Every member of the health care team is invited to attend the 8th Annual WRHA Critical Care Outcomes Improvement Symposium. This year’s event entitled, “Quality Improvement in Times of Change” will provide attendees with two keynotes, a variety of educational workshops and multisession tracks exploring the use of QI tools in the ICU, opportunities to network and learn about Site/Unit-specific improvement projects, and meaningful reflections during our health system’s transformation. Please join us on May 31, 2019 for a Friday filled with learning, collaboration and the inspiration we need to transcend our traditional models of care across different health care settings
Dr. Dick Zoutman is a physician, health care leader, innovator, educator and scientist from both Queen’s University and University of Toronto. He currently serves as the Inaugural Chief of Staff of the Scarborough Health Network (SHN), a newly amalgamated large hospital system in Toronto. He is also Professor in the Healthcare Quality Graduate Programs at Queen’s University. A transformational leader who has broad experience improving health care delivery, Dr. Zoutman has worked extensively nationally and internationally.
Effective quality improvement requires engaged front line staff that are committed to improving care. This keynote will review both leadership and front-line staff strategies to effectively navigate difficult changes, develop a new shared common vision, and remain engaged and energized to continue improving care for our patients.
Dr. Jill Horton is a general internist, Associate Head of Professionalism and Diversity, and Director of Physician and Learner Wellness at University of Manitoba. She has trained in the internationally renowned Mindful Practice program, and has taught this evidence-based, JAMA-published program both locally and in the US. Dr. Horton is an accomplished musician and writer. She authors a blog and podcast series for the CMAJ entitled “Dear Dr. Horton”, and recently published a graphic novel titled ‘Medicine’.
A career in healthcare can be extremely stressful, and this can be further increased during times of change. Health care worker (HCW) burnout is common, and can impact both the healthcare provider and patient care. This keynote will explore underlying determinants of HCW burnout, focusing on how mindfulness can be learned and applied in clinical practice to improve not only the quality of our care but also the quality of our lives.
Over three sessions, attendees will discuss an important ICU topic and using quality improvement tools develop a strategy to address this issue within their own units
In these stand-alone sessions, attendees will learn about a specific topic through didactic style lecture.
Interactive Hands-on Sessions
In these stand-alone interactive small group sessions, attendees will learn thorough discussion and hands-on activities.
MINIMIZING SEDATION USE IN THE ICU—more is not better (A1 to A3)
Mark Oppenheimer, MD FRSPC, Trauma Surgeon & Critical Care Physician, University of Manitoba
Analgesics and sedatives are frequently used in the intensive care unit to address patient pain, anxiety and delirium. Over sedation however can cause significant patient harm and increased healthcare costs. In this series of three workshops, we will 1) review literature supporting targeted sedative and analgesia treatment and sedation minimization strategies, 2) understand different root causes of over sedation and barriers to sedation minimization within our units, and 3) explore local solutions and implementation strategies to address this issue.
- Understand how targeted sedative and analgesic therapies and sedation minimization strategies can improve patient outcomes
- Identify local barriers to effective sedative and analgesia delivery
- Explore different strategies to address the issue of over sedation within our units
RATIONAL TEST ORDERING (B1 to B3)
Allan Garland, MD, MA Professor of Medicine & Community Health Sciences, University of Manitoba
Diagnostic laboratory testing accounts for a substantial fraction of total ICU costs, but good evidence indicates that much of it is unnecessary, increasing costs while not improving patient outcomes. In this series of three workshops we will: (1) review existing knowledge about lab testing, (2) map the processes by which labs are performed, and (3) propose Quality Improvement interventions aimed at reducing unnecessary lab testing in ICUs.
- Discuss existing knowledge about diagnostic laboratory testing in ICUs
- Analyze the processes that lead to performance of diagnostic lab testing in ICUs.
- Apply Quality Improvement principles, to identify implementation strategies for reducing unnecessary diagnostic lab testing in ICUs.
