. I was thrilled to know that someone else was undertaking the implementation of TeamSTEPPS training into Canada. We quickly connected with CPSI, and are moving along in our teamwork journey as we "Canadian-ize" TeamSTEPPS content, together, as a team (see what I did there?). There are numerous stories where if teamwork were improved, then the outcome for the patient may have been different. Of course there is no way to know what could have been, but there are pivotal moments in all tragic patient outcome stories where it is clear that working together as a team could have improved the situation. Yup. Teamwork is where it's at! By Rhonda Shea BSc MA MLT Lead, Collaborative Learning &EducationHealth Quality Council of Alberta 12/5/2017 7:00:00 AMWhen I started at the Health Quality Council of Alberta (HQCA) in 2015, my director handed me a giant binder – 3 inches, D-ring – it was huge. I12/5/2017 9:32:19 PM283http://www.patientsafetyinstitute.ca/en/NewsAlerts/News/Pages/Forms/AllItems.aspxhtmlFalseaspx
#SuperSHIFTERS Q and A with Patrick Nellis33209Super SHIFTERS ​Are you prepared for surgery? Learn how to be informed, stay safe and take control of your health journey! Patrick Nellis is the creator of a new, innovative surgical patient engagement program called Ready for My Surgery. His book, Ready for My Surgery Be Informed, Stay Safe and Take Control During Your Journey Through Surgery, is being released November 2017. Why did you write this book? It was a bit of a journey for me to come to the place where I realized there was a real need for this type of resource. For most of my clinical career, I worked as an anesthesia assistant at two large teaching hospitals in downtown Toronto. I was a member of a team providing anesthesia care to patients undergoing a wide variety of surgeries. During that time, I was also an educator, teaching healthcare professionals at the bedside and in the classroom. I've also had the opportunity to travel extensively to hospitals across Canada. I had the privilege of spending weeks at a time in the operating rooms of these different hospitals and this gave me a wonderful opportunity to observe patient care across the country. These experiences allowed me to recognize that patients undergoing surgery remain largely unaware of what is happening to and around them and what their role is in their care. Having recognized this, I felt quite driven to share what I know with patients in an attempt to help them have a better experience. I wanted to provide a resource for people from every walk of life that would reduce the common feelings of fear and anxiety that often go along with having surgery. There is no shortage of unknowns—from the operating room to the surgery itself, managing pain, and managing at home after the surgery. The goal with my book, Ready For My Surgery Be Informed, Stay Safe and Take Control During Your Journey Through Surgery is to not only reduce anxiety, but to give patients the knowledge and tools to take control of their health and be better prepared to actively participate in their healthcare. The great thing is that there is mounting research to show that this has the potential to improve outcomes and significantly improve the patient experience. Who will benefit from reading your book? I wrote this book for patients and their families. It isn't simply about the surgery, which is just one part of their journey. It attempts to address all aspects of care including recovery, discharge, and home preparation. Patients often have anxiety about the surgery itself, but sometimes it's their recovery that can be the biggest challenge. There are three core sections of the book—before surgery, the day of surgery, and recovery. Inside each chapter, there are insider tips, calls to action and patient stories. What ties it together is a comprehensive checklist, a practical tool to carry and use throughout the entire process. I think the importance of families and caregivers deserves equal attention—healthcare can be overwhelming and their roles should not be underestimated. I believe the book can also help healthcare practitioners and students build empathy for patients by better understanding the patient journey. There are tools that they can share with patients. In fact, some of the tools are already in use by healthcare professionals that worked with me to review the book. How did you develop this book? One of the things I realized early on when writing the book is that I needed to connect with the reader. I wanted to share a little bit of my story and give people the inside scoop on what to expect. My goal was for the book to feel like a personal conversation, rather than a clinical brochure. I ended up writing the book twice—it turns out that writing