W21C Patient Safety Podcast

 Emails, comments, feedback to w21cedu@ucalgary.ca 

In this podcast, Dr. Shawn Dowling explains the benefits and costs of the Computerized Provider Order Entry (CPOE), a complex healthcare intervention used for entering and managing orders.

“CPOE and EHR (Electronic Health Records) are the future of where patient health data is moving toward”, Shawn says.  Effective ways to enter, collect and communicate data bring benefits to providers and patients.  There are the potentials to reduce errors, increase patient safety, and maximize the use of information for appropriate medical decisions. Shawn highlights the importance of clinical decision support and describes how CPOE works as a tool to help physicians make the best decision at the point of care.

Emails, comments, feedback to w21cedu@ucalgary.ca

In this episode Craig Curtis talks about the role of pharmacists in Alberta in the development and use of the CKD (Chronic Kidney Disease) Pathway. He highlights the importance of building an evidence-based pathway that includes international recommendations easily accessible to family physicians and pharmacists.

After listening to this podcast the listeners will be able to recognize the primary interventions for managing chronic kidney disease (CKD) in adults: 

• Prevent progression: ACEi/ARB, DM
• Reduce cardiovascular (CV) risk: statin, antiplatelet
• Renal dose adjustments
• Avoid nephrotoxic medication

Email comments and feedback to w21cedu@ucalgary.ca

In this episode Dr. Chandra Thomas talks about safety related to medications in patients with Chronic Kidney Disease (CKD).  Individuals with CKD are at very high risk for medication incidents associated with enormous costs for the society and the individuals.

After listening to this podcast listeners will be able to:

1) Understand the risks for medication related safety incidents in patients with CKD
2) Know the complexity and uniqueness of individuals with CKD

Email comments and feedback to w21cedu@ucalgary.ca 

In this episode Marlene Donahue talks about simulation and the growing interest and demand for healthcare applications. After listening to this podcast listeners will be able to:1) Look at the evolution of simulation into healthcare,2) Explore the diversity of applications and uses for simulation in healthcare,3) Consider areas and possible challenges for future development and research.

Email, comments, feedback at w21cedu@ucalgary.ca

In this episode Dr. Jessica Simon describes Advance Care Planning as a novel social process.

After listening to this podcast listeners will be able to:

• Understand the term "Advance Care Planning" and its 5 elements 
• Recognize the harms and benefits in Advance Care Planning
• Learn about national and local findings in Advance Care Planning
• Understand the Knowledge to Action Cycle and The Theoretical Domains Framework

Email comments and feedback to w21cedu@ucalgary.ca

In this episode Dr. Sam Gharbi describes patient handover as a major issue in patient safety.  

After listening to this podcast listeners will be able to:

• Understand the problems around patient handovers
• Evaluate a need for a structured handover process
• Know the benefits and features of the Virtual Ward (now known as Arya Handover)

Email comments and feedback to w21cedu@ucalgary.ca

In this episode Dr. Liane Ginsburg updates our thinking about patient safety culture and patient safety climate.  

After listening to this podcast listeners will be able to:

• Differentiate between patient safety culture and patient safety climate 
• Understand the barriers to strong and positive patient safety culture and climate
• Consider patient safety climate strength in addition to climate level

Email comments and feedback to w21cedu@ucalgary.ca

In this episode Dr. Wes Jackson gives a detailed description of the online CKD clinical pathway. 

After listening to this podcast listeners will be able to:

• Recognize the criteria for Chronic Kidney Disease targeted testing
• Identify the tests that should be ordered
• Know how to diagnose, manage and refer with the Online CKD Clinical Pathway

Email comments and feedback to w21cedu@ucalgary.ca 

In this episode Dr. Jeptha Davenport provides the definition of migraine, the meaning of ‘primary’ and ‘secondary’ headaches, and a list of 'red flag' features to recognize life-threatening headaches.

After listening to this podcast listeners will be able to:

• Name the most common types of headache brought to medical attention
• Discuss reasons to correctly identify different types of headaches
• List ‘red flag features’ of headache in 4 large groups
• Feel confident in planning management of ‘red flag’ headaches (including referral)

Email comments adn feedback at www.21cedu@ucalgary.ca

In this episode Dr. Chester Ho discusses pressure ulcers and their causes, costs, prevention and management.  

After listening to this episode, listeners will be able to:

• Recognize that pressure ulcers are common and under-recognized as a patient safety issue.
• Pressure ulcers are largely preventable and are indicative of patient quality of care.
• Pressure ulcers are expensive to treat and cause great discomfort to patients, decreasing quality of life.

