You are a resident rotating through the ICU. One of your patients is a 75-year-old female who was admitted for urosepsis (sepsis originating from the urinary tract). She required vasopressor support and had an internal jugular vein central venous catheter placed in the ED. Since admission, the patient has been improving with broad-spectrum antibiotics. However, on the 7th-day post-admission, you’re alerted that the patient is deteriorating, with tachycardia and worsening fever. You rush …
HiQuiPs: Patient Safety Fundamentals – Reducing Pressure Injuries
Hilary Weatherby is a Registered Nurse working as a Patient Safety & Quality Improvement (QI) Specialist. Hilary helps teams apply QI methodology to organization-wide projects and reviews patient safety events for the purposes of continuous quality improvement across a large, downtown Toronto, hospital system. You are a medical student seeing patients on a medicine unit at your local community hospital. One of your patients is an 81-year-old female with Parkinson’s disease who was …
HiQuiPs: Using In Situ Stress Testing to Address Latent Safety Threats
It’s a night shift, quieter than usual, though you wouldn’t say so out loud. As if the thought is enough to tempt fate, EMS rolls by. You got no patch, no heads up. “Car accident, just outside the hospital,” a paramedic calls as the patient is transferred onto the trauma stretcher. All you hear are unintelligible moans. All you see is blood streaming from a severely injured face. But the team’s already working, …
HiQuiPs: Dashboards Demystified Part 2 – Designing Your Dashboard
Your meeting with hospital stakeholders on designing a dashboard to better care for COVID-19 patients who are experiencing homelessness was a resounding success. Everyone was engaged and helped craft a problem statement, KPIs, and OKRs that you then presented to your hospital IT team. Luckily, IT has the bandwidth available to support developing this dashboard—but they need your help through the process. In today’s post, we’ll go over the second phase of designing …
HiQuiPs: Dashboards Demystified Part 1 – Problem Identification
You are working in an inner city emergency department (ED) and you notice that there are 10 patients who are waiting for their COVID-19 test results. You know that these patients are all experiencing homelessness but you have no idea if they were all exposed at one place, what symptoms they’re experiencing, and how best to inform your local public health department. You create a spreadsheet to start keeping track of these details …
Predicting Occult Scaphoid Fractures in the ED Using Clinical Features
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 …