a book isn't easy! The first round was really about getting my thoughts on paper. I then worked hard to find my voice as a writer and connect with the reader. The more I wrote, the more I realized how much there was to write about, and how much I needed to research. I wanted this to be an engaging and useful book that would empower patients and help them take action. I included some of the important work being done across the country, such as the "5 Questions to Ask About Your Medications" infographic produced by CPSI and others, infection control tips, and smoking cessation tools. Overall, the book is meant to be a tool to help build engagement and provide patients a greater sense of control. What was your greatest learning when writing the book? There came a point in time when I realised that while the book may be a good resource, it wasn't good enough on its own. I wanted to engage people much earlier in the process and explain why they needed to be involved in their healthcare. I wanted to walk them through all of the steps of their care, from the day their surgery is booked through their period of recovery. We know that teaching patients to be actively involved in their healthcare makes a difference; it can improve their outcome post-surgery and reduces their risk of re-admission. I've heard from many patients that it's also important not to inundate people with tons of information at one time, but instead share small bits of relevant information throughout their journey. With this in mind, I expanded the scope of my project. I have a good understanding of the modern, digital tools available to support communication and content delivery so I used this to build what has become a surgical patient engagement program. The book is a major pillar of this program but it is just one part. It's personal, digital, accessible and inexpensive to deliver—I want to impact as many patients as possible so I worked hard to reduce barriers for people to access this information. The hub for this program is my new website www.readyformysurgery.com For the most part people don't want to have surgery, but they want a good outcome. I found that I was not alone in feeling like we could take the patient experience and patient engagement to another level. Meaningful patient engagement is not a one-way street. What is important to patients should be important to their healthcare team, and vice versa. I see it as a step beyond patient-centred care. It isn't simply focusing on the patient, but instead involving the patient as a partner in their care. The best analogy I've come up with is to consider the patient as a core member of their healthcare team. For example, it's not until the patient walks into the operating room on the day of surgery that the OR team is complete. In a team, when everyone understands and fulfills their role, the team will function at its best. Looking at it this way, it becomes clear just how important the role of the patient really is. What is the best advice you received when writing the book? Don't try to build something in isolation. With this in mind, I made a point of sharing the book early in the process even though it wasn't perfect. I found that the more people you reach out to and the more feedback you get early on, the better. I connected with anesthesiologists, respiratory therapists and nurses, the Canadian Patient Safety Institute, and a number of patients, including some from Patients for Patient Safety Canada to read drafts of the book. I took all of that feedback to edit and refine the content. This was actually one of the most fun and validating aspects of this project, building new relationships with others that are also working hard to make the patient experience better. There is an important movement happening here. Being patient and persistent is the other valuable piece of advice I received. It takes a lot of time to introduce a new idea and bring people to the place where its value is seen. The book alone took eight or nine drafts. It exciting to now have a beta version to share. The Ready for My Surgery program is now ready for a pilot run. Once I've received further feedback from patients, healthcare providers and organizations such as CPSI and PFPSC, I'll move the book and program through final production. This has been fascinating journey for me and I'm looking forward to seeing the impact this program has on patients, their families and those that care for them. Where can we learn more? I'd be thrilled to chat with anyone interested in patient engagement or with those that think this program may be a fit for their patients or their institution. Feel free to visit my website at www.readyformysurgery.com or email me at Patrick.Nellis@readyformysurgery.com Our thanks to Patrick Nellis for sharing a profile of his new book, Ready for my Surgery Be Informed, Stay Safe and Take Control During Your Journey Through Surgery, which is currently in production. Join us next month to meet our next #SuperSHIFTer …11/16/2017 7:00:00 AM Are you prepared for surgery? Learn how to be informed, stay safe and take control of your health journey! Patrick Nellis is the creator of a new,12/6/2017 2:13:10 AM223http://www.patientsafetyinstitute.ca/en/NewsAlerts/News/Pages/Forms/AllItems.aspxhtmlFalseaspx