Email comments and feedback to w21cedu@ucalgary.ca

In this episode Jonas Shultz discusses how the built environment affects patient safety and patient outcomes. 

After hearing this episode listeners will be able to:

• Describe how the build environment affects patient safety
• Outline approaches to involve healthcare providers and patients in the design process
• Advocate for the use of patient simulation in mock-ups to make evidence based design decisions

Email comments or feedback to w21cedu@ucalgary.ca

In this episode Dr. Bhatia explains the harms associated with the over utilization of low value care, a type of care that  provides little benefit to the patient and increases costs for the health system.  After listening to this podcast listeners will be able to:

• Recognize low value are as an issue affecting fiscal sustainability of the health care system
• Appreciate measures for reducing low value testing
• Discuss Choosing Wisely Canada with in depth knowledge of the campaign

Email comments or feedback to w21cedu@ucalgary.ca

In this episode Dr. Dave Hogan introduces the concept of "deprescribing" which is defined as carefully getting patients off some of the medications.  

After hearing this episode listeners will be able to:

• Define the concept of "deprescribing" and evaluate its potential benefits in older patients
• Identify opportunities to review a patient's drug regimen
• Consider a prudent approach to withdrawing medications 

Email comments and feedback to w21cedu@ucalgary.ca

In this episode Dr. John Conly highlights the importance of antibiotic stewardship, which is the appropriate and optimal use of antibiotics in outpatient and inpatient settings.  After listening to this podcast listeners will be able to: 

• Understand the importance of antibiotic resistance
• Evaluate the messages to improve their own antibiotic stewardship
• Consider possible actions to take for a wise use of antibiotics

Email comments and feedback to w21cedu@ucalgary.ca 

In this episode Dr. Deborah Marshall and Karen MacDonald discuss how the lack of consistent outcomes, adverse event definitions and non-standardized measures challenges their ability to compare outcomes between total hip replacement and a newer technology called hip resurfacing.   After listening to this podcast listeners will be able to: 

• Understand the importance of being critical when reviewing the literature
• Make valid comparisons by using standardized, comparative outcomes
• Evaluate the need of joint replacement registries 

Email comments or feedback to w21cedu@ucalgary.ca 

In this episode Brent Thorkelson, a Registered Paramedic and Senior Staff Development Officer with AHS EMS, joins us to talk about an ambulance design study conducted in collaboration with the W21C and Auto 21.

After listening to this podcast listeners will be able to:

• List the benefits of pairing research and education in a simulation program
• Describe how an efficient work environment can enhance patient safety in the ambulance context
• Comprehend the challenges practitioners face when trying to provide appropriate medical care within the confines of an ambulance compartment

Please email comments and suggestions to w21cedu@ucalgary.ca 

In this episode Dr. Selena Au defines PFCC and highlights its importance by sharing a case in which a young girl experienced a tragic adverse event that could have been prevented by better use of family centred care. After listening to this podcast listeners will be able to:

• Define patient and family centred care
• Describe a situation where the healthcare system could become safer by integrating PFCC
• List the lessons learned from Josie King's story
• Describe Condition H

We love to hear from you so please provide any feedback, comments, or suggestions to w21cedu@ucalgary.ca 

In this episode Greg Hallihan describes the science of human factors and its application to the design of healthcare systems. 

After listening to this episode, listeners will be able to:

• Describe the science of human factors and its potential applications to the design of healthcare systems (e.g., medical technologies, environments and systems) 
• Identify possibilities for the use of simulation in the evaluation of design of these systems, particularly healthcare environments
• Delineate the history of patient-centered design, and be able to describe different methods to engage “users” of the health care system in the design process 

Please email comments, suggestions, and feedback for our series or this episode to w21cedu@ucalgary.ca 

 In this episode Alyshah Kaba shares the results of her national award winning doctoral research on group conformity.  After listening to this episode listeners will be able to:

• Define group conformity and share examples of how it may occur in healthcare
• Describe empirical evidence that demonstrates group conformity amongst interprofessional students
• Consider potential implications of group conformity for patient safety and education

For feedback, comments, or suggestions, email us at w21cedu@ucalgary.ca

In this episode Paul Campsall and Elizabeth Parfitt describe an antimicrobial stewardship smartphone application that they have developed specifically for the Calgary region. 

