Safety: Always on my mind


Ian Safety

Dr. Fraser & Jerome the Safety Gnome

By: Dr. Ian Fraser, Chief of Staff

While we celebrate Patient Safety Week in Canada this week, safety of patients is something that is always on my mind and, I expect, everyone who works at Michael Garron.  In fact, risks to patient safety make up most of our critical incidents, never events and insurance concerns.  Not surprisingly, these risks take a toll on everyone involved, patient, family and provider alike.  My wish has always been that we are the safest community teaching hospital in the country.

However, improving patient safety is not merely about reacting to rare adverse events after they have happened and ensuring that they never happen again. It is about using savvy clinical judgment to anticipate things before they get worse and intervening as early possible.

Although we know that one in twenty people deteriorate under our care in hospital, this is largely related to their underlying disease getting worse and rarely related to a potentially preventable adverse event of care provided.  Therefore, it makes sense that the greatest opportunity to improve patient safety is in enhancing our ability to deal with this unexpected deterioration.

When I walk down our halls, it makes me quietly proud when I hear snippets of conversation that begin with “I’m concerned about..”, “uncomfortable with..” or  “the safety of ..”.  Patient safety is a team sport in which everyone can contribute to an awareness of the situation and identify who is likely to get into trouble in the next few hours.  Just like Wayne Gretzky, it would great to know where to be at the right moment and intervene.

Just as important as recognizing things early is knowing who to call to help out, and who to call if help doesn’t come immediately.

This is why our journey as a high reliability healthcare organization is focused on the early recognition, timely escalation of care and successful rescue of our deteriorating patients in the upcoming year.   Success depends on the knowledge and skills of every person in the healthcare team who can respond to the unexpected events that we see everyday in our hospital.

For example, we have been amazingly successful with our ER-STOP program in reducing the number of patients who get into trouble within 24 hours of admission to a ward bed.  Likewise, unexpected mortality on our wards is so rare that it may be months between events. We’ve also had a very successful launch and uptake of Daily Safety Checks in the organization, shifting awareness of safety issues to the forefront of all our work.

With this in mind, I’m looking forward to seeing how the results of the wonderfully quirky awareness campaign “Comics for Quality” that highlights our existing best practices and successful improvements inpatient safety.  It is the work of a talented inter-professional team and, of course, Jerome the Safety Gnome.

Please join me in continuing to ask the simple question everyday and before every shift “Are we safe?”

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