Enhanced Recovery Canada: a collaboration to improve surgical safety33210Patient Safety News Enhanced Recovery Canada (ERC) is well-positioned to improve surgical safety across the country. Since the group was formed earlier this year, a project charter, governance structure and position statement have been developed and stable funding has been secured. Enhanced Recovery Canada recently reached out to a number of industry partners and over $500,000 has been committed over five years to fund the work of the project. An Enhanced Recovery After Surgery (ERAS) project plan has been finalized. Membership supporting the six guideline working groups is being determined. These guideline working groups will develop clinical pathways based on six core ERAS evidence informed principles patient engagement, nutrition, mobility, perioperative fluid management, multimodal pain management and evidence-based surgical best practices. The first clinical pathway being developed will support colorectal surgery. A knowledge management specialist from Alberta Health Services' Guideline Resource Unit (GURU) has been hired to support the guideline working groups gather existing evidence and defining any gaps that may need to be addressed. Colorectal pathways will be launched during the Canadian Anesthesiologists' Society Conference in June 2018. The work will then spread to other surgical types, incorporating the colorectal pathways that can be more broadly applied. Enhanced Recovery Canada members are looking to raise the visibility of the project. Presentations have been made at a number of conferences and members will highlight their activities at a number of events to be held in 2018. In addition, a six-part Enhanced Recovery After Surgery video interview with Dr. Henrik Kehlet is now available on the Canadian Patient Safety Institute's ERC webpage. Click here to view the video series. "I am very pleased with the momentum that has been maintained by our partners group. The passion and interest of our industry partners is very evident," says Carla Williams, Patient Safety Improvement Lead, Canadian Patient Safety Institute. We have a lot of irons in the fire to ensure the long term sustainability of Enhanced Recovery Canada." Visit www.patientsafetyinstitute.ca to learn more about Enhanced Recover After Surgery and Enhanced Recovery Canada.11/15/2017 7:00:00 AMEnhanced Recovery Canada   (ERC) is well-positioned to improve surgical safety across the country.  Since the group was formed earlier11/14/2017 11:11:43 PM185http://www.patientsafetyinstitute.ca/en/NewsAlerts/News/Pages/Forms/AllItems.aspxhtmlFalseaspx
Patient Safety Power Play: Your Words Guide our Future9805Patient Safety Power Plays Healthcare is a big deal in Canada. Not only is it one of the biggest expenditures for governments, both provincially and federally, but it has a tremendous personal impact on the life of every Canadian. With those kinds of stakes, it's important to ask some pretty serious questions about the future of our healthcare system, and CPSI's role within it. Are we equipped to continue improving patient safety in the future? As patients or providers, what do you need from us, to continue accelerating change in healthcare? How can we at CPSI build on the momentum we've created since 2003 to make Canada's healthcare system the safest in the world? As it happens, Health Canada is asking those very same questions. Making sure that Canadians are getting the best from the healthcare system is top priority for Health Canada. To that end, Health Canada is conducting a review of all government funded, pan-Canadian healthcare organizations, including CPSI. The objective of the review is to advise the Minister of Health on the future of healthcare policy, and deliver to Canadians the care they need. This is a unique opportunity to share your thoughts on our healthcare system, and where it's going, with Health Canada. We ask that you set aside some time to share a few words about your involvement with CPSI and the importance of keeping patient safety on the national agenda. What you share can aid us in showing just how strong and impactful our mandate is. You can click here to share your thoughts directly with the