HAND OVERS IN CRITICALLY ILL PATIENTS—Making Safer Transition of Care (C1 to C3)
Carmen Hyrmak, MD, FRCPC, Emergency & Critical Care Physician, University of Manitoba
Although handovers are essential, they can be a significant cause of medical error and patient harm. In this series of three workshops, we will 1) review current evidence to define and quantify good hand-overs, 2) identify local priorities and explore underlying causes of ineffective handovers using the group’s expertise, and 3) explore implementation and maintenance strategies for improving our handovers. There will be a survey ahead of the conference seeking input on which part of handover the group would like to focus on for this session.
- Explore how poor handovers contribute to medical error and patient harm
- Understand the elements required for effective handovers and the evidence that supports their use
- Identify priority areas to improve handovers in our intensive care units
- Explore local solutions and implementation strategies to address these high priority areas
EARLY WARNING SYSTEMS IN MEDICAL PRACTICE—where there is smoke, there is usually fire…
Kerstin Jordan, RN, BN, Reg. Director of QI & Patient Safety, WRHA
Dave Easton MD, FRCPC, Critical Care Physician, University of Manitoba
Isabelle Jarrin, RPN, BScPN, BA, MN, CNS QI & Safety, WRHA
One of the leading causes of admission to ICU is the “deteriorating patient” on an outlying medical/surgical ward in Hospital. Ironically, we as a medical system struggle with recognition and subsequent escalation of appropriate care in these patients. This often leads to suboptimal outcomes. Join us as we explore our Regional data/experience in this area and talk about Early Warning Systems (EWS) and how they can be used to help provide the right care at the right time in the right place!
- Identify Challenges in Recognizing the Deteriorating Patient
- Identify barriers to escalation of care
- Understand what an EWS is
- Understand how EWS will be use in the WRHA and the role of Critical Care
Sheila Betker, CTDP, CPHR, WRHA Staff Development Consultant
Questions, concerns and worry begin long before the project plans for implementing change are created. This session is designed to help individuals help themselves through the uncertainty associated with transformation. We will look at the common reactions we have during times of disruption and strategies we can use to move ourselves from denial through anger to acceptance and commitment. Tapping into our personal power and building resilience are essential for individuals in our organization to make a successful transition to the new health system while continuing to offer quality, safe care. Join us for an insightful, uplifting and participative workshop.
- Explore common reactions of individuals during times of change
- Learn about tools and strategies to support yourself through uncertainty and build resilience
ANTIBIOTIC STEWARDSHIP IN THE ICU
Rob Ariano, Pharm.D BCPS, FCCM, Critical Care Pharmacist, SBGH Clinical Professor of Pharmacy & Medicine, University of Manitoba
As multi-drug resistance organisms (MDRO) are on the rise, research into new antibiotics with novel mechanisms has declined rapidly. The high costs of research and development with poor investor return are considered the main drivers of this situation. The only recourse for clinicians is aggressive antibiotic stewardship in order to retain the effectiveness of currently available agents.
- Review the importance of MDRO as a global health concern and the factors related to their increasing prevalence
- Understand the role of advanced molecular methods on the diagnosis of microbes
- Discuss various proven effective strategies to decrease unnecessary antibiotic use and explore how these strategies could be applied to our intensive care units
SLEEP IN THE ICU: SCIENCE, IMPACT, & STRATEGIES
Diana McMillan, RN, PhD, Associate Professor, College of Nursing, University of Manitoba & Associate Professor of Clinical Practice, HSC
Join this workshop to learn the latest discoveries in sleep physiology and circadian rhythmicity. Find out why good sleep is critical for patients in the ICU and identify barriers to getting it. Learn about and discuss simple and effective strategies to support better sleep and circadian rhythmicity, and in turn, better patient outcomes.
- To gain a basic understanding of sleep physiology and circadian rhythmicity
- To discuss consequences of sleep disturbance for patients in the intensive care unit (ICU) setting.
- To identify contributors to sleep disturbance in the ICU setting.
- To learn about sleep and circadian health promotion strategies to support ICU patient health outcomes.
