During a busy night shift, you are reading a series of chest X-rays when you overhear a colleague remark, “This will all be replaced by computers soon, anyways”. You think back to a few Tweets on artificial intelligence in medicine and wonder if her comment has merit. There has been so much hype about the topic of Artificial Intelligence (AI) in recent years, much of which is optimistic and some of which is …
Checklists and the Hierarchy of Effectiveness
You are working a particularly busy overnight solo coverage shift when a very sick 4-year old patient with respiratory distress begins desatting requiring urgent intubation. A team is quickly assembled and preparation is completed for the procedure. You begin attempting endotracheal tube insertion but after two failed attempts with direct laryngoscopy you ask for a bougie, and none is delivered. You ask again, and nothing. As you momentarily take your eyes off of …
Expert’s Corner – Dr. Kaveh Shojania on Common QI Pitfalls
Welcome to another HiQuiPS post! Our series has aimed to present foundational topics in Health informatics, Quality Improvement and Patient Safety in a practical manner. In this new section – Expert’s Corner, we ask an expert some important questions to deepen our understanding of these sciences and improve our implementation. For our inaugural Expert’s Corner post, we invited Dr. Kaveh Shojania. Dr. Shojania is the Vice Chair (Quality & Innovation) in the Department …
Reporting Patient Safety Events in the Emergency Department
You are a physician caring for a 4-year-old patient in the Emergency Department (ED) presenting with a fever. Before ordering Acetaminophen for the patient, you check the patient’s weight on the emergency record, which you read as 17kg. You then write an order based on this weight. The ED nurse checks the order to see if the medication dose is safe using the hospital medication formulary. After that, the nurse approaches you and …
Better Measurement in Quality Improvement
You are getting handover at the beginning of a shift in the emergency department (ED) and hear about a 71 year old woman who presented with a hip fracture. You’ve read about the benefits of nerve blocks for hip fractures, but still don’t feel prepared or supported to perform one. You text message a couple of colleagues and realize you are not alone. Others also understand that there are clear benefits, but don’t …
Human-Centered Design in Healthcare
You are working a busy shift in the emergency department and are trying to quickly disposition patients. As the shift progresses and your feet hurt, you wonder why your work space is far removed from the patient care area, and different walls have bins that contain order sets, handover notes, and referral forms. Moreover, the route to sending the tube to the lab crosses too close to the dirty utility room. You think …