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Invited Speaker Rounds: Thursday, May 19th @ 12-1PM

Speaker: Dr. Noah Ivers
Title: The science and practice of Audit and Feedback: data-driven quality improvement
Description: All too frequently, when quality improvement interventions are tested in trials, the effects are less than expected. This talk will review the empirical evidence for audit and feedback as an intervention to improve quality of care and summarize best practices in the design of such interventions. It will also explore how those leading quality improvement initiatives can simultaneously contribute to the underlying science regarding how the effectiveness of such interventions can be optimized.

Noah Ivers is a scientist at Women’s College Research Institute (WCRI) and adjunct scientist at the Institute for Clinical Evaluative Studies. He is also a family physician at Women’s College Hospital (WCH) and an Assistant Professor in the Department of Family and Community Medicine and at the Institute for Health Policy, Management and Evaluation at the University of Toronto.

Noah’s focus is on developing approaches for evaluating physician performance to improve the quality of care that patients receive in primary care settings. His research is based on the principle that when healthcare providers have a solid understanding of how they rank among their peers in treating specific diseases and conditions, it can help drive change and improve health outcomes for all.

Noah’s research draws on a foundation in clinical epidemiology and health services research. He focuses on the use of data to drive decision making in healthcare, as well as the design of systems that improve interactions between doctors and patients. Always with a strong evidence-based approach, Noah is advancing the global research agenda in quality improvement and patient-centred care.

Noah received the Rising Star Award from the Canadian Institutes of Health Research-Institute of Health Sciences and Policy Research (CIHR-IHSPR) in 2013. He has also received New Investigator Awards from CIHR and from the Department of Family and Community Medicine at the University of Toronto.

City Wide Quality and Safety Rounds: Thursday, May 11, 2017 @ 12-1PM

Topic: FIXING IT FOR GOOD: How human factors informed design can create a safer, more resilient health system

Speaker(s): Joseph A. Cafazzo, PhD PEng and Anjum Chagpar, MHSc PEng

Host Site: University Health Network: Toronto General Hospital, Peter Munk Building, 11th floor, Rm 190

Sites participating via OTN: C-QuIPS/Sickkids: 525 University Avenue, Rm 630; St Michael’s – Li Ka Shing Knowledge Institute, Rm 211; Sunnybrook: Bayview Campus – McLaughlin Auditorium, EG-61

OTN Webcast Link:

The rate of preventable adverse events has been stubbornly unchanged after many years of concerted effort to reduce harm in healthcare settings. Safety research and practice in healthcare continues to focus on measurement and cause of adverse events. Far less time has been focused on creating resilient solutions to the problem. This gap is likely why we’ve seen little progress in our safety efforts. There is however precedence in other industries on how to design safety critical systems that are resilient to human error, or that eliminate risk altogether. This presentation will describe how the healthcare settings must change in fundamental practice and governance to truly address the continued safety chasm.

The objectives of the session are:

I. To describe well established human-factors informed design methods that create more resilient mitigations to reduce and even eliminate harm.

II. To describe how safety practitioners can use these methods right now, and see results sooner, by diverting their time toward designing more resilient corrective actions, and focusing less on measurement and cause analysis.

III. To discuss how fundamental change is needed in healthcare practice and governance to reflect other safety critical industries.

Dr. Joseph Cafazzo co-founded Healthcare Human Factors @ UHN in 1994, growing to become largest group of its kind devoted to the application of human factors engineering to problems of healthcare delivery and patient safety. He is Associate Professor, University of Toronto, where he teaches and conducts research in the areas of human factors, clinical engineering, and health informatics. He is a recipient of the Career Scientist award by the Ontario Ministry of Health and Long Term Care and is Clinical Lead, Design and Engineering, of the Techna Institute at the University Health Network.

Anjum Chagpar is the cofounder and Managing Director of Healthcare Human Factors. Over the last 15 years, she has adapted and expanded the focus of her team to address broader patient safety challenges through the fusion of design disciplines with human factors engineering. Anjum holds degrees in Systems Design Engineering and Clinical Engineering from the Universities of Waterloo and Toronto respectively.

