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  • Annonymous 13 March 2020

    dsadasdasdas

  • Annonymous 20 May 2020

    etttt

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    Amber Daugherty 03 June 2021

    test

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    Brian M. Wong 03 June 2021

    this is a great poster

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    Allison Brown 22 June 2021

    Great job Dr. Spenard et al! I really appreciate your use of figures and tables to summarize this initiative and the outcomes. I notice a huge increase in the treatment rate for anemia screening after the third and fourth intervention that were introduced simultaneously, can you share any insight regarding whether or not you have a sense of what was most impactful at that time when treatment rates started to decline - educating providers and patients or creating a process that is triggered for patients who meet the criteria? I know education and training staff about a new intervention can be very helpful to increase uptake in the short-term but can be tricky in sustaining individual behaviour changes in the long term without having an intervention that targets the system. Again, well done!

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    Christine Soong 24 June 2021

    Great work in an important area! A few comments/questions: 1. 'readiness' is not defined making it unclear how it enables improved outcomes 2. more description of the intervention would help others decide if feasible in their settings 3. it would be helpful to display outcomes data as SPC or run charts. It is not clear from the bar graphs whether the differences observed is statistically significant 4. what were the balancing/process measures and their results?

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    genevieve.bouchard-fortier@uhn.ca 29 June 2021

    Congratulations Dr. Spenard et al. for the OPRA study! Your data is well presented and within a few months, you have already improved rate of preoperative anemia treatment and reduced perioperative transfusion. It would be interesting to know what % of preoperative anemia you are hoping to reach with your interventions. Also, I would like to know the impact of your interventions on postoperative complications such as VTE, SSI, length of stay. Good work!

  • Joanne Goldman 02 July 2021

    Your poster very nicely presents the range of factors that participants identified as likely to influence the success of the PPH bundle implementation as well as the system-level factors contributing to management delay. I'm wondering if you identified any patterns of perceived facilitators or barriers by professional group in your results? If yes, are there implications for the intervention strategy?

  • Blanca Bolea 06 May 2022

    The SCOPE Mental Health Program: supporting family doctors and their patients in the era of Covid-19. Purpose To evaluate use of the SCOPE Mental Health (SCOPE-MH) program by primary care practitioners (PCPs) and patients, over the period January 1, 2022 to October 31, 2022. Aim To summarize information on the use of SCOPE-MH by PCPs and patients, and to understand PCP and patient views of the program. Benefit Will provide an understanding of the effectiveness of the SCOPE-MH program., and inform future expansion of the program to different regions and populations Calculated key indicators of program reach, adoption, implementation, and maintenance (as per RE-AIM framework)

  • Joanne Goldman 24 May 2022

    Hello, thank you for sharing this interesting work on community pharmacy practice during the COVID-19 pandemic with attention to implications following the pandemic. I'm wondering if you can share further details about how you conceptualized 'safety' in relation to the review question - "...to keep community pharmacies safe in Canada during the pandemic..."? Can you also share more details or your reflections regarding the types of data/findings found in the electronic databases versus the grey literature? What are the implications for having identified 5 studies in the databases and 449 items in the grey literature?

  • Joanne Goldman 24 May 2022

    Thank you for an excellent poster and video about your study of the experience of a novel emergency response intubation collaboration during the pandemic. The poster and video very nicely report on the range of significant issues related to interprofessional collaboration in this particular clinical context. The number of responses you received from participants is impressive! From your data, is it possible to gain insights into how participants adapted to the challenges they experienced such as ED nurses struggling to balance role with ERIT vs ED team or ED physicians hesitancy to adopting a passive role? Is this intervention continuing in some way? If there are plans for 'areas for improvement' such as the joint simulation or shared decision making, would be greatly interested in hearing more about how these interventions will be planned/studied to address the range of issues identified in your findings (e.g., criteria for ERIT activation, roles during intubation, handover details), which as you note, are relevant to other interprofessional collaboration activities.

  • Joanne Goldman 25 May 2022

    Thanks for sharing your study in a visually impactful way and for the video explanation. Interesting analysis of the similarities and differences in adverse event rates in mental health services and those commonly seen in a medical hospital setting. I'm wondering if you can elaborate on the implications of your findings - will you be developing/using a tool informed by the findings to continue to collect data? How will the findings inform subsequent QI work?

  • Laura Pozzobon 26 May 2022

    Thank you, Joanne, for your question. In this review, “safety” was defined broadly. This research question was actually brought to the research team by community pharmacists who identified that with the rapid changes in policy / guidelines / practice during the pandemic, there was likely potential risk to client/worker safety. In regards to the data/findings, the grey literature primarily consisted of policies/procedures/guidance developed by regulatory bodies, government bodies, professional organizations and retail pharmacy corporations. The primary studies included were comprised of qualitative studies, commentaries and a systematic review. The full scoping review is available here: https://sporevidencealliance.ca/wp-content/uploads/2022/01/SPOREA_Community-Pharmacy-Review_2021.11.10-2.pdf Many thanks, Laura & Kim

  • Joanne Goldman 30 May 2022

    Thank you Laura and Kim for your response and for the link to the full scoping review!

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    Marie Pinard 31 May 2022

    Great work team! Excellent application of QI methods to this common but complex problem within ambulatory care. It's interesting that this issue highlights potential equity gaps. What are the next steps to further study and/or address this challenge?

