Clinical scenario A 27-year old female presents to the emergency department (ED) after a fall onto her hand from amotorized scooter. She has pain on the radial aspect of her left wrist and anatomical snuffbox.However, the X-rays do not indicate an obvious scaphoid fracture. Clinical question: What are the predictive clinical features for occult scaphoid fractures in patients with normal initial radiographs in the ED? Background Scaphoid fractures commonly occur from a fall …
HiQuiPs: Using dashboards to supercharge clinical care and quality improvement
Odds are in your favourite sci-fi movie or TV show, a character spends time looking at a dashboard to determine their next course of action. However, dashboards are not limited to sci-fi! Many organizations across sectors make daily use of dashboards to run smoothly and work towards their goals. St. Michael’s Hospital of Unity Health Toronto has designed, developed, and ultimately deployed dashboards to solve real-world problems. Examples include supporting community partners by …
What is the role of systemic thrombolysis in the management of pulmonary embolism?
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 …