After listening to this podcast, listeners will: 

• Be aware of the SpectrumCalgary app, how it was developed, the logic behind it, the goals of use, and how it differs from other apps on the market. 
• Understand the area of research called human factors. Learn how human factors testing revealed potential issues with the original design of SpectrumCalgary, and a few changes made as a result of the testing. 
• Realize the importance of human factors usability testing as a key component in the development process for apps and other software. 

If you have any comments, suggestions, or feedback for us, please email us at w21cedu@ucalgary.ca

In this episode Margot Harvie discusses the importance of analyzing patient safety events from a systems view, and explores the relevance of teaching healthcare professionals to think about patient safety from this broader point of view. After listening to this podcast, listeners will be able to: 

• List the five levels that need to be considered when conducting a patient safety review
• Explain the importance of using a methodology for completing patient safety reviews
• Describe which healthcare workers could benefit from training in investigating and managing patient safety events

Email comments and feedback to w21cedu@ucalgary.ca

In this episode Dr. Deborah White discusses ingredients necessary to creating a high-quality healthcare system.

After listening to this podcast listeners will:

• Understand what is required of effective leaders in creating and sustaining an environment of quality and safety in healthcare.
• Recognize that leadership is required at all levels of the organization from the boardroom to the front line.
• Realize that focus and priorities are key in an environment that is continually asking for change.  Leaders who can manage change and retain enthusiasm in demanding environments must have the resources and accountabilities to make changes happen. 

Email comments and feedback to w21cedu@ucalgary.ca

Undergraduate medical students at the University of Calgary have an opportunity to participate in quality improvement projects via Med 440, an Applied Evidence Based Medicine course. 

After listening to this podcast listeners will be able to:

• Understand how the Med 440 course provides undergraduate students an opportunity to explore quality improvement projects in ways not available elsewhere in the curriculum.
• Learn how two students conduct their research and what findings they report at completion of their projects.

Email comments and feedback to w21cedu@ucalgary.ca 

Undergraduate medical students at the University of Calgary have an opportunity to participate in quality improvement projects via Med 440, an Applied Evidence Based Medicine course. After listening to this podcast, listeners will:

• Understand how the Med 440 course provides undergraduate students an opportunity to explore quality improvement projects in ways not available elsewhere in the curriculum.
• Learn how three students conduct their research and what findings they report at completion of their projects.

Email comments, feedback to w21cedu@ucalgary.ca 

In this episode Nancy Marlett and Sandra Zelinsky give us an update on the PACER (formerly PERs) initiative and then Sandra describes her PACER project "The Hidden Pathways of Chronic Illness" in detail. After listening to this podcast, listeners will be able to:

• Understand that patients diagnosed with a chronic illness will often undergo a journey through hidden pathways to redefine themselves and learn to live with their disease.
• Know how a participant in the PACER group undertakes a project and involves patients in improving the healthcare system

Email comments, feedback to w21cedu@ucalgary.ca 

In this episode Dr Marcia Clark introduces the Safe Surgery Checklist, which is mandatory for all surgical procedures in Alberta. 

After listening to this podcast listeners will be able to:

• Understand the history of the Safe Surgery Checklist.
• Know the three phases of the Safe Surgery Checklist – Before Induction of Anesthesia, Before Skin Incision, and Before Patient Leaves Operating Room – and be familiar with the items covered in each phase.
• Consider other applications of the checklist in procedurally based areas outside of surgery.

Email comments, feedback at w21cedu@ucalgary.ca

In this episode Dr. Claudia Steinke introduces elements of service design that can help empower patients in the healthcare system, especially within emergency departments. 

After listening to this podcast, listeners will be able to:

•  Describe the benefits of looking to the fields of service management, business, and architecture to design healthcare services
• Discuss how physical design can facilitate service quality, patient satisfaction, and patient empowerment
• Consider how empowering patients can lead them to take ownership of their individual health and well-being

Email comments, feedback to w21cedu@ucalgary.ca

In this episode Nishan interviews Dr William Ghali and Dr Jacques Cornuz regarding an international patient safety initiative between Canada and Switzerland focused on improving communication during transitions of care.

To learn more about the Seamless Transitions of Care project here at W21C visit our website at www.w21c.org

If you have any comments or suggestions for us, please email at w21cedu@ucalgary.ca 

In this episode Dr Maeve O'Beirne discusses patient safety and quality of care in family medicine. 

