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ASPIREAdvancing Safety for Patients in Residency Education
November 28 to December 1, 2017Ottawa, Ontario
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Tuesday November 28
Wednesday November 29
Thursday November 30
Friday December 1
0800- 0830Registration/
Breakfast
0730- 0800Breakfast
0730- 0800Breakfast
0730- 0800 Breakfast
0830- 0900Introductions
0800-0845Home groups
0800-0845Home groups
0800-1000Presenting your ASPIRE projects
0900- 0930A call to action:
Integrating patient safety, QI and
resource stewardship into residency
education
0845-1030Patient engagement in teaching patient
safety and QI
0845-1015Human and systems
factors0930-1030
Instructional design/ASPIRE curriculum proposal overview
1030-1045Break
1030-1045Break
1015-1030Break
1000-1015Break
1045-1215Culture of patient
safety
1045-1215Handover
1030-1200Resource
stewardship
1015-1130Closing Keynote
Jason Frank
1130-1230Closing remarks and program evaluation
1215-1300Networking lunch
1215-1315Networking lunch
1200-1300Networking lunch Lunch available
1300-1430Recognizing and
responding to patient safety incidents
(PSIs)
1315-1445Teamwork
1300-1600 More to quality
improvement than meets the eye I:
Quality improvement methods
More to quality improvement than meets the eye II:
Curricula in QI
More to quality improvement than meets the eye III: a) ethics b) project
supervision
1430-1445Break
1445-1500Break
1445-1600Analyzing and
designing systems to address and prevent
PSIs
1500-1615Integrating patient safety, QI and/or
resource stewardship discussions into daily clinical supervision
1600-1700Home groups
1615-1700Home groups
1600-1700Home groups
1830-2100Dinner Off Site
(Fairmont)Joshua Tepper
2017 ASPIRE Program At-a-Glance
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8:00 - 8:30 Registration/Breakfast
8:30 - 9:00 Introductions
0900 - 0930 A call to action: Integrating patient safety, QI and resource stewardship into residency educationDonna Davis, Andrea Pisesky & Brian Wong
Session OutlineThis opening session emphasizes the critical viewpoints that surround patient safety and quality improvement education, including the faculty member, the resident, and most importantly, the patient and family perspective. Following a brief overview of the various ways that patient safety and quality improvement intersect with residency education, participants will hear directly from a resident and a patient and discuss concrete examples that demonstrate the critical role that learners and patients play in advancing the goals of patient safety and quality improvement education.
Learning Objectives1. Describe how patient safety, quality
improvement, and resource stewardship intersect with residency education
2. Reflect on the multiple perspectives, including learners and patients, that influence patient safety and quality improvement education
0930 - 1030 Instructional design/ASPIRE project proposal overviewBrian Wong
Session OutlineThis session introduces the participants to a commonly-used curriculum design and development framework, starting with carrying out a needs assessment, setting goals and objectives, selecting teaching approaches and modalities, learner assessment and program evaluation. Participants will familiarize themselves with the ASPIRE curriculum planning tool, which they will use throughout the 4-day program to formulate their patient safety, quality improvement and/or resource stewardship curriculum plan.
Learning Objectives1. Describe the key steps to designing a
patient safety, quality improvement and/or resource stewardship curriculum
2. Describe how patient safety, quality improvement and resource stewardship have been integrated into the CanMEDS 2015 framework
3. Create a proposal that outlines the key elements of a patient safety, quality improvement and/or resource stewardship learning experience / curriculum
1030 - 1045 Break
1045 - 1215 Culture of patient safetyStacy Ackroyd, Chris Hillis & Sherissa Microys
Session OutlineDuring this session presenters will define the need for a safe and just culture and describe factors that promote or inhibit such a culture. Using a case example, the group will construct an educational activity with a goal of achieving a patient safety culture. These examples can be used to teach safety culture within the postgraduate setting.
Day One Tuesday November 28, 2017
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Learning Objectives1. Describe the factors within the medical
profession that influence a patient safety culture
2. List the attributes of a safe and just culture
3. Utilize a case example to develop an activity that advances patient safety culture
1215 - 1300 Networking lunch
1300 - 1430 Recognising and responding to PSIsDonna Davis, Andrea Pisesky & Brian Wong
Session OutlinePhysicians must be able to recognize patient safety incidents (PSI) and respond appropriately. This session will make use of case-based learning to demonstrate how one can teach residents about how to recognize and respond to PSIs (i.e., prioritize initial management, disclose the incident, ensure investigation occurs to prevent similar events), engage participants in a discussion to explore how faculty can support residents as ‘second victims’ when PSIs occur, and provide a patient’s account for what is needed for disclosure to be effective. It will end with a demonstration of a disclosure OSCE, which can be used for either teaching or assessment of disclosure skills.
