A previously well 41-year-old woman on OCP presents to the emergency department with acute-onset tachycardia, dyspnea, and leg swelling. While awaiting imaging, she rapidly deteriorates and BP drops to 86/60 (triage BP 134/78). CT shows bilateral pulmonary emboli. Risk Stratification Pulmonary embolism (PE) is a cardiovascular emergency which can result in significant morbidity and mortality for patients.1 It is classified as high risk (formerly “massive”), intermediate (formerly “submassive”), or low risk. High-risk PE …
HiQuiPs: Engaging Residents in QIPS – Current and Future Perspectives
Welcome to this HiQuiPs post on Quality Improvement in Residency Education where we will review the current status of Quality Improvement and Patient Safety (QIPS) education in postgraduate medical education and strategies to effectively engage trainees in QIPS. CanMEDS and QIPS In 2015, the updated CanMEDs framework broadened accreditation standards for residency programs across Canada.1 As part of the CanMEDS roles, competencies in QIPS methodologies have been highlighted in each of the six …
HiQuiPs: Managing Crises – What’s going on behind the scenes?
You are on-call – covering medicine and ICU admissions – while overseeing 20 admitted patients. Your wards are at capacity. You receive 3 new admissions from the ED, but you still have to move 2 sick patients to the ICU. You also have to prepare 3 discharges for the next morning. You wonder how you can best deal with the situation and help your patients. Where do you begin? How do you prioritize …
HiQuiPs: Design Thinking in Quality Improvement
Is your team about to embark on a new Quality Improvement (QI) project that involves patients but you’re not sure how to structure it? Are you looking for a meaningful and empathetic approach that champions the user perspective from start to finish and complements traditional QI methods? Design thinking has been gaining attention across a wide range of industries over the past several years, building a strong reputation for its emphasis on forging …
HiQuiPs: How do we evaluate virtual care?
You are a resident coming in to see a patient who has come into the ED complaining of a new, sudden-onset, 9/10 pain headache. You run a CT scan and rule out any hemorrhage or stroke, referring them to the Stroke Prevention Clinic for a consultation. The patient asks if they can receive a virtual appointment for the future, as they live quite far away and would much prefer it. You wonder if …
HiQuiPs: Root Cause Analysis in the Time of COVID-19
You are midway through a busy rapid response shift where you have noticed an increased response time of the hospital’s intubating teams to decompensating patients. Over the last few months, the COVID-19 pandemic has prompted a restructuring of the use of many spaces to accommodate the influx of patients. You understand that the system is overwhelmed but you are optimistic that you can optimize the interprofessional team’s response times. This sets off a …