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Critical Care Medicine

Quality and safety

OVERVIEW

A primary focus for the Department of Critical Care Medicine is to provide the highest quality and safest care possible. This is our commitment to all patients and their families, and one to which we dedicate time and resources. 

The critical care environment is complex and intense. There is a large amount of data streaming from monitors at the bedside and via the electronic health record that the Critical Care team needs to integrate into decision making. We also know there are many competing demands in the critical care environment because of the busy workflow, challenges with multi-tasking, and because a patient’s condition can deteriorate suddenly and unexpectedly. 

Our focus for the analysis of safety issues is identifying those systems issues, which can inadvertently lead to error. 

 

QUALITY AND SAFETY COMMITTEE

We have established a robust quality and safety committee within the Department, which is led by Dr. Gail Annich, Dr Michael-Alice Moga, Dr. Lennox Huang, Dr. Roxanne Kirsch, Andrea McCormick (Division of Critical Care) and Jennifer Kilburn (Division of Heart Centre). In addition, we have safety champions: Brittany Lyn, Alexandra Bonin and Lynsey Mcmullin.  

These Quality Leads and Patient Safety Champions report monthly to the Department's Quality and Safety Committee to review results and events, and make adjustments and improvements as necessary.
 

QUALITY AND SAFETY INITIATIVES IN CRITICAL CARE MEDICINE

Health care Acquired Conditions - This initiative involves reviewing bundles, tracking  rates of infection, and optimizing practices to minimize risk.

The Continuous Improvement Program (CIP):  Through the Family CIP Board SickKids has made continuous improvement a focus of their strategic directions and values. We are currently implementing this program hospital-wide for front line staff to provide feedback on issues in practice and then help to create their solutions.  

Medication Safety Group: This is a multidisciplinary group which aims to make medication processes safer for patients and easier for staff.

Specimen Integrity Group: This is to decrease the occurrence of mislabeled or unlabeled specimens sent to the lab from Critical Care.

Safety Driver Metrics: Metrics are monitored and reported monthly. These metrics are measured and reported to several committees both at the departmental and organizational level. The rates and successes are posted for staff and families to see and serve as a visual in our day-to-day care to keep quality and safety at the forefront of our care. 

These metrics include:

    • Hand hygiene
    • Ventilator associated pneumonia
    • Central line associated blood stream infection
    • Catheter associated urinary tract infection
    • Medication reconciliation
    • Pain assessment
    • Transfer delay
    • Readmission rate
    • OR cancellation
    • Deferral