Learning Objectives1. Recognize a PSI and respond
appropriately when one occurs2. Provide support to residents who have
suffered emotional harm as a result of being involved with a PSI
3. Describe the key steps to disclosure from the perspective of patients and families
4. Demonstrate the use of an OSCE to assess residents’ disclosure skills
1430 - 1445 Break
1445 - 1600 Analyzing and designing systems to address and prevent PSIsEd Kwok
Session OutlineSystem analysis is essential to our learning from patient safety incidents and proactive management of potential risks to patient safety. This session will introduce key principles of patient safety incident analysis. Tools to engage medical learners in system analysis will be outlined.
Learning Objectives1. Outline methods to analyze healthcare
systems with a patient safety and quality improvement lens
2. Demonstrate 2 tools you can use with residents tomorrow to analyze and design safer systems
1600 - 1700 Home groups
1830 - 2100 Dinner & Keynote speaker
Dr. Tepper is a family physician and the President and Chief Executive Officer of Health Quality Ontario (HQO).
Previously, Dr. Tepper served as the first Assistant Deputy Minister (ADM) at the Ministry
of Health and Long-Term Care, Health Human Resources Strategy Division. He was also the Vice President of Education at Sunnybrook Health Sciences Centre, a senior medical officer for Health Canada, an adjunct scientist at the Institute for Clinical Evaluative Sciences (ICES), and a research consultant for the Canadian Institute of Health Information (CIHI).
Dr. Tepper has a degree in Public Policy from Duke University, a Masters of Public Health from Harvard, and an MBA from the Richard Ivey School of Business
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0730 - 0800 Breakfast
0800 - 0845 Home groups
0845 - 1030 Patient engagement in teaching patient safety and quality improvementStacy Ackroyd, Donna Davis, Joan Fernandez & Chris Hillis
Session OutlineEngaging patients and families is now recognized as essential to safe care. The engagement of patients and families however in teaching patient safety and quality improvement is the next level of engagement which this module will address. The session will outline the principles of patient engagement including patient centred communication; identify challenges and strategies for engaging patients in teaching patient safety and quality imporvement; and provide practical resources which can support patient engagement.
Learning Objectives1. Outline the principles of patient
engagement and its importance in teaching patient safety and quality improvement
2. Identify challenges and strategies for engaging patients in teaching activities
3. Demonstrate how to debrief a patient story involving harm.
4. List opportunities to engage patients in teaching patient safety and quality improvement.
1030 - 1045 Break
1045 - 1215 HandoverEd Kwok, Andrea Pisesky & Julien Poitras
Session OutlineThis session, through interactive lecture, small group exercises, case review and debriefing, will examine handover communication from different perspectives, including the need for effective handovers and their implication for patient safety/quality of care; the evidence behind practice recommendations, including commonly promoted mnemonics; and teaching and implementation of handover strategies. Elements of good handover and how they fit into a greater handover culture in different clinical contexts will be explored.
Learning Objectives1. Describe the purpose of handovers and
how they can impact patient safety2. Practice using a structured communication
approaches to handover patient care3. Use role play and feedback to teach
patient handover4. Describe how handover templates fit into
greater handover culture and strategies in specific clinical contexts
1215 - 1315 Networking lunch
Day TwoWednesday November 29, 2017
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1315 - 1445 TeamworkLisa Calder, Alex Lo & George Mastoras
Session OutlineThe goals of this session are to describe the elements of effective teamwork and communication, demonstrate and apply principles of effective teamwork and communication in a simulated teaching activity, and discuss strategies for teaching teamwork and communication. The instructional methods that will be demonstrated include interactive lecture, simulation and facilitated debrief.
Learning Objectives1. Describe the relationship between
effective teamwork and improved patient care and safety
2. Understand the role of leadership and communication in effective teams
3. Identify strategies to improve teamwork and communication
4. Describe the principles of debriefing a simulated teamwork scenario
1445 - 1500 Break
1500 - 1615 Integrating patient safety, QI and/or resource stewardship discussions into daily clinical supervisionBrian Wong
Session OutlineOpportunities exist in everyday clinical supervision to integrate discussions about patient safety, quality improvement and/or resource stewardship. During this interactive session, participants will reflect on their clinical supervision practices and identify opportunities to create teachable moments to highlight important patient safety, QI or resource stewardship concepts. They will then use a structured template
to create a teaching script, which they can use as part of their daily clinical supervision to lead informal discussions about patient safety, QI and/or resource stewardship with trainees and students.