Work in Progress Rounds: Thursday, May 5th @ 12-1PM

Speaker(s): Dr. Lianne Jeffs and Michelle Zahradnik
Title: Keeping on Track and Moving Forward Antimicrobial Stewardship Using Quality Improvement Methods and Sustainability Planning
 A body of empirical evidence exists on the benefits of Antimicrobial Stewardship Programs (ASPs) however, less is known about what components within ASPs and what factors and conditions influence the sustainability of ASPs. In response, a Quality Improvement strategy with integrated sustainability planning was developed to improve and sustain ASPs. The developed ASP-SUSTAIN project combines interactive learning, coaching and mentorship within a networked Communities of Practice (CoP) model to improve and sustain four local ICU ASPs. The objectives of the project are to facilitate the development, implementation and evaluation of sustainability plans with local teams. Four teams from different hospital ICUs are working on project topics which range from reducing the duration of empiric therapy to improving antimicrobial discussion during daily rounds through nurse engagement. The learning framework, team projects, evaluation framework and preliminary findings will be discussed during this seminar.

Speaker(s): Drs. Geetha Mukerji and Ilana Halperin

Title: Balanced scorecard development for ambulatory diabetes care: a multi-site quality initiative
Description: The goal of this quality initiative is to develop and implement a set of appropriate indicators for diabetes care in the form of a balanced scorecard. The indicators will be translated into a balanced scorecard for diabetes care to compare and monitor performance, analyze programmatic strengths and weaknesses, and track progress and improvement in diabetes care. The resulting scorecard will be pilot tested and implemented in ambulatory care diabetes clinics across five Toronto academic health centres.


Webcast URL:



C-QuIPS/VAQS/CQI Joint Rounds: Friday, May 1st @ 12-1PM

Speaker: Yoel Donchin
Title: Safety is not a commodity – It is a value (or if you like, How to teach HF for safety via eLearning and movies)
Description: After a short (very short) history of the struggle to eradicate medical mishaps, the talk shall demonstrate another approach to create a safety climate in the medical domain based on what we know from cognitive psychology and Human Factors Engineering (*see reading material below).  Our approach to educate the medical community to behave safely, from medical students to ALL physicians in Israel shall be demonstrated, based on eLearning and using feature movies as a trigger tool for discussion.

*Kahneman, D. (2011). Thinking, fast and slow. New York: Farrar, Straus and Giroux.

City Wide Quality and Safety Rounds: Thursday, April 13, 2017 @ 12-1PM

Topic: Discharge Before 1100: Advancing a Quality Culture through Team Based Discharge Planning

Speaker(s): Lina Gagliardi MSW, RSW & Tracey DasGupta, RN, MN

Host Site: Sunnybrook: Bayview Campus – McLaughlin Auditorium, EG-61

Sites participating via OTN: C-QuIPS/Sickkids: 525 University Avenue, Rm 630; St Michael’s – Li Ka Shing Knowledge Institute, Rm 211

OTN Webcast Link:

Discharge Planning is fundamental to quality person centred care. Sunnybrook Health Sciences Centre has implemented and evaluated a multi-pronged Discharge Program which seeks to improve the patient experience while advancing safety, effectiveness, and efficiency of care. This presentation will provide an overview of the implementation and evaluation of key interprofessional practices including standardized and consistent discharge processes within and across acute care clinical settings, engagement of patients and families in discharge planning as full partners, and use of a Discharge Dashboard to monitor progress and results.

Learning objectives:

1) To describe the implementation of a Discharge Planning Program within a shifting quality culture.

2) To share an organizational approach and lessons learned related to standardized discharge practices.

3) To highlight the use of a Discharge Dashboard to engage teams in quality improvement and quality conversations.

Lina Gagliardi, MSW, RSW, is the Professional Leader for Social Work. Lina is an alumni of the Factor Inwentash Faculty of Social Work, U of T and has both clinical and leadership experience within the discharge planning domain. Lina co-leads the Discharge and Transition Planning Steering Committee at SHSC and has presented “Discharge Planning through Interprofessional Person Centred Care” Poster at HQO in 2015.

