Connecting with the Public, Providers
and Leaders

Knowledge Translation

A 40-member international expert faculty has been assembled to focus specifically on knowledge translation and implementation science. The faculty has been working to imbed knowledge translation science into the Canadian Patient Safety Institute’s education programming and has created a knowledge translation webinar series. The webinar series, designed for the public, providers and leaders within healthcare, provides understanding on how to harness knowledge translation science as a powerful tool in patient safety improvement.

The Knowledge Translation and Implementation Science webinar series 2018 launched on February 26th, with Dr. Jeremy Grimshaw and Dr. Justin Presseau providing a background summary of the concepts of knowledge translation and implementation science, and an overview of the models, theories and frameworks and how they can be used to implement and evaluate patient safety initiatives. The inaugural webinar attracted 402 participants and the second webinar in the series garnered 417 participants.

Two knowledge translation tools were implemented to spread patient safety practices across Canada and connect with patient safety champions. The SHIFT to Safety blog - #SHIFTtalks, and conversations with key influencers - #SuperSHIFTERS, highlight and share innovation and expertise in patient safety. The stories were viewed 3,786 times last year.

Human Factors

Human Factors is a growing field that has a significant impact on patient safety outcomes. SHIFT to Safety partnered with the Canadian Human Factors in Healthcare Network to provide human factors education and information to healthcare professionals and organizations to add to their existing knowledge base, related to quality and patient safety. A webinar series has been developed through this partnership that aims to improve the health system knowledge of human factors engineering and provides tangible tools to improve safety outcomes. On March 21, 2018, the first webinar in the series, International Approaches to Health Information Technology Safety was held, with 117 participants.

Clinical Deterioration

The Healthcare Insurance Reciprocal of Canada (HIROC) has ranked failure to recognize clinical deterioration as number two in healthcare claims in Canada. In a SHIFT to Safety partnership, the Canadian Patient Safety Institute, Patients for Patient Safety Canada and HIROC curated content to support the public, providers and leaders in the recognition and management of Clinical Deterioration. The initiative was formally launched in April 2017 during HIROC’s Annual General Meeting. Additionally, through this work the Canadian Patient Safety Institute was able to influence updates to the Health Standards Organization’s standards sets for critical care and acute care, further advancing the platform of the recognition of clinical deterioration.

The Canadian Patient Safety Institute continues to connect partners through hosting or contributing to promotional webinars, social media advertising, the development of a promotional video, and most recently convening an expert panel of clinicians and patients to produce a tool for the public to support recognition of clinical deterioration of the pediatric population.

Second Victim

When patients are harmed, there is often a second victim – a healthcare provider who is traumatized by the event. The Canadian Patient Safety Institute will strengthen the commitment for patient safety by working with patients, governments, regulators, educators, professional groups and other partners to promote individual, organizational and health system accountabilities for safer care through policy, legislation and accreditation. A report on peer-to-peer support after a patient safety incident (Second Victim) is under development and is expected to be released in the Fall 2018. In addition, policy statements and briefs designed to influence public policy and incite action by health leaders and the public will be published.

Framework for Measuring and Monitoring Safety

The Measuring and Monitoring of Safety Framework, created by Professor Charles Vincent and colleagues from the Health Foundation, consists of five domains that prompt a series of key questions to help you to rethink your understanding of safety in your own clinical environment. It provides a broader view of the information needed to create and sustain safer care. The primary questions to be answered by patients, providers and leaders are: Has care been safe in the past? Are our clinical systems and processes reliable? Is care safe today? Will care be safe in the future? Are we responding and improving?

To increase awareness of the Framework, a national call was hosted on June 21, 2017, How can your Board use the Measuring and Monitoring for Safety Framework? During the call, 111 attendees learned how the Measurement and Monitoring of Safety Framework can contribute to board understanding and help to align strategic and operational approaches to patient safety.

Beginning in May 2017, eight teams from seven healthcare organizations participated in an 11-month collaborative called the Measuring and Monitoring Safety Framework in Canada – Demonstration Project. The teams reported that safety has taken on a new meaning and that their outlook on safety had evolved. Teams participating in the project were able to demonstrate a shift in their thinking about patient safety and reported an improved patient safety culture. A national network has been created as a forum for participants to continue to share and learn.

A roundtable meeting of CEOs and senior leaders took place in April 2018, to spread learnings from the collaborative and advance understanding of implementation opportunities and challenges within the Canadian context for different sectors and speciality areas.

TeamSTEPPS Canada™

TeamSTEPPS® is an acronym for Team Strategies and Tools to Enhance Performance and Patient Safety. It is a teamwork system developed jointly by the United States Department of Defense (DoD) and the Agency for Healthcare Research and Quality (AHRQ) to improve institutional collaboration and communication relating to patient safety.

The Canadian Patient Safety Institute is licensed as the exclusive Canadian TeamSTEPPS holder to adapt, maintain and offer the TeamSTEPPS Canada™ training and curriculum. The program has been updated to better suit the Canadian context. This work included the addition of patient engagement content created by members of Patients for Patient Safety Canada, and the inclusion of Canadian resources, references, and videos. With SHIFT to Safety being our go-to-source for patient safety information across the country, we know that TeamSTEPPS Canada™ is a natural fit for providing providers, leaders and patients seeking a comprehensive curriculum to significantly improve teamwork and communication skills within the healthcare team. Effective teamwork skills are essential for safe, quality healthcare that prevents and mitigates harm.

The Canadian Patient Safety Institute, through its faculty and Training Centers, will help Canadian healthcare teams implement TeamSTEPPS Canada™ modules and content to address patient safety challenges. The long term vision is to connect and engage healthcare facilities with a growing Canadian TeamSTEPPS Canada™ community, and learn from international TeamSTEPPS colleagues.

