Mary Glover Lecture 2005: patient safety, accountability and leadership--flavour of the day or here to stay?
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Accident Prevention↗
Biomedical subjects
Wendy Nicklin
Publications and source records attributed to Wendy Nicklin.
Nursing and patient outcomes: it's time for healthcare leadership to respond.
An increasing body of research confirms the link between nursing variables (e.g. staffing ratios, skill mix) and patient outcomes including morbidity and mortality. This article presents the key themes that have emerged in this research and translates them into action for senior healthcare leaders. Immediate action is required in order for hospitals to effectively recruit and retain nurses, and to provide high quality patient care that minimizes risk.
Canada↗
Enhancing skills for evidence-based healthcare leadership: the Executive Training for Research Application (EXTRA) program.
The Executive Training for Research Application (EXTRA) is a new training program that aims to increase the skills of health services executives and their organizations to use research evidence in healthcare management and decision-making. This paper describes the goals and rationale of the EXTRA program and its learning objectives and curriculum, and reports on some early baseline evaluative research. In particular, the authors address the opportunities that EXTRA offers to leaders in the nursing profession to transform the practice of nursing and patient care, and the unique opportunities that the program offers for collaboration across the healthcare professions and disciplines. While the EXTRA training program requires substantive investment of time and commitment by healthcare leaders and their organizations, it offers great potential for increasing research application in healthcare leadership decision-making. It is therefore a potential long-term lever of cultural decision-making change within healthcare organizations.
Canada↗
Performance reporting: alignment with accreditation.
This paper reviews the strong relationship of performance measurement and reporting with the Canadian Council on Health Services Accreditation (CCHSA) accreditation program and consistency with the direction of ongoing development. The CCHSA authors discuss the issue of public reporting of the accreditation results, the impact of public reporting on accreditation, aligning accreditation with the public reporting requirements, the measurement framework, quality improvement results and reporting and the linkage of accreditation with accountability. As public reporting gains momentum, the accreditation program must align to enable this while protecting the fundamental integrity and value of the program. Participating in the accreditation program clearly demonstrates the organization's commitment to accountability.
Accreditation↗
Patient safety culture and leadership within Canada's Academic Health Science Centres: towards the development of a collaborative position paper.
Currently, the Academy of Canadian Executive Nurses (ACEN) is working with the Association of Canadian Academic Healthcare Organizations (ACAHO) to develop a joint position paper on patient safety cultures and leadership within Academic Health Science Centres (AHSCs). Pressures to improve patient safety within our healthcare system are gaining momentum daily. Because AHSCs in Canada are the key organizations that are positioned regionally and nationally, where service delivery is the platform for the education of future healthcare providers, and where the development of new knowledge and innovation through research occurs, leadership for patient safety logically must emanate from them. As a primer, ACEN provides an overview of current patient safety initiatives in AHSCs to date. In addition, the following six key areas for action are identified to ensure that AHSCs continue to be leaders in delivering quality, safe healthcare in Canada. These include: (1) strategic orientation to safety culture and quality improvement, (2) open and transparent disclosure policies, (3) health human resources integral to ensuring patient safety practices, (4) effective linkages between AHSCs and academic institutions, (5) national patient safety accountability initiatives and (6) collaborative team practice.
Academic Medical Centers↗
Patient safety: springboard to nursing accountability.
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Canada↗
Restrictive visitor policies: feedback from healthcare workers, patients and families.
With the hospital-based transmission of Severe Acute Respiratory Syndrome (SARS) in Ontario, acute care hospitals severely restricted visitor access. Now that the SARS outbreak is under control, hospitals struggle with the balance between adhering to patient- and family-centred care models, and addressing the future threat of infectious diseases. To evaluate the effect of visitor restrictions and to guide future visitation policies, the Ottawa Hospital conducted a preliminary survey of patients, next of kin, staff, physicians and volunteers. Ninety percent of staff surveyed supported some form of visitor restrictions, while 71% indicated that they felt comfortable asking visitors to leave if they had exceeded current restrictions. The majority of patients (80%) and next of kin (76%) were at least moderately satisfied with current restricted limiting hours. A disproportionate number of positive comments on current visiting restrictions were received from both patients and staff. In the absence of evidence on which to base future visitor policy development, objective input from healthcare workers, patients and families is invaluable.
Attitude of Health Personnel↗
Healthcare: navigating without a compass. Poor data, poor healthcare? Who knows?
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Academies and Institutes↗
Canadian nurses' perceptions of patient safety in hospitals.
The topic of patient safety within the health care system is receiving increasing attention. The Academy of Canadian Executive Nurses conducted a national survey on nurses' perceptions of patient safety, using focus groups from Academic Health Science Centres. Over a three month time frame, 22 organizations, and 33 focus groups comprised of 503 nurses provided responses to six questions regarding patient safety in hospitals. The study was designed as a preliminary fact finding initiative resulting in this descriptive report of the concerns as identified within the focus groups. With each issue identification, they were coded and grouped into 23 themes. Nurses overwhelmingly responded that the health care environment, in which they provide care, presents escalating risk to their patients. In particular, Workload/Pace of Work, Human Resources, Nursing Shortage/Staffing, Restructuring/Bed Closures, Patients/Clients, Systems Issues, Physical Environment and Technology/Specialization were themes emphasized as contributing to increased risk in patient care. Health care leaders must play a key role in developing strategies to address the issues nurses have identified and demonstrate a commitment to controlling the situation. This study encourages research into a more explicit understanding of the issues and identification of strategies to address patient safety in health care.
Attitude of Health Personnel↗