Learning Objectives1. Identify opportunties in their daily clinical
supervision to create a patient safety, QI and/or resource stewardship teachable moment
2. Prepare a teaching script that can be used to lead informal discussions about patient safety, QI and/or resource stewardship during daily clinical supervision
1615 - 1700 Home groups
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0730 - 0800 Breakfast
0800 - 0845 Home groups
0845 - 1015 Human and systems factorsLisa Calder & Sherissa Microys
Session OutlineThis session will first focus on how, when, where, how and why cognitive biases occur; the importance of situational awareness will be emphasized as well as systems thinking. In the second part of this session, we will demonstrate how these concepts can readily be brought into educational exercises such as morbidity & mortality rounds.
Learning Objectives1. Describe the fundamentals of human and
system factors, including cognitive biases and the mitigation of human factors;
2. Apply a structured model to morbidity and mortality rounds to capture discussion of cognitive & system issues;
3. Use examples to demonstrate how to apply human and system factor analysis to clinical cases.
1015 - 1030 Break
1030 - 1200 Resource stewardshipChris Hillis & Julien Poitras
Session OutlineThis session will introduce participants to the knowledge required to implement training and assessment in resource stewardship. Barriers and facilitators to implementation of resource stewardship initiatives will be discussed. The Choosing Wisely Canada campaign will be highlighted as a platform for engaging trainees in resource stewardship. Participants will practice analysis of patient data in real time as a method of teaching and assessment in stewardship.
Learning Objectives1. Reflect on the environment and culture
of medical training and its negative influence on developing competency in resource stewardship
2. Select instructional methods and assessment tools for resource stewardship education
3. Identify opportunities at their home institutions for integration of resource stewardship education using the Royal College Resource Stewardship Toolkits.
1200 - 1300 Networking lunch
1300 - 1600 Quality Improvement
Session OutlineThe goals of the Quality Improvement sessions are to outline an approach to QI, describe ethical issues associated with QI projects, and discuss challenges, barriers and solutions related to QI project supervision. The session will also discuss modular QI training that can be tailored to the needs of your program using specific examples of different QI curriculums. The instructional methods that will be demonstrated include interactive lectures, small group learning, project-based learning, and use of audience response systems.
Day Three Thursday November 30, 2017
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More to quality improvement than meets the eye I: Quality improvement methodsStacy Ackroyd, Chris Hillis & Alex Lo
Learning Objectives1. List the key steps in designing and
implementing a quality improvement project
2. Develop a modular QI curriculum combining didactic content with interactive exercises
More to quality improvement than meets the eye II:Curricula in QIStacy Ackroyd, Chris Hillis & Alex Lo
Learning Objectives1. Describe current examples of curricula in
QI.2. Recognize potential barriers and ancillary
benefits to QI projects; 3. Describe potential models for selection,
optimization, governance and evaluation of QI projects.
More to quality improvement than meets the eye III:a) Ethics b) project supervision
Learning Objectives1. Recognize ethical issues associated with
QI projects
2. Identify challenges, barriers and potential solutions related to the supervision of QI projects
1600 - 1700 Home groups
0730 - 0800 Breakfast
0800 - 1000Presenting your ASPIRE projects
Session OutlineASPIRE participants will prepare and deliver short presentations that outline their proposed patient safety, quality improvement and/or resource stewardship curriculum plans, and offer the opportunity for others to provide feedback and suggestions for improvement.
1000 - 1015 Break
1015 - 1130 Closing Keynote Jason FrankHow to LEAD educational changeJason R. Frank
1130 - 1230 Closing remarks and program evaluation
Day Four Friday December 1, 2017
Director, Specialty Education, Strategy and Standards in the Office of Specialty Education at the Royal College of Physicians and Surgeons of Canada, and Director of Educational Research & Development in
the Department of Emergency Medicine, University of Ottawa
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Dr. Calder is an emergency physician and Director of Medical Care Analytics, The Canadian Medical Protective Association (CMPA); Affiliate Investigator, Ottawa Hospital Research Institute; Associate Professor, Department of Emergency Medicine, University of Ottawa. Patient safety researcher with previous focus on adverse events in the emergency department and current focus on patient safety issues identified through medico-legal case analysis.
LISA CALDER
Faculty
DONNA DAVIS
Occupational therapist with doctoral and post-doctoral training in patient safety; Affiliated Scientist, Department of Emergency Medicine at Dalhousie University; led development of patient safety content in UGME program and is currently chair of PGME task force on patient safety teaching at Dalhousie University
STACY ACKROYD-STOLARZ
Donna Davis has nursed for 40 years; raised their first born to be an independent, confident young lady, despite being a high level paraplegic due to Spina Bifida, and has moved beyond the loss of their 19 year old son, Vance, as a result of medical error, to embrace partnership with the health care community to ensure the patient/family voice is heard in the development of policy and programs aimed at improvements in patient safety.
