View Post

Predicting Occult Scaphoid Fractures in the ED Using Clinical Features

In Featured by George KachkovskiLeave a Comment

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 …

View Post

HiQuiPs: Using dashboards to supercharge clinical care and quality improvement

In HiQuiPs by Vinyas HarishLeave a Comment

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 …

View Post

What is the role of systemic thrombolysis in the management of pulmonary embolism?

In Medical Concepts by Ming LiLeave a Comment

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 …

View Post

HiQuiPs: Engaging Residents in QIPS – Current and Future Perspectives

In HiQuiPs by Fadi BahodiLeave a Comment

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 …

View Post

HiQuiPs: Managing Crises – What’s going on behind the scenes?

In HiQuiPs by Tiffany TseLeave a Comment

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 …

View Post

HiQuiPs: Design Thinking in Quality Improvement

In HiQuiPs by Lucas ChartierLeave a Comment

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 …