By Madeline Kubiseski:

Madeline is a Master of Health Administration student at Dalhousie University. She completed a Bachelor of Science in Biology and a Master of Science in Global Health at McMaster University. She recently spent the summer at CPSI doing her summer residency, working on various projects with individuals across the organization. After completing the MHA degree in the spring, she has plans to return to Nepal and apply for internship opportunities with the World Health Organization. 

“What about the Canadian Patient Safety Institute?” My professor said as I sat in his office and pondered where to complete my summer residency placement. 

 It was the beginning of October, and I was only one month into the Master of Health Administration (MHA) program at Dalhousie University, already having to decide where I would do my residency 8 months down the road. It was a tough decision as I was still adjusting to living in a new city and beginning the MHA program after spending the summer abroad. I was having a difficult time identifying what it was that I wanted out of this degree and specifically the residency experience.  

 Admittedly, I told my professor I had never heard of CPSI, but I was certainly intrigued. Up to this point, I had plenty of experience working and volunteering in the healthcare system. I spent the summer months during my undergraduate career working as an administrative assistant in a family clinic, working as a pharmacy assistant at Rexall, volunteering at the local hospice and hospital, and I was fortunate to grow up in a household with a family doctor. My combined passion for travel and healthcare took me to Kenya when I was 17 with suitcases of medical supplies for a clinic in Nairobi and I recently spent 3 months in Nepal working to implement a mobile health post in rural communities. However, through all these experiences I had never been introduced to the field of patient safety and the implications it has on our healthcare system.   

Looking back, patient safety inadvertently crossed my mind while lying in a hospital bed in Nepal, after being admitted for gastro symptoms. I was in a ward with many local Nepali women, all surrounded by loved ones in their beautiful coloured clothing. With a higher than usual prevalence of tuberculosis in Nepal, it was then that I noticed the hospital did not have any isolation rooms that I was used to seeing in Canada. There were no barriers or protective equipment, no infection control, and I could not read the information on the medication I was taking. I suddenly began to worry that I may leave the hospital more unwell than when I entered. As I lay there for 48 hours with no TV or cellphone, and only one book that I had already finished, I began to think about the harm, both preventable and non-preventable, that could come from a visit to any healthcare institution. I began to wonder what would happen if I became sick with an infectious disease or if I received medication I wasn’t meant to have. I began to wonder about these situations in Canada and more developed countries around the world.  

As I did my research on patient safety and CPSI in early October, I couldn’t help but reflect on these 48 hours in the hospital. I quickly realized that the fear I experienced in the hospital in remote Nepal was happening within our own country. I scrolled through the long list of topics on the CPSI website within the four categories of medication safety, infection control, teamwork and communication, and surgical safety. I read through the alarming statistics of patient safety incidents in Canada, the cost to the healthcare system, and the strikingly high mortality rate. While I had certainly come to understand through my years of work, educational and volunteer experiences that the Canadian system needs improvement in various areas, I was not aware of the severity and prevalence of patient safety incidents in Canada. I was shocked but immediately motivated and inspired to inform myself about the issue and pursue a placement with CPSI.  

From the beginning of my undergraduate degree and possibly earlier I always knew I wanted a career in the healthcare system. I admired my mother for her hard work, commitment to her career, and passion for helping to improve the health and lives of others. For many years I struggled to understand what I could do in the healthcare system without entering a clinical field such as nursing or medicine. However, my journey in the MHA program along with the opportunities I’ve had with CPSI have provided me with a clearer understanding of the important work that needs to be done at local, provincial, national and international levels to improve the quality, safety, and accessibility of healthcare.   

As I prepare to begin my second year of the MHA program, I am continuously thinking about what is on the horizon for me and the impact I hope to have on the system. I look forward to career opportunities where I can work collaboratively with healthcare providers, leaders, patients and families across the country to reduce inefficiencies in the system, improve the quality of care, reduce patient safety incidents, and improve the accessibility and affordability of care, especially for marginalized populations in Canada. Additionally, I am interested in pursing patient safety on a global scale to enhance the understanding and research available about the issue in underdeveloped and transitional countries. I am excited to pursue post-graduate internship opportunities with the World Health Organization to gain experience within their departments of patient safety, health system governance and financing, and health system service delivery and safety. As we continue to move the dial on patient safety in Canada, I hope we can take what we know and the basic principles to improve healthcare systems in various developing and transitional countries. I am hopeful that this will contribute to a future where healthcare is affordable, accessible, equitable, effective and safe for all.