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    Marie Pinard 31 May 2022

    Great work and so relevant to our current context as we continue to live through the pandemic and its impact. Connectors to care seem to be very powerful in terms of patient outcomes as well as the conditions that enable better outcomes. You mention that you identified some gaps in the community that you plan to address in future iterations (hurray for PDSA) - can you elaborate on what those gaps are and how you might modify your approach as a result?

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    Marie Pinard 31 May 2022

    Wonderful presentation! I found the video very engaging and it served well to illustrate the impact of small changes to climate change. Reflecting on one's personal practice is so powerful. Thank you for sharing your great QI work - amazing results.

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    Marie Pinard 31 May 2022

    Great work Sunnybrook team! As someone who manages an organizational safety event reporting system, I found this work very interesting and relevant. I loved the video - it was so creative and engaging. It's widely known that addressing the big "themes" or contributing factors at the organizational level is much more impactful in terms of harm prevention. However, these are typically quite challenging issues to address. Now that your team has started this journey, can you provide an example of a potential organizational strategy to address such a theme? I completely agree, partnering with other organizations can strengthen this work. I am so looking forward to learning more.

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    Marie Pinard 31 May 2022

    This is great work! It serves to highlight the importance of something considered as "basic" as a mattress and illustrates the significant impact on quality and safety. The poster was nicely organized and presented the information well. The photos were enlightening. How many mattresses were assessed at Sunnybrook and how many needed some sort of repair? I am sure many organizations would also be interested in the details of any assessment and maintenance program implemented as a result. It might serve to answer the age old question as to what's the best approach - centralized management, area-specific, or a hybrid? It's not uncommon for such projects to be relegated to a lower priority because they are not "cool" and coordinating the folks involved is challenging. But I see from the poster that there's was a large interprofessional group involved. How did you get the buy-in to undertake such a endeavour during these very busy times?

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    Marie Pinard 31 May 2022

    Sarah & team, this is great work. Excellent use of QI methodology to achieve a desired performance against a best practice. 0 to 70% is pretty impressive. The annotated control chart provided a nice overview of the multiple interventions used to achieve the aim. Do you think one (or more) of the numerous interventions was the "secret sauce"? It looks like perhaps the standardization of the protocol/integration within the workflow coupled with the feedback had the biggest impact. Will the team be monitoring this process going forward? Will the target remain 70% or is the plan to increase the target? The poster was really nicely laid out and the recorded explanation was really easy to follow. Thank you for sharing this great work.

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    Marie Pinard 31 May 2022

    Thank you for this great poster and presentation! It's very well presented and presents a unique organization-wide approach to improving safety Mackenzie Health. It's clear from the data, that the significant effort has really paid off. The approach or framework was nicely described and the timeline is encouraging to others undertaking similar efforts. Can you elaborate on how you were able to garner organization-wide support for this comprehensive approach? Was there a particular driver? How did this work fair during the pandemic? Congratulations again on a wonderful poster and presentation.

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    Marie Pinard 31 May 2022

    What an interesting perspective on falls. Not only have you included the rehab perspective but you have integrated the perspective of the patient! Such important considerations. I am sure there are many in a variety of settings that are very interested in learning more about the shared decision-making process and how that's reflected in the patient materials, including the consent form. Was there any input from your insurers? I know it's early days, but overall how has this been received from patients? Are there any plans to explore (perhaps using qualitative methods) whether they feel their rehab goals and sense of autonomy were better achieved using this approach? Great presentation and poster.

  • Joanne Goldman 01 June 2022

    Great video! I'm curious about your finding that utilization of the data varied by teams capability and capacity to interact with the data. Does this have implications for team training?

  • Joanne Goldman 01 June 2022

    Thank you for sharing your experiences with the Emergency Medicine QI Digest. Are there any plans to build upon this work? For example, any changes to the format based on feedback, further study of its impacts, or explore how it could lead to further collaborative QI work across EDs?

  • Maria de las Mercedes Magaz 06 June 2022

    Thank you for this interesting study that showcases a great QI field to work on. It would be interesting if you know and could share the most common changes in status that warranted escalation of care and the comparison between the current way to assess them vs. an ideal scenario. Additionally, do you envision as a next step the development of a standard way to identify or address patients (or both?) that meet the predefined criteria? How can you control if the interventions deployed are appropriate (or if there is inappropriate "deactivation") in the case of an escalation of care?

  • Maria de las Mercedes Magaz 06 June 2022

    Thank you for presenting this interesting innovation study showing how a change in utilization of a known tool has the potential to improve efficiency in the management of stroke without changes in efficacy or safety outcomes. I was wondering if you could elaborate more on: a) possible challenges that the broader application of this tool could bring and how to address them, b)whether the patients treated by telehealth were different at baseline (e.g., severity of disease). Additionally, which other conditions do you think could potentially benefit from using similar tools?

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    Sarah J. Mah 07 June 2022

    Marie- thank you for your feedback and reviewing our work! I would agree that designing a one-step protocol and then integrating it into existing tasks (triage, chemotherapy ordering) seemed to have the highest impact. The next steps at our institutional level have been shaken up by our transition to the EPIC EMR system which means that workflow and ordering are now completely different, but the project has gained interest and momentum across other oncologic specialties and we are now in the process of designing an algorithm for screening across all disease sites and how to build it into our new EPIC order sets. If the screening is built into the routine chemotherapy order sets, screening targets may be raised to 100%-- the more important next question will be follow-up, adherence, and whether positive results can trigger appropriate management in a timely fashion.

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    Marie Pinard 10 June 2022

    Thank you Sarah. It's very exciting to hear about a build within Epic as well as continued efforts to better understand outcomes and fidelity. Great work.

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