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Uncategorised
Quality & Patient Safety
Quality & Patient Safety
Quality of care and patient safety are at the very core of the RPPEO. We work toward a culture of safety where every patient gets the care we would want for our loved ones. In this culture, patient safety incidents and hazards are regularly identified using a fair and just process. Audits and improvement initiatives are constantly working to pinpoint and downgrade risk all while working to create new ways to bring safer care to our patients.
The quality review and quality improvement dimensions built into our program are founded on Just Culture principles. Building on Just Culture, we approach patient safety incident reviews from a systems perspective. Our philosophy balances the accountability of the individual health care provider and the system attributes in which the paramedic works.
In addition to identifying omissions or commissions in care, we seek to uncover contributing factors that led to the incident - the "why is this happening" - and mitigate those circumstances. This systemic approach follows best practices in quality and patient safety, and is endorsed by renowned institutions such as the World Health Organization, the Institute for Safe Medication Practices, the Institute for Healthcare Improvement, and the Canadian Federation for Healthcare Improvement.
Read more …Quality & Patient Safety
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Quality Assurance
Quality Review
The RPPEO’s Quality Review processes monitor the quality and safety of controlled medical acts delegated to paramedics. Our mandate is to track controlled acts to ensure patients receive care consistent with the provincial Advanced Life Support Patient Care Standards.
Our quality processes also identify opportunities to provide treatment when a controlled medical act was indicated by the Standards and not offered or administered in the provision of patient care.
When a paramedic performs controlled medical acts, their Medical Director needs to see that they did so according to the accepted medical direction in the standards. Physicians are compelled by the Ontario College of Physicians and Surgeons to have quality assurance processes in place in order to be able to delegate controlled medical acts.
The Ministry of Health sets minimum requirements for what base hospitals must review in quality assurance programs through a performance agreement.
For precise information about how we approach quality assurance and all other quality and patient safety programming, see the RPPEO’s Quality and Patient Safety (QPS) policies.
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Auditing
We look at thousands of Ambulance Call Reports (ACR) every year. Most of the ACRs are as they should be. Regular quality assurance audits or special audits are the result of monitoring specified in our Performance Agreement with the Ministry of Health, complaints related to clinical care, requests for review from the Ministry of Health, patient safety incident reports from paramedics or requests for reviews of care from our stakeholder ambulance services. Paramedics may hear from us about what’s in one of their Ambulance Call Reports if we need to ask a question about the care or when we have some clinical feedback for them.
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Improvement Science
Uncovering best practices and discovering the science to make decisions supports patient safety and quality of paramedic care. We investigate questions systematically to better understand safe and quality care as well as the contextual factors of paramedic practice.
More and more of the interventions paramedics use are based on recent scientific evidence. The RPPEO contributes to this scientific knowledge and we regularly use the evidence to inform our work.
Quality & Safety Improvement
Closely related to our research efforts, our quality improvement initiatives rely on strong data and systematic analysis. Whether opportunities for improvement come from quality assurance processes or from patient safety incident data, it’s important to us to work with all our partners to find better, safer methods and means to clinical care.
Some of our recent quality improvement projects include:
Feedback to paramedics on patient outcomes – working with partners at the Ottawa Hospital’s trauma program, we provide information to the treating paramedics about the hospital disposition of the patients transported to the Ottawa Hospital trauma centre. This allows paramedics to reflect on their care given findings at the hospital.
In 2019, we started a similar feedback program with the Children’s Hospital of Eastern Ontario. Paramedics receive information about the in-hospital outcomes of their CTAS 1 and 2 pediatric patients.
Patient Safety Incident Report – the current tool that paramedics use to flag clinical hazards and patient safety incidents is the result of a quality improvement project. Paramedics told us that they were concerned that the previous “self-report” form for reporting safety incidents seemed focussed on the paramedic rather than on clinical quality and safety. We re-developed the reporting process to bring it in line with the RPPEO’s (Conceptual Framework for patient safety) and our (Fair and Just Process) for reviewing incidents.
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Quality Management
Quality Management
One of the primary responsibilities of the Regional Paramedic Program for Eastern Ontario is to monitor and ensure compliance of Advanced Life Support Patient Care Standards provided by paramedics in our catchment area. This is accomplished in a number of ways:
- Monitoring ambulance call reports (ACRs) in which a controlled act was performed by a paramedic or was indicated but not provided,
- Performing clinical focused audits,
- Assisting in or conducting a review or investigation of a complaint,
- Applying a system and/or process approach to patient care variances,
- Evaluating the effectiveness of controlled medical act training, certification and continuing medical education,
- Providing positive feedback to paramedics via clinical excellence letters and survivor pins.
- Retrospective analysis and decision making of calls during Regional Clinical Review committee meetings
- By performing all of the above, the Quality Management portfolio can offer recommendations to the Senior Management Team, the education portfolio and to the EMS services in our catchment area.
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Quality News
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Quality News
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Quality Team
| Name | Phone # | Campus |
|---|---|---|
| Benjamin De Mendonca (Program manager) | 613-737-7228 x 77927 | Ottawa |
| Megan Wall | 613-737-7228 x 77933 | Kingston |
| Susan Duncan | 613-737-7228 x 77929 | Kingston |
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Remediation
Remediation Process
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Research Links
Research Links
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Annals of Emergency Medicine
Audio and Podcasting Archives
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The Bottom Line
This site has been built to create a compendium of all the landmark papers which are shaping the way we manage our critically ill patients. Each paper has been summarised and critiqued using a standard template and ends with a 'bottom line' paragraph to allow a quick reminder of the key points.
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Emergency Medicine Journal Jams
Journal Jam is the EM Cases podcast that brings together leading EM researchers, EM educators and EM clinicians from around the world to discuss practice-changing EM articles; with your hosts Anton Helman & Teresa Chan. Together, we’re smarter!
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EM Ottawa – Emergency Medicine Ottawa
This is the official blog for the Department of Emergency Medicine at the University of Ottawa. Our main goal is to share the results of our monthly Journal Club for people to view and for our staff/residents to have as a resource if the need arises to review the content. The scores and analysis of each article are derived from an initial critical review of the literature by a single reviewer, followed by a group discussion.
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KeyLIME - Key Literature in Medical Education
Bringing the main points of a medical education article in a 20 minute podcast.
"Key Literature in Medical Education (KeyLIME) is a bi-weekly podcast produced by the Royal College of Physicians and Surgeons of Canada. Articles that are important, innovative, or will impact your educational practice are discussed."
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Prehospital Evidence Based Practice (PEP)
The Prehospital Evidence Based Practice (PEP) PEP is a collaborative effort of Canadian and international EMS Clinicians (paramedics, physicians, nurses and other allied health professionals). PEP is sponsored and managed by the Dalhousie University Department of Emergency Medicine Division of EMS, and Emergency Health Services Nova Scotia
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Research & Reviews in the Fastlane
Research and Reviews in the FastLane: where experts worldwide tell us what they think is worth reading from the emergency medicine and critical care literature.
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The Skeptics Guide to Emergency Medicine
The Skeptics’ Guide to Emergency Medicine (SGEM) is a knowledge translation (KT) project. The goal of the SGEM is to shorten the KT window from over ten years down to less than one year. It does this by turning traditional medical education on its head.
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UCLA Prehospital Care and Research Forum
"The Prehospital Care Research Forum is dedicated to fostering and improving research in EMS. Below you will find select podcasts discussing current research that affects EMS. These podcasts are meant to review methodology and applicability to prehospital care, promote healthy and respectful discussions, and inspire new research."
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Research News
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