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As you know, it is UHN's goal to be Canada's safest hospital. To achieve this goal one of the tactics we use is patient safety walkarounds, which is recognized as a best practice in ensuring organizational learning about improving safety.
In short, a patient safety walk-around involves the CEO and other senior executives visiting the in-patient or ambulatory unit to talk to the staff about their observations and opinions on safety. Let's face it, the people who understand how we can enhance safety are the people who spend most of their day with patients - the nurses, allied health staff, housekeepers and ward clerks who spend their entire day in the patient environment.
Over the past year, I have visited just about every in-patient unit and I'm starting on a second round of in-patient units and ambulatory care areas. Last week I had a remarkable visit to 8B at the Toronto Western Hospital and want to share the experience with you.
As you may know, there are three General Internal Medicine (GIM) units at TWH - 8A, 8B and 3B Fell. These units look after some of the most vulnerable patients in our hospital - elderly, often unable to converse in English, and often admitted with multi-system illness. 8A and 8B, in particular, have been challenged by outbreaks of nosocomial infection, especially Clostridia Difficile, which is particularly challenging to deal with. These outbreaks, which are vigilantly managed by the units and the IPAC team, have necessitated closures to admissions of parts or all of the units. These closures have put tremendous strain on other units, especially the Emergency Department, since the majority of ED admits go to GIM.
In a true spirit of interprofessional collaboration, all of GIM has embarked on evaluating practice and placing focused attention towards infection control. All members of the program, including nursing, physicians, allied health, environmental services, IPAC and support personnel have rallied to be engaged in improving patient safety by creating, evaluating and implementing best practice. They have agreed that everyone should observe and comment on each other's practice - recognizing that a license to "call each other" on any breach will keep our patients safer.
"We believe that everyone has a right to a safe environment that is free of hospital-acquired infections.
We hold all disciplines accountable for being knowledgeable and maintaining Infection Prevention and Control standards."
This attention to improving practice has culminated in a Unit Charter that describes the expectations for everyone who comes onto the unit. The GIM staff spend their worklife on that unit and the Charter clearly states the standards that everyone, including the health care team, the patients and visitors must hold themselves to while on the unit. The focus of the charter is on Patient Safety - hand hygiene, attention to isolation protocols and providing patients with the information they require.
Every time I go on a patient safety walk-around I learn something about how we can improve safety. On GIM the attention to improving patient safety has become a worklife constant. This kind of attention to improving patient outcomes is spreading across UHN - it is gratifying and exciting to see it happen.