reviewers. Speaking of sharing, we have just come off our annual Canadian Patient Safety Week, a time where we shine a spotlight on patient safety. The momentum generated during this week across the country is incredible, and I'd like to thank everyone who took part. Here is a brief glimpse of the week and the reach it hadOur PATIENT podcast reached number two for the week in the medical category on iTunes The Take With Questions Quiz had 4911 participantsOur Question Your Meds Contest received 125 entries#asklistentalk received 3.744 million impressions, 1469 tweets, and had 700 participants using it, with an average of 15 tweets per hour From all of us at the CPSI, we thank you! As always, I'm open to your questions and comments. Do you have any Canadian Patient Safety Week memories to share? Do you have any questions about Health Canada's pan-Canadian Healthcare Organization Review? Feel free to contact me at cpower@cpsi-icsp.ca. Yours in patient safety Chris PowerCEO, Canadian Patient Safety Institute11/10/2017 7:00:00 AMHealthcare is a big deal in Canada. Not only is it one of the biggest expenditures for governments, both provincially and federally, but it has a11/9/2017 11:06:51 PM386http://www.patientsafetyinstitute.ca/en/NewsAlerts/News/Pages/Forms/AllItems.aspxhtmlFalseaspx

 Upcoming Events

 

 

“Safe Medication - Think Global, Act Local” – a global webinar series designed and facilitated by patient partners33251Webexhttp://www.patientsafetyinstitute.ca/en/Events/Pages/Safe-Medication-Think-Global-Act-Local-2017-12-18.aspx12/18/2017 3:00:00 PM12/18/2017 4:00:00 PMUnsafe medication is a leading cause of harm, most of it preventable, in health care systems across the world. Medication incidents occur when weak medication systems and/or human factors such as fatigue, poor environmental conditions or staff shortages affect prescribing, transcribing, dispensing, administration and monitoring practices, which can then result in severe harm, disability and even death.11/28/2017 5:05:58 PM16http://www.patientsafetyinstitute.ca/en/Events/Lists/Events/calendar.aspxFalseWebcastFalse
Super Early Bird Deadline: Canadian Patient Safety Officer Course33316Ottawahttp://www.patientsafetyinstitute.ca/en/education/psoc/Pages/default.aspx12/31/2017 12:00:00 AM12/31/2017 11:59:00 PMThe Canadian Patient Safety Officer Course is jointly developed and delivered by the Canadian Patient Safety Institute and HealthCareCAN, supported by experts from across Canada and internationally.12/11/2017 8:58:51 PM3http://www.patientsafetyinstitute.ca/en/Events/Lists/Events/calendar.aspxFalseWorkshopTrue
Reducing infection rates through optimal healthcare design: How you can change your environment to positively impact patient safety outcomes33324Webexhttp://www.patientsafetyinstitute.ca/en/Events/Pages/Reducing-infection-rates-through-optimal-healthcare-design-2018-01.aspx1/16/2018 5:00:00 PM1/16/2018 6:00:00 PMThink Human factors doesn't have an impact on clinical outcomes like infection rates? Guess again! According to the World Health Organization (2017), infections acquired in healthcare settings represent the most frequent adverse event occurring in the delivery of healthcare and no institution or country has solved the problem yet. Furthermore, with growing concerns for antibiotic resistance, effective strategies to support infection prevention and control (IPAC) are in desperate need. 12/13/2017 8:15:55 PMhttp://www.patientsafetyinstitute.ca/en/Events/Lists/Events/calendar.aspxFalseWebcastFalse
Registration Deadline: Become a Patient Safety Trainer [EDMONTON]5783Edmonton, ABhttp://www.patientsafetyinstitute.ca/en/education/PatientSafetyEducationProgram/Pages/PSEP-Edmonton-2018-02.aspx1/24/2018 12:00:00 AM1/24/2018 11:59:00 PMThe Canadian Patient Safety Institute (CPSI), in collaboration with MacEwan University, is pleased to announce that the Become a Patient Safety Trainer course, a high impact, 2-day comprehensive train-the-trainer patient safety education program will be offered in Edmonton, Alberta.10/23/2017 7:53:21 PM70http://www.patientsafetyinstitute.ca/en/Events/Lists/Events/calendar.aspxFalseWorkshopTrue
Become a Patient Safety Trainer [EDMONTON]5782Edmonton, ABhttp://www.patientsafetyinstitute.ca/en/education/PatientSafetyEducationProgram/Pages/PSEP-Edmonton-2018-02.aspx2/21/2018 12:00:00 AM2/22/2018 11:59:00 PMThe Canadian Patient Safety Institute (CPSI), in collaboration with MacEwan University, is pleased to announce that the Become a Patient Safety Trainer course, a high impact, 2-day comprehensive train-the-trainer patient safety education program will be offered in Edmonton, Alberta.10/23/2017 7:51:26 PM47http://www.patientsafetyinstitute.ca/en/Events/Lists/Events/calendar.aspxFalseWorkshopTrue