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HiQuiPs: Quality Improvement in the time of COVID-19

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You are attending your monthly ED staff meeting where the main topic of discussion is the COVID-19 pandemic. Recent events around the world have compelled your hospital to make changes to better prepare for the expected increase in local respiratory cases. The ED staff meeting has a debrief about some changes that will be happening including personal protective equipment use changes, new COVID-19 swab testing, ED triage and flow changes and many other …

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Designing a QI project – a Comparison of Quality Improvement and Traditional Research Paradigms

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You are attending your local ED monthly rounds where a journal club is being held discussing a Quality Improvement (QI) published paper. As the rounds progress, your presenter critiques the article and discusses perceived weaknesses including a small sample size, lack of  randomization and blinding, and lists many different possible biases in this project. You reflect back on your previous journal clubs and wonder whether it makes sense to apply a research-style critical …

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HiQuiPs: Year in Review

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It has already been one year since we launched the HiQuiPs (Health informatics, Quality Improvement, Patient Safety) series on CanadiEM.  This year we had fifteen contributors from across the country, and over 15,000 page visits to our series.  Over the past year, we have produced thirteen posts over the HiQuiPs interrelated fields:  Quality Improvement: On QI, we introduced what is quality of care in the ED, then to guide our readers through the …

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HiQuiPs: Patient Safety in the ED Part 5 – Patient Communication in the ED

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You are working in the Emergency Department on a day when it is busy and bed blocked. You assess a patient presenting with chest pain in the EMS offload area. Standing next to the stretcher, stopping to move every time a porter comes by with another patient stretcher, you sense that your patient is frustrated.  After the initial workup is complete, you go to reassess your patient and review the results. As you …

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HiQuiPs: Patient Safety in the ED Part 4 – Patient Handovers and Transitions of Care

In Education & Quality Improvement, HiQuiPs by Shawn.Mondoux1 Comment

You are beginning a morning shift in the Emergency Department when the overnight physician comes up to you and asks “Hey, can I give you a few handovers?” Your colleague provides a brief verbal handover for three patients and then says “this fourth one is a slam dunk admit, I’ve called the hospitalist and they’ll come to see the patient sometime this morning. Don’t even worry about it.” A few hours later, a …

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HiQuiPs: Implementation Part 2 – Which Strategy to Choose: PDSA, Lean, or Six Sigma?

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PDSA, Lean, and Six Sigma are three different frameworks that can be part of your quality improvement armamentarium. Each of them can often be applied to the same quality issue. Deciding on which one to use requires an understanding of their inherent strengths and weaknesses. In our last post, we briefly introduced the theory behind Lean, Six Sigma, and PDSA cycles. Here, we will practically apply each methodology to one quality problem to …