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CPSI Share                                                  
3/11/2010 5:00 PM


Inside this Issue:

Safer Healthcare Now! Moving Forward with Vigour

This much-anticipated, information-packed workshop is sure to sell out!  Sa​fer Healthcare Now! Moving Forward with Vigour will be held on Monday, April 12, 2010 from 8:30 am to 5:00 pm at the Westin Harbour Castle in Toronto (Ontario). 

This is your opportunity to acquire strategies for success in these challenging times! Keynote speakers include Joe McCannon, Institute for Healthcare Improvement (Leader for 100K Lives and 5 Million Lives Campaigns) and Rabih Darouiche, MD (Lead Author of landmark New England Journal of Medicine article on Skin Prep in the OR). Learn about the future of Safer Healthcare Now! from Hugh MacLeod, CEO, Canadian Patient Safety Institute and hear rapid fire presentations from faculty. In addition, the Safer Healthcare Now! Team Awards will be presented to recognize and celebrate your work.

Register Now! Join your Safer Healthcare Now! colleagues for this one-day workshop and stay for the Forum!


Canada's Forum on Patient Safety and Quality Improvement: “Improving Safety Across the Continuum”

Canada's Forum on Patient Safety and Quality Improvement

Don’t miss this opportunity for thought-sharing, networking and celebration! Register now for Canada’s Forum on Patient Safety and Quality Improvement!  The 2nd annual forum will take place from April 12 to 14, 2010 at the Westin Harbour Castle, Toronto (Ontario).

The Forum is designed to highlight safety issues across disciplines, across settings, across the country and around the world, offering you many solutions, tools and other resources that have proven effective in care settings both nationally and internationally.

An outstanding list of international speakers will talk about the challenges and successes of leading national initiatives to improve the quality and the safety of care provided across nations and across all sectors. The speakers list will include:

  • Jim Easton, National Director for Improvement and Efficiency for the National Health Service in the UK, is currently leading the UK’s national strategy to deliver a better quality of care in an environment of cost containment. Jim will speak to the link between quality and safety and the current cost environment.
  • Rahaf Harfoush is a ‘New Media’ expert who was integral to the success of the Obama presidential campaign.  She will talk about the value and the role of social media in creating national campaigns that capture the hearts and minds of leaders and frontline workers across the country.
  • Jason Leitch, National Clinical Lead for Safety and improvement for the Scottish Government Health Foundation will talk about their two-year journey to reduce mortality in acute-care by 15 per cent over five years and reduce adverse events by 30 per cent across the Scottish Healthcare System.

Canada’s Forum will also have six concurrent streams that will provide specific examples of successful initiatives that have made care safer for patients across the healthcare continuum. The streams will include Infection Prevention and Control, Medication Safety, Learning from Adverse Events, Partnering for Patient Safety, and Building a Culture of Quality and Safety. An applied learning stream will provide attendees with tools to improve safety as well as the opportunity for hands on learning of the use of these tools.

Click on these links to access the Preliminary Program and Concurrent Session Guide.


Update on new web-based measurement tool

Safer Healthcare Now! to roll-out new Web-based Data Submission and Reporting System

The Safer Healthcare Now! Central Measurement Team and the Web-Based Tool Development Committee are very excited to report that Phase 1 of the new tool will soon be ready for testing. “We started working with ABS Systems last Fall to modify and merge the enrollment and measurement databases , convert the current interventions and measures into the web-based tool  and develop standardized reporting tools similar to reports currently available such as run charts and Quarterly Reports,” says Virginia Flintoft, Central Measurement Team Project Manager. “Our guiding principles for the development process have been to create an intuitive system that requires minimal clicks to access screens.  We have worked hard to reduce the barriers encountered in data submission while retaining appropriate procedures to ensure data security.”

The overall goals of this project are to streamline enrollment for organizations and data submission for teams, and to enhance reporting and provide real-time access to data and standardized reports for Safer Healthcare Now! users. The existing Excel worksheets used for reporting will be phased out by March 31, 2011.

The enhanced functionality of the web-based tool will permit new organizations to enroll with greater ease.  More importantly it will provide the users rapid access to data reports as well as the ability to aggregate and disaggregate results, thereby allowing organizations to report by region, facility or individual patient sample (team).  Teams will be able to report results for the numerator and denominator only, or follow the full step-by-step process.  Any user may submit data by providing their name and email – no login is required, however, only registered users may see data results.  Other improvements include automatically designating the activity and implementation levels as well as allowing teams/organizations to identify when they have withdrawn from a measure or intervention, or have multiple groups report as a single “spread” team.

Watch upcoming issues for more news about the Web-based Data Submission and Reporting System and information on upcoming webinars, face-to-face and individual training sessions.


A well-charted path to Opioid Safety In Paediatrics

New! Phase II Report - Advancing Medication Safety in Paediatrics – Opioid Safety

Paediatric healthcare facilities face unique challenges in the medication delivery systems. It is well known that various patient and system factors place paediatric patients at greater risk of experiencing harm from medication errors, and that certain medications have a higher potential to cause harm when used in error.