Donna is the past co-chair for Patients for Patient Safety Canada-a position she held for 8 years. She remains a PFPSC member working on several PFPSC and CPSI committees, such as the ASPIRE program, bringing the patient/family voice to the conversation. Being honored with the Quality of Life award from the Canadian College of Health Leadership in June 2014 affirms, for her, the importance of the patient/family as we strive to achieve the Patients For Patient Safety Canada vision, “Every Patient Safe.”
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Dr. Kwok is an emergency medicine physician at the University of Ottawa. He has a Masters in Health Administration from the Telfer School of Management, where he subsequently returned to lecture and was awarded the Teacher of the Year in 2014. His special interests and research focus include ED flow, Quality Improvement and Patient Safety. Ed has successfully led large healthcare change projects such as the development of ED Surge Plans and the implementation of structured hospital-wide M&M processes.
Dr. Hillis is a hematologist, assistant professor and the director of Post-Graduate Quality Improvement and Patient Safety Education at McMaster University. He completed an MSc in Quality Improvement and Patient Safety at the University of Toronto. He is a medical education specialist at Choosing Wisely Canada and is associate course director of ASPIRE International.
CHRIS HILLIS
Dr. Alex Lo is a physiatrist specializing in Stroke and Acquired Brain Injury rehabilitation at Toronto Rehabilitation Institute. He is a Clinician-Teacher and Assistant Professor in the Department of Medicine, University of Toronto, and is cross-appointed to the Institute of Health Policy, Management and Evaluation, University of Toronto. He has a Masters in Quality Improvement and Patient Safety from the University of Toronto, and his academic focus is on curriculum and faculty development, teaching and project mentorship in quality improvement.
ALEX LO
ED KWOK
Registered nurse, MPH (education), Patient Safety Improvement Lead at the Canadian Patient Safety Institute – leads the Patient Safety Education Program Canada (PSEP – Canada) which focuses on how to teach and implement patient safety initiatives with an emphasis on an interprofessional team approach and peer to peer education.
JOAN FERNANDEZ
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Pediatric Cardiology Fellow (PGY5), University of Toronto. She completed her medical training in the UK, during which she established resident-led quality improvement and patient safety education programs for post-graduate trainees. During her residency, in Ottawa, she co-developed a Patient Safety Resident Education Curriculum currently in use for pediatric trainees.
ANDREA PISESKY
General Internist; Director of Continuing Education and Quality Improvement, Department of Medicine; Associate Director, Centre for Quality Improvement and Patient Safety, Clinician Educator with the Royal College of Physicians and Surgeons of Canada; and Medical Education Lead of Choosing Wisely Canada; academic affiliation: University of Toronto
BRIAN WONG
Dr. Sherissa Microys is an Anesthesiologist and Intensivist with the Canadian Forces and works at The Ottawa Hospital and Montfort Hospital. She completed the Patient Safety Leadership Fellowship from the Health Research and Education Trust (American Medical Association) in the United States. She was a faculty member and subsequently co-chair of the Canadian ICU Collaborative (CIC), a national group of interdisciplinary professionals focused on improving patient care and safety for critically ill patients and provide support to Safer Healthcare Now teams enrolled in the ICU-related interventions.
SHERISSA MICROYS
JULIEN POITRAS
Dean of Faculty of Medicine of Université Laval and Emergency Physician at the affiliated hospital Hôtel-Dieu de Lévis of the CISSS de Chaudière-Appalaches.
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Dr. Mastoras is a Fellow of the Royal College in Emergency Medicine and works at The Ottawa Hospital with a focus on resuscitation medicine. He has a keen interest in the intersection of resuscitation science, human factors, and quality improvement in the context of ED critical care and is engaged clinically and academically in efforts to enhance care during medical crises. He is the Simulation Lead for Faculty CPD within the Department of Emergency Medicine, co-director of the TOH ED in-situ simulation program, Chair of the Department’s Resuscitation Committee, and is a regular instructor in the Residency, Trauma, and Point-of-care Ultrasound programs. Dr. Mastoras’ academic work focuses on teamwork and human performance during resuscitation and he has published and lectured on a range of related topics in ED critical care.
George Mastoras
Guest Faculty
The residents joining us for the Teamwork simulation session will be Dr. Julie Kim, PGY5 in Emergency Medicine, and Dr. Richard Hoang, PGY2 in Emergency Medicine.