After listening to this podcast listeners will be able to:

• Describe the four steps outlined in the PDSA cycle
• List the three questions that need to be asked at the beginning of a PDSA cycle
• Apply the PDSA cycle to a real life example

If you have any questions, comments, or suggestions please contact us at w21cedu@ucalgary.ca 

In this podcast Chloe Atkins explores discomfort with uncertainty in medicine using her own story as a backdrop. 
After hearing this podcast listeners will be able to:

• Recognize the discomfort both patients and physicians experience around uncertainty, and how that discomfort can provoke undesirable behaviours.
• Understand that relationships and communication are key to achieving satisfaction with health outcomes.
• Realize that medicine is not all-powerful, that there are limits to understanding and treatment. It is important to be aware of and tolerate the unknown.

If you have any suggestions for future podcast, or comments about our series, contact us at w21cedu@ucalgary.ca 

In this episode Dr Bruce MacLeod discusses the importance of having disclosure conversations with patients when they have experienced harm or near misses as a result of the care that they received in hospital and not from their underlying disease process.  After listening to this podcast listeners will be able to: 

• Recognize the importance of having disclosure conversations with patients who have experienced harm or near misses
• Describe the challenges that healthcare providers face when they need to have a disclosure conversation

Email comments, feedback at w21cedu@ucalgary.ca

 In this episode Dr Nancy Marlett and Sandra Zelinsky discuss an innovative program at the University of Calgary - The Patient Engagement Researcher (PER) Program. After hearing this podcast listeners will be able to: 

• Describe the Patient Engagement Researcher program
• Consider how engaging patients as researchers and informed partners in care can improve patient safety

Email comments, feedback to w21cedu@ucalgary.ca

In this episode Dr Ghazwan Altabbaa suggests that medical students and residents are frontline healthcare providers and that not enough has been done to teach them about patient safety. 

After listening to this podcast, listeners will: 

• Understand the inconsistencies in the teaching of patient safety to Canada’s medical students and residents. 
• Recognize High-Fidelity Human Patient Simulation as an effective teaching modality for medical residents because it addresses patient safety on multiple levels: medical knowledge, crisis resource management, and team dynamic skills.
• Understand that cognitive biases can lead clinicians down the wrong path when it comes to diagnosis. Using simulation, learners can explore those biases and learn from others during the debriefing phase of the learning process.

Email comments, feedback at w21cedu@ucalcary.ca

 In this episode Dr. Sachin Pendharkar explores overcrowded or access-limited healthcare systems and suggests that discussions of supply and demand are often inappropriately limited to lack of supply.

After listening to this podcast, listeners will: 

• Understand that problems with overcrowding and long wait times are not always due to inadequate supply. 
• Be aware of concepts of demand, supply and capacity and how they relate in healthcare systems. 
• Recognize how variation can be a barrier to access, even in systems with an adequate supply to meet demand.

Email comments, feedback at w21cedu@ucalgary.ca

In this episode Dr Brian Wong discusses steps to engage academic faculty in quality improvement and patient safety.

After listening to this podcast, listeners will: 

• Be aware of trends toward embedding patient safety information within broader courses and conferences 
• Discover how the University of Toronto, the University of Calgary’s W21C and others are recognizing the importance of quality improvement with courses, degree programs and job profiles 
• Be aware of new medical journals that focus specifically on patient safety and quality improvement 

Email comments, feedback to w21cedu@ucalgary.ca

In this episode Dr Chris Pysyk discusses the risks associated with smoking during the peri-operative period, which is before, during, and after surgery. After listening to this podcast, listener's will be able to:

• List the "Big 5" complications that smokers are at an increased risk of having after surgery
• Explain how many smokers are in the "preparation stage" of behaviour change and why this stage of change is so important
• Reflect on how healthcare providers can influence smokers and list some resources for smoking cessation

Email comments, feedback at w21cedu@ucalgary.ca 

In this episode Dr Marcia Clark discusses patient safety in terms of surgical care.   After listening to this podcast listeners will be able to: 

•  Explain the aspects of surgical care that may influence the higher rate of error seen in these patients versus non-surgical patients
• List the seven phases of surgical care where error can occur
• Describe the four practices described by Marcia that are used to mitigate and prevent errors in surgical practice
• Think of other possible solutions that could be used to decrease the rate of error in surgical patients

Email comments, feedback to w21cedu@ucalgary.ca

In this episode Dr Irene Ma discusses how education plays a critical role in promoting patient safety during invasive bedside procedures, which are commonly performed but can have a high rate of complication. After listening to this podcast listeners will be able to:

• Describe why invasive bedside procedures are necessary despite their relatively high risk of complications
• Compare the logbook method of teaching procedural skills with a competency based education model
• Define a never event and list some simple measures that can help promote patient safety by decreasing the complication rates and preventing never events
• Describe how technological advances such as the use of simulation in education can enhance procedural safety

Email comments, feedback at w21cedu@ucalgary.ca

 In this episode Dr Trevor Chan and Dr Sunita Chacko discuss the quality improvement (QI) project that they completed for the 2012/13 W21C Patient Safety and Quality Management course called: Conversations Matter.  After listening to this podcast listeners will be able to: 

• Define the difference between Advance Care Planning and Goal of Care Designations
• List the interventions that Trevor and Sunita used in their project and which were most successful
• Describe how advance care planning conversations, and especially the tracking tool, can positively affect patient safety and quality of care
• Discuss some of the barriers that physicians encounter that could decrease their use of the tracking tool

Email comments, feedback to w21cedu@ucalgary.ca

 In this episode Dr Christopher Pysyk discusses the importance of determining perioperative mortality rates in common surgical procedures. After hearing this podcast listeners will be able to: 

• List the four key principles supporting establishment of perioperative mortality rates
• Describe the importance of measuring perioperative mortality rates
• Discuss how locally relevant perioperative mortality rates can decrease anxiety in patients and families before common surgical procedures

Email comments, feedback at w21cedu@ucalgary.ca

In this episode Dr Maria Santana discusses the use of patient-reported outcomes measures in clinical practice as a means of enhancing patient safety. After listening to this podcast listeners will be able to:

• Define PROMs
• Explain how the use of PROMs can enhance patient safety
• Consider areas in healthcare where PROMs could be used to improve the quality and safety of care that patients receive

Email, comments, feedback to w21cedu@ucalgary.ca

 In this episode Dr Alan Forster discusses the importance of measuring patient safety.  After listening to this podcast listeners will be able to:

• Describe the most common method of identifying adverse events
• Explain how peer-review processes can be embedded into other detection methods
• Describe the steps that need to occur after adverse events are identified

Emails, comments, feedback to w21cedu@ucalgary.ca

In this episode Dr Ward Flemons discusses how healthcare providers and organizations should respond to an adverse event, a situation where a patient is harmed due to medical care that they did or did not receive. After listening to this podcast listeners will be able to:

• Describe the steps involved in the immediate management of an adverse event
• Explain the importance of offering immediate and long-term support for patients, families, and healthcare workers involved in adverse events
• List activities that need to take place after immediate management that can be used to improve healthcare systems and prevent future adverse events

Emails, comments, feedback to w21cedu@ucalgary.ca

In this episode Dr John Conly discusses hand hygiene as an effective means of preventing the transmission of germs.

After listening to this podcast listeners will be able to:

• Describe the difference between hand washing and hand hygiene 
• Explain the importance of hand hygiene using real life scenarios
• Provide possible techniques for improving hand hygiene

Emails, comments, feedback to w21cedu@ucalgary.ca

In this episode Dr Jane Lemaire describes her work with Dr Jean Wallace on physician wellness, a fundamental concept for a functioning healthcare system that also plays a huge role in patient safety and health. After listening to this podcast listeners will be able to: 

• Describe the challenges and barriers to wellness that physicians face in healthcare
• Consider the multi-faceted impact of physician wellness on patient care, safety, and health
• Use the information in the podcast to reflect on ways to facilitate physician wellness

Emails, comments, feedback to w21cedu@ucalgary.ca

In this episode Dr Chad Saunders explains the current and prospective role of the Personal Health Record (PHR) as a tool for patient safety and improved quality of care by defining the PHR, highlighting it's role in patient safety, and discussing the challenges associated with this type of technology. After listening to this podcast listeners will be able to: 

• Define the "Personal Health Record"
• Differentiate the Personal Health Record from Electronic Health Records
• List and describe the 5 roles the PHR has in improving patient safety
• Consider potential challenges and weaknesses of this technology

 Emails, comments, feedback to w21cedu@ucalgary.ca 

 In this episode Dr Ward Flemons discusses six patient safety principles that define the basic requirements for safe healthcare and guide the management of both safety and quality in healthcare through the development of a "healthcare culture of safety".  After listening to this podcast listeners will be able to: 

• List the six principles that guide the management of safety and quality in healthcare
• Describe each principle in detail
• Apply the principles to real life scenarios

Emails, comments, feedback to w21cedu@ucalgary.ca