Tracey DasGupta, RN, MN is the Director of Interprofessional Practice at Sunnybrook Health Sciences Centre and an adjunct lecturer for the Lawrence Bloomberg Faculty of Nursing at the University of Toronto. Tracey is providing leadership for Person Centred Care and Interprofessional Collaboration at Sunnybrook, both of which are integrated and fundamental to Discharge Planning.

Invited Speaker Rounds: Friday, April 1st @ 12-1PM

Speaker: Dr. Mary Patterson
Resilience and Precarious Success: How Human Adaptation Keeps Patients Safe

Learning Objectives:

At the end of this presentation, participants will be able to:

1. Describe the roles of Safety I and Safety II in Patient Safety
2. Recognize the ways in which humans make use of system capabilities and proactively mitigate the effects of system limits in the quest to improve the healthcare delivered to patients.
3. Describe the four primary activities of resilience engineering

Mary recently returned to Children’s National Medical Center and now serves as Associate Vice Chair Medical Educational Research in Simulation and CAPE in addition to her duties in the ED. Previously she was a founder and the Medical Director of the Cincinnati Children’s Center for Simulation and Research from 2002 to 2011. She is past- president of the Society for Simulation in Healthcare. She currently serves on the BOD for the International Pediatric Simulation Society.

Mary completed pediatric residency training at Columbus Children’s Hospital and then served as a primary care physician in the United States Air Force. Mary’s pediatric emergency medicine fellowship was at CNMC and her first attending physician position was here in the emergency department.

Dr. Patterson has completed a Master’s in Education at the University of Cincinnati and a Patient Safety Fellowship at Virginia Commonwealth University.

Dr. Patterson’s primary research interests are related to the use of medical simulation to improve patient safety , team performance and human factors work related to patient safety. She is a federally funded investigator in these areas.

Please find a list of references to the topic provided by Dr. Patterson here.

Invited Speaker Rounds: Thursday, Feb 18th @ 12-1PM

Speaker: Ryan Brydges
Title: Competency by what design? Results of a scoping study and realist synthesis on competency in bedside invasive procedures

Description: Dr. Brydges will report on a recent scoping review he completed on procedural skills training in internal medicine, the results of which raise questions about whether we should be treating competency as a blanket concept. Ryan raises the idea that rather than expecting everyone to be competent, it may be necessary to develop a system where there are streams of proceduralists and non-proceduralists. This thinking, of course, can be extended way beyond procedures.

Ryan is an Assistant Professor at the University of Toronto within the Department of Medicine, the Institute of Health Policy, Management and Evaluation, and the Institute of Medical Science. He is also a Scientist and the Associate Director at The Wilson Centre, University Health Network and Senior Editor for Advances in Simulation, the official journal of the Society in Europe for Simulation Applied to Medicine (SESAM). He obtained his MSc and PhD degrees from the Institute of Medical Science. Ryan conducts research in three related domains: (i) understanding how to optimize the use of healthcare simulation (i.e., simulated patients) for training and assessment of healthcare professionals, (ii) clarifying how healthcare trainees and professionals manage (through self-regulation) their life-long learning, (iii) identifying the best practices in the training and assessment for bedside invasive medical procedures (e.g., lumbar puncture, central line insertion, thoracentesis). Through studies of self-regulation and simulation, Ryan aims to understand how training interventions translate into healthcare professionals’ behaviours and patient outcomes.

City Wide Quality and Safety Rounds: Thursday, Feb 9, 2017 @ 12-1PM

Topic: Bridging the divide between health professions education and quality improvement

Speaker: Dr Brian Wong, MD, FRCPC

Host Site: 525 University Avenue, Rm 630

Sites participating via OTN: St Michael’s – Li Ka Shing Knowledge Institute, The Allan Waters Auditorium; Sunnybrook: Bayview Campus – McLaughlin Auditorium, EG-61

OTN Webcast Link:

The Royal College of Physicians and Surgeons of Canada recently organized a 2-day conference called Building the Bridge to Quality in September 2016. Its goal was to determine how to establish ‘health professions education’ as a key driver of improved outcomes for patients and populations. This meeting brought together an international group of educational and health system leaders, educators, front-line clinicians, trainees and patients. Together, participants helped to generate a draft list of strategies that guide the integration of patient safety and quality improvement learning and practice. Participants attending these rounds will have an opportunity to learn about these recommendations, discuss their potential implications, and provide input and feedback to refine and improve upon them.