The Institute for Safe Medication Practices Canada (ISMP Canada) and the Canadian Association of Paediatric Health Centres (CAPHC), with support  from The Canadian Patient Safety Institute, Medbuy Inc., and Baxter Corporation have established a partnership intended to advance medication system safety in the delivery of high alert medications in Canadian paediatric facilities.

Phase 1 of the project completed in 2008, provided the necessary context to develop best practice strategies. Through a comprehensive Medication Incident Analysis, Phase 1 identified the top five medications reported as causing or potentially causing, harm to paediatric patients. Two of the five are opioids, morphine and fentanyl.

What is unique about Phase 2 is the synergy of perspectives applied to the issues of safer opioid delivery in paediatric healthcare settings. Health professionals, human factors experts and psychologists worked together to address the critical issues identified in Phase 1, creating an intervention that that will assist in the implementation of safe medication practices for the delivery of opioids in paediatric  settings. This includes all aspects of the opioid medication system from prescribing to storage and administration.

The conclusions of Phase 2 investigations support:

  • Moving to standardized concentrations to reduce calculation and other errors
  • Customization of recommendations for community and tertiary hospitals
  • The benefits of an optimal psycho-physiological state to deliver opioids

Future work will involve testing, validating and building support for these recommendations in the paediatric community across Canada.

To access a copy of the report, click on the link: Phase II Report - Canadian Paediatric High Alert Medication Delivery: Opioid Safety toward a Change in Practice

Further information is also available through CAPHC (High Alert Medication Delivery in Paediatrics - Implementing Leading Practice) or ISMP Canada (A National Collaborative: Advancing Medication Safety in Paediatrics).


STOP! Clean Your Hands Day

The Canadian Patient Safety Institute and Accreditation Canada invite you to participate in "STOP! Clean Your Hands Day"

STOP! Clean Your Hands Day will be held Wednesday, May 5, 2010. This national event will coincide with the World Health Organization's 2nd Annual Global Save Lives, Clean Your Hands Day.  There are a number of opportunities available to get involved and results will be showcased and prizes awarded for participation:

  • National Hand Hygiene Observation Day - will allow organizations to enrol in a dedicated day (or week) of hand hygiene observation in healthcare facilities. A variety of observation and surveillance tools will be available for use. Information packages will be sent out well in advance and training in use of the Observation tool and analysis tool is scheduled to take place in April.
  • National Peer to Peer Review Day - will allow organizations to seek out groups of healthcare workers interested in conducting peer reviews of hand hygiene practices.
  • National Patient /Family Observation Day - a new Patient and Family Hand Hygiene Observation Card will be launched by the Canadian Patient Safety Institute that can be used by any patient or family member to observe and report the hand hygiene activities of the individuals providing care.  This postcard will include prepaid postage to the Canadian Patient Safety Institute and results from the National Patient Family Hand Hygiene Observation Day will be reported back to the participating organizations.  A new Patient Family Hand Hygiene Guide will also be launched in advance of the event.
  • National Healthcare Worker and Volunteer Hand Hygiene Training Day - will allow healthcare workers and/or volunteers across the country to log into the Canadian Patient Safety Institute’s Discovery Campus Hand Hygiene Training Module to complete online training and receive a certificate of completion.

To support these initiatives, Canada's Hand Hygiene challenge "STOP! Clean Your Hands" website will be re-launched with a new look, renewed emphasis, new tools, information, and strategies.

Stay tuned to for information on how you can participate and enroll in Canada’s Stop! Clean Your Hands Day.


Ontario Node offers Medication Reconciliation Workshops

The Quality Healthcare Network (home of the Ontario Node of Safer Healthcare Now!), in partnership with ISMP Canada and with support from the Canadian Patient Safety Institute, is providing two workshops on how to implement Medication Reconciliation in your organization. The workshop, entitled - One Bite at a Time - Eating the Medication Reconciliation Elephant, will take place:

  • March 29 - 30, 2010 - Ontario Shores Centre for Mental Health Sciences, Whitby, Ontario
  • April 7 - 8, 2010 - Perley and Rideau Veterans Health Centre, Ottawa, Ontario

This workshop will help you to gain practical knowledge for success with Medication Reconciliation at admission, transfer and discharge; further your understanding of the measurement process for Medication Reconciliation; acquire a clear understanding of the Accreditation requirements for Medication Reconciliation and practical approaches to meet them; identify supports for Medication Reconciliation (training, IT solutions, and workable paper-based systems); and learn principles and strategies for spreading Medication Reconciliation beyond the pilot unit.

Space is limited; the deadline for registration is March 25, 2010.  For more information or to register, click here.


National Calls

Join us on an upcoming National Call to learn more! Click on Events and Calls for further information on these sessions: