Adverse event rates in Canadian hospitals have not significantly improved. According to “The Canadian Adverse Events Study” published in the Canadian Medical Association Journal, approximately 7.5 per cent of hospitalizations are associated with at least one adverse event, of which 37 per cent are preventable. In 2013, a Commonwealth Fund Study revealed that Canada is not doing as well as could be expected, according to its national health care scorecard. So what are we doing wrong? How can we change the culture of patient safety in Canadian hospitals and teaching institutions?
Those are some of the important questions that were addressed during the five-day ASPIRE (Advancing Safety for Patients in Residency Education) program held in Ottawa, Ont., from November 16-20, 2014.
Building on the success of the first ASPIRE in 2013, the Royal College and the Canadian Patient Safety Institute, its partner in this initiative, offered this second edition to align patient safety and quality improvement concepts with the CanMEDS 2015 Framework, taking a very focused and hands-on approach.
“As a profession, we have an obligation to step up to the plate and contribute to solving quality and safety problems. The Royal College has recognized these issues and has proactively embedded patient safety and quality improvement throughout the newly-revised CanMEDS 2015 Physician Competency Framework,” remarked Brian Wong, MD, FRCPC, ASPIRE chair and physician at the Sunnybrook Health Sciences Centre in Toronto, Ont.
“We need to firstly recognize the gaps in quality of care, and then incorporate evidence to improve practices in our health care system that will help us close those gaps.”
ASPIRE participants create enhanced educational plans
During the ASPIRE program, faculty-participants covered a wide range of topics such as the culture of patient safety, recognizing and responding to adverse events, analyzing and designing systems, patient-centred communication skills, patient engagement, teamwork, handovers, human and system factors, and quality improvement (QI).
Attendees also worked in teams and learned about how to integrate essential patient safety and QI concepts into concrete educational plans, which they now intend to implement in their local institutions.
Touching patient story reinforces the need for patient-centred care
During one of the program sessions, a video by Ms. Donna Davis, an acclaimed patient safety advocate from Saskatoon, Sask., was played. Ms. Davis also shared her poignant story with the ASPIRE group during a live Skype session, encouraging them to include patients in patient safety training efforts and reinforcing the need for patient-centred care.
One participant, fifth-year resident in Anesthesiology Ashleigh Farrell, MD, admitted that the domain of patient safety has only recently been taught in her program. She has seen firsthand clinical crises and a few debriefs, leading her to suggest that “check-backs” and self-reflection should be better incorporated into daily practice to address and prevent safety gaps.
Julien Poitras, MD, FRCPC, vice dean, School Directions and Strategies Projects at l’Université Laval in Québec, Que., believes that future residents will have a key role to play in making these changes, as their learning will bring new patient safety standards to the forefront.
Upcoming programs
The next ASPIRE program will be offered in French in June 2015, and another English course will be offered in conjunction with the 2015 International Conference on Residency Education (ICRE) in Vancouver, B.C., next October. Preliminary planning for an international ASPIRE program is also underway.
For more information on ASPIRE, and to access some of the tools explored during the program, please visit our website.