Brian Wong is the Associate Director for the Centre for Quality Improvement and Patient Safety, Associate Professor and the Director of Continuing Education and Quality Improvement in the Department of Medicine at the University of Toronto. Clinically, he works as a general internist in the Division of General Internal Medicine at Sunnybrook Health Sciences Centre. Over the past 5 years, he has trained hundreds of interprofessional trainees and faculty through various educational activities at the local and national level.

He created an innovative ‘co-learning’ model of QI education, whereby faculty learn alongside residents to develop expertise in carrying out and teaching QI. More broadly, he chaired the Patient Safety/Quality Improvement Expert Working Group for the Royal College of Physicians and Surgeons of Canada and generated a series of recommendations that led to the integration of patient safety and QI as core competencies in the updated CanMEDS 2015 framework.

City Wide Quality and Safety Rounds: Thursday, Jan 12, 2017 @ 12-1PM

Topic: Choosing Wisely SMH: Developing a grassroots approach to tackle overutilization in the hospital setting.

Speaker: Lisa Hicks, MD, FRCPC, MSc

Host Site: St Michael’s Hospital – Li Ka Shing Knowledge Institute, Rm 211

Sites participating via OTN: CQUIPS and Sickkids: 525 University Avenue, Rm 630; Sunnybrook: Bayview Campus – McLaughlin Auditorium, EG-61; UHN – TBD

OTN Webcast Link:

The Choosing Wi‎sely campaign encourages clinicians to reduce unnecessary testing. Dr. Lisa Hicks is the St. Michael’s Hospital (SMH) Choosing Wisely lead and she will describe the organization’s strategy for developing local Choosing Wisely initiatives.

St. Mike’s grassroots approach has led to several projects developed by clinicians across the organization. One area of particular focus has been repetitive “routine” blood testing. “Routine” daily blood testing is common in the inpatient environment and may contribute anemia, increased transfusion and in-hospital to the patient. The SMH program aims to use multi-layered interventions (order set changes, education) to reduce this style of testing. The presentation will discuss results thus far and opportunities for further improvement.


1. To learn about a method to inspire and support local initiatives addressing overutilization in the hospital setting

2. To understand the extent and impact of repetitive, routine blood testing in hospitalized patients

3. To learn about a change strategy addressing repetitive and routine blood testing at St. Michael’s Hospital and review preliminary outcomes

Lisa Hicks is an Associate Professor in the Department of Medicine at the University of Toronto and a clinical hematologist at St. Michael’s Hospital where she also leads the St. Michael’s Hospital Choosing Wisely Initiative. Lisa received her medical training as well as a Masters in Clinical Epidemiology from the University of Toronto. She completed training in Quality Improvement through the Veterans Affairs Quality Scholars program from Dartmouth. Lisa has been active in the utilization space since 2012 when she developed and led the Choosing Wisely campaign for the American Society of Hematology.

RIP Rounds: Friday, February 20th, 2015 @ 12-1PM

Speaker: Lisa K. Hicks
Title: Reframing Overutilization in Healthcare: It’s the harms that matter
Description: The Institute of Medicine (IOM) and others have suggested that overutilization is widespread in medicine and may contribute to as much as one-third of healthcare spending. Discussions of overutilization by the IOM and others have tended to focus on the economic aspects of the problem. An alternate, and possibly more effective approach is to focus on the harms that overutilization can cause.

Lisa is an Assistant Professor at the University of Toronto where she is appointed as a Clinician in Quality and Innovation. She has a Masters Degree in Clinical Epidemiology and advanced training in Quality Improvement through the VAQS program. Lisa leads the Choosing Wisely campaign for the American Society of Hematology and is engaged in health services research focused on optimizing the quality and safety of cancer care.

Save the date for our virtual C-QuIPS Symposium on Tuesday, November 24, 2020, 9:30AM to 11:30AMClick here for more information
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