Through strategic partnerships and pilot delivery of the TeamSTEPPS Canada™ Master Training sessions, teamwork, communication skills, and patient safety culture in healthcare environments will be improved. The Health Quality Council of Alberta has been designated as the first TeamSTEPPS Canada™ Master Training Centre and a Master Trainer session took place in May 2018, in Calgary. The Atlantic Health Quality and Patient Safety Collaborative delivered a TeamSTEPPS Canada™ Master Trainer session in Halifax, in April 2018.

Patient Safety Culture Bundle for CEOs and Senior Leaders

The Patient Safety Culture Bundle for CEOs and Senior Leaders is a robust framework to advance a culture of safety. Strengthening a safety culture requires interventions that are attuned to the existing culture and simultaneously enable, enact and elaborate. Through a literature review of more than 60 resources, the Patient Safety Culture Bundle was created and validated through interviews with Canadian thought leaders. The Bundle is based on a set of evidence-based practices that must all be applied in order to deliver safe care. All components are required to improve the patient safety culture.

The Patient Safety Culture “Bundle” for CEOs and Senior Leaders encompasses key concepts of safety science, implementation science, just culture, psychological safety, staff safety/health, patient and family engagement, disruptive behavior, high reliability/resilience, patient safety measurement, frontline leadership, physician leadership, staff engagement, teamwork/communication, and industry-wide standardization/alignment.

Enhanced Recovery after Surgery

Enhanced Recovery Canada (ERC) is leading the drive to improve surgical safety across the country through evidence-informed Enhanced Recovery After Surgery (ERAS) best practices.

Six core ERAS principles have been endorsed to shift the surgical care paradigm: patient and family engagement, nutrition management, perioperative fluid and hydration management, multi-modal opioid sparing analgesia, perioperative best practices, and mobilization. With the patient at the core, the successful implementation of Enhanced Recovery principles involves all members of the healthcare team caring for the patient before, during and after surgery.

A governance team and structure has been established to provide direction regarding clinical pathway development, dissemination and implementation. A pan-Canadian patient engagement working group and five clinical expert pathway working groups have been formed to adopt and adapt the existing ERAS related evidence tools and resources required to support implementation for colorectal surgeries, with a vision to then spread the implementation to other surgery types.

The work of ERC is supported by an extensive network of healthcare associated and industry partners including approximately 30 healthcare groups who developed and endorsed an ERC Position Statement. In addition, 13 industry partners have made a financial commitment to support the work. Going forward, the dissemination of ERAS best practices will be integrated into the new CPSI strategic plan in order to support an implementation strategy being planned for 2019-20.

Atlantic Learning Exchange

The Atlantic Health Quality Patient Safety Collaborative (AHQPSC) was established in 2010 by the Atlantic Deputy Ministers of Health to aid in facilitation, capacity relationship-building, and knowledge exchange to advance quality improvement and patient safety in Atlantic Canada. The Canadian Patient Safety Institute is a member of the AHQPSC and serves as secretariat for the group.

The Atlantic Health Quality & Patient Safety Learning Exchange, held in Charlottetown, PEI on May 30 and 31, 2017, attracted 160 delegates from the four Atlantic Provinces. The theme of the event was advancing the patient safety culture to improve the patient experience. A key highlight of the event was the release of the Engaging Patients in Patient Safety: a Canadian Guide. Healthcare leaders and patient safety champions took in engaging presentations on quality improvement from the system, provider and patient experiences, and rapid fire presentations that showcased local initiatives. Copies of the presentations are available for download.

Ontario Initiatives

In Ontario, the Canadian Patient Safety Institute continues to maintain and strengthen relationships with a number of organizations, including regional Quality and Patient Safety collaboratives and Ontario-based Quality and Patient Safety Representatives Groups. We also work with Health Quality Ontario to advance common strategic priorities, and participate in and support the planning of the Health Quality Transformations Conference, held October 24, 2017. This was the Health Quality Ontario’s sixth annual interactive conference for patients, caregivers, healthcare providers and system leaders.

Strengthening relationships in Quebec

The Canadian Patient Safety Institute has maintained and strengthened its relationships with Quebec quality and patient safety leaders, including provincial health organizations and quality and safety committees/councils to share information, align priorities, identify opportunities, and secure commitment to patient safety projects and initiatives. In 2017-18, a representative from the Canadian Patient Safety Institute joined the Réseau pour l’amélioration continue de la qualité (RACQ) Collaborative Executive Committee and participated in the 2018 Colloque (Conference) Planning Committee. The RACQ represents 15 of 18 integrated health and social services centres (CIUSSS/CISSS) across Quebec. Over 100 participants attended the 2018 Colloque in Montreal.

Advancing patient safety in Western canada

To advance patient safety initiatives in Western Canada, the Canadian Patient Safety Institute provides leadership, coordination and support to regional health authorities, quality councils and regional patient safety committees in the provinces of British Columbia, Alberta, Saskatchewan and Manitoba. These groups identify and discuss quality and patient safety priorities with an aim to learn from each other and identify opportunities for their provincial initiatives and programs. The Canadian Patient Safety Institute maintains participation at relevant strategy tables, conferences and events and continues to provide secretariat support to, and participate in the Western Quality and Patient Safety Representatives Group. These regional partnerships provide valuable information on emerging issues at the frontlines and assist to ensure our initiatives and outputs are practical and useful to patient safety leaders in the health system.

In March 2018, staff from the Canadian Patient Safety Institute visited the Yukon Territory for the first time, to meet with healthcare leaders and learn about their patient safety priorities, and to introduce them to the work of the Canadian Patient Safety Institute.