ENHANCING CRISIS TEAM DYNAMICS
Lawrence Gillman, MD, MMedEd, FRCSC, FACS, Trauma & Acute Care Surgeon, Intensivist, Director, Clinical Learning & Simulation Program, University of Manitoba
Most medical errors are nontechnical and include failures in team communication, situational awareness, resource use, and leadership. Other high-risk industries have adopted team-based crisis resource management (CRM) training strategies to address “nontechnical” skills and to improve human error and safety. This workshop will adapt on crisis leadership, communication, teamwork, situational awareness and problem solving skills that were developed for the airline industry and applies them to resuscitation training.
- Discuss the rationale behind the principles of crisis resource management
- Use low fidelity simulation to illustrate the unique dynamics created by a multidisciplinary team
- Identify simple strategies that can be employed during a medical crisis
THE UNCONFERENCE (aka THE UNWORKSHOP)
Basil Evan, RN, BA, BN, TQM, WRHA Critical Care QI Officer
Delegates will participate in an informal, fun, fast-paced and free-form learning experience. Unlike traditional workshops with strict agendas and planned presentations, an unconference utilizes open space technology. The fundamental goal is to create a round table discussion where team members can share their thoughts and debate the issues that they decide are important. This format (without a format) promotes a culture of thought diversity, creative problem solving, faster change and improved outcomes.
- Discuss the model for improvement
- Describe how to use a fishbone diagram
- Differentiate between primary and secondary drivers
- Develop specific change concepts
0700 – 0800
0800 – 0815
0815 – 0930
Morning Keynote: Towards a Unified Theory of Things – Dr. Zoutman
0930 – 0950
0950 – 1040
Minimizing Sedation (A1)
Rational Test Ordering (B1)
Hand Over (C1)
Early Warning Systems
Sleep in ICU
1045 – 1140
Minimizing Sedation (A2)
Rational Test Ordering (B2)
Hand Over (C2)
Sleep in ICU
Enhancing Crisis Team Dynamics
1140 – 1230
1230 – 1315
Afternoon Keynote: The second best time is now: Preventing Health Care Worker Burnout – Dr. Horton
1320 – 1410
Minimizing Sedation (A3)
Rational Test Ordering (B3)
Hand Over (C3)
Enhancing Crisis Team Dynamics
1410 – 1430
1430 – 1530
1530 – 1550
Wind-up Session and Awards
Register by selecting your education track of choice, and any optional events.
All attendees are automatically registered for both keynote sessions.
An Evening of Recognition: Dr. Easton’s Contribution to Winnipeg Critical Care
1800h, Thursday, May 30 at Inn at the Forks
Team Building Evening Events
1600h, Friday, May 31 at Canad Inns Fort Garry Tavern United
Interact and get inspired with your colleagues. Join us at Tavern United after the Symposium to celebrate our quality improvement efforts and successes. Remember teams that eat together, succeed together! Reserved seating at Tavern United with complimentary appetizers and cash bar from 4:00-6:00 PM
Corporate event pricing at Celebrations Dinner Theatre for the show, “The Big Boom Theory”. Tickets are $62 (includes 4-course dinner, non-alcoholic beverages and taxes). Attendees are welcome to reserve a table and bring a guest for an evening of fun and friendship.
Workshop spots fill up quickly so register early! Special EARLY BIRD registration is $75 (before April 30). Regular registration fee is $85 (deadline is on May 28). At-the-door registration fee is $99. Registration is online by credit card only – no cheques or cash will be accepted.
Registration fee includes breakfast and lunch on May 31. Please advise Canad Inns Destination Centre Fort Garry directly if you have any dietary restrictions.
SYMPOSIUM SCHOLARSHIP is available. Talk to your manager or click here download scholarship application forms..
POSTER PRESENTATION – Click here for poster session instructions.
Contact us: WRHA_OITsymposium@wrha.mb.ca
THE OUTCOMES IMPROVEMENT SYMPOSIUM RECEIVED AN EDUCATIONAL GRANT FROM THE ICU PHYSICIANS’ FUND. THANK YOU!