​A Conversation between the Manitoba Institute for Patient Safety and CPSI

The longstanding relationship between the Manitoba Institute for Patient Safety (MIPS) and the Canadian Patient Safety Institute (CPSI) is a mutually beneficial, dynamic, and supportive one. When CPSI sought out a partner to test out a new policy framework through which patient safety could be introduced to government decision-makers, MIPS was among the first to sign on!

CPSI's strategic plan for 2018-2023 promises to lead health system-level strategies to ensure safe healthcare by demonstrating what works and by strengthening commitment. Patient safety incidents in total (acute care and home care combined) are the third leading cause of death, behind cancer and heart disease with just under 28,000 deaths across Canada (in 2013). This is equivalent to such harm events occurring in Canada every one minute and 18 seconds, resulting in a death every 13 minutes and 14 seconds.

This rate and scale of harm is unacceptable.

Strengthening Commitment for Improvement Together: A Policy Framework for Patient Safety focuses on key policy levers available to influence system changes. As the national thought leader in patient safety, CPSI supports provincial/territorial governments, health system leaders, and other policy actors to develop and enhance legislation, regulations, standards and organizational policies to improve patient safety. CPSI also engages with the public to raise awareness about patient safety.

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Jan Byrd and Laurie Thompson

MIPS was thrilled to consult on the development of the policy framework. Laurie Thompson, Executive Director of MIPS, believes "it would have been invaluable to our early work, when the landscape was very different. For us, and organizations starting out on or refreshing their patient safety agenda, the framework will serve as an excellent guide."

Laurie Thompson, Jan Byrd and Renee Misfeldt (co-authors of CPSI's Policy Framework), worked together to offer examples of MIPS initiatives that illustrate the framework's five policy levers in action!

1 Legislation

Government leadership is essential for putting into place protections to address and reduce patient safety incidents in healthcare.

MIPS assesses legislation with a patient safety lens. During the latest review of the Personal Health Information Act, MIPS posed questions about disclosure of information to patients/families such as: "Is there enough emphasis on the balance of privacy, with the needs of patients and families to have information in order to make decisions?" and "Are there positive messages being conveyed in the educational materials about patient and family centred care principles as they relate to provision of information in a timely way?"

2 Regulation

Embedding patient safety within professional self-regulation sets out clear expectations for safe patient care by healthcare providers.

MIPS has worked on a number of projects over the years with regulators to strengthen patient safety such as The Importance And Impact of An Apology: An Information Sheet, to support regulators in promoting apology as an essential component of disclosure of patient harm. Since 2016, MIPS has partnered with the Manitoba Alliance of Health Regulatory Colleges on a new provincial patient safety reporting and learning system to extend opportunities for creating safety, learning and improvement across disciplines and sites of care.

3 Standards

Accreditation is an important driver for patient safety and quality improvement.

MIPS creates tools and resources for use by service delivery organizations that meet accreditation standards. Examples include: a tool to support policies in eliminating the use of dangerous abbreviations, dose designations and symbols; a tool to provide clear messaging to patients, families and healthcare providers about the critical incident process; and a family of resources entitled "It's Safe to Ask" supporting patient/client engagement, self-advocacy, and health literacy. The It's Safe to Ask suite of resources – initially led by CPSI's own Jan Byrd in 2005! - was a specific request from regional health authorities during the early years to support accreditation.

4 Organizational Policies

Improving safety requires an organizational culture that enables and prioritizes patient safety.

MIPS initiated governance education in 2006, working with provincial leaders. Boards assessed their governance education needs against leading practices in governance for patient safety and quality. MIPS worked with CPSI to test governance education and continued to offer tailored programs for several years, with evaluations noting a positive impact in governance practices.

5 Public Engagement

MIPS has been committed to engaging the public since early in their existence.

In addition to a collection of self-advocacy tools and resources, extensive social media, volunteer-led public presentations and information sessions, MIPS hosted nine public forums in a series, "We listen, We learn, We evolve". These forums are opportunities for patients/families and the public to meet and talk about patient safety issues and concerns.

Can you see your work within the 5 Policy Levers we have outlined?

Please reach out and let us know at jbyrd@cpsi-icsp.ca