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The 2008 Annual General Meeting of the Manitoba Institute for Patient Safety was held June 12, 2008. The full annual report and a summarized version are available at http://mbips.ca/wp/annual-reports/
Marilyn Hendzel and Ron Black, members of the MIPS Patient Advisory Committee (MPAC) made a presentation at the 2008 Annual General Meeting on the Patient Advocacy in the Community Project.
Dr. Stavros Prineas facilitated several workshops and presentations during the week of November 18 – 26, 2007 while in Winnipeg for his keynote presentation at the Provincial Patient Safety Conference. Dr Prineas conducts workshops around the world on a variety of patient safety topics. MIPS arranged for him to be accessible to individual organizations during his time in Winnipeg. Events included:
• Workshop on Open Disclosure of Adverse Events Friday, November 23, 2007. The workshop was designed for physicians, nurses and other health care providers from any practice setting. Participants learned about open disclosure, when disclosure should take place, preparing for open disclosure, and practical steps. Thanks to Merck Frosst for their funding contribution to the event.
• Workshop on “Teamwork and Patient Safety” Friday, November 23, 2007. The 2007 Provincial Patient Safety Conference Committee sponsored this event. Students from across health disciplines learned together about the importance of teamwork in the practice setting, barriers to team formation, and team effectiveness tools. Thanks to Merck Frosst for their funding contribution toward the event.
• Workshop on Disclosure of Adverse Events on Tuesday, November 20, 2007, St. Boniface Research Centre and linked via telehealth across Manitoba. The Manitoba Pharmaceutical Association sponsored this event for Pharmacists on: Understanding Open Disclosure; Guidance on Reporting and Providing Open Disclosure on Medication Errors; and Responsibilities for Reporting under Bill 17
• Workshop on the Human Factors of teaching Human Factors on Thursday, November 22, 2007. The Faculty of Medicine, a MIPS member, coordinated this workshop for faculty of several health disciplines to address what extent can the key concepts of human factors relevant to patient safety - communication, teamwork, leadership and situation awareness - be reflected in methodologies used to train undergraduates and postgraduates
• Workshop on Teamwork on Monday, November 26, 2007. Health Sciences Centre sponsored this event. Participants reviewed what teams are and what they are not, and reviewed team effectiveness tools
• Workshop on Situation Awareness on Monday, November 26, 2007. South Eastman Regional Health Authority sponsored this event. Participants learned about individual and team situation awareness, and active situation awareness tools.
Provincial Patient Safety Conference
November 21, 2007: Let’s Talk About it!
The 2007 Provincial Patient Safety Conference took place Wednesday November 21, 2007 at the Winnipeg Convention Centre. The theme was Communication and Patient Safety. Approximately 360 people from across Manitoba registered for the conference, including 140 students from the Faculties of Medicine, Nursing and Pharmacy at the University of Manitoba (all three are MIPS’ members). The Provincial Patient Safety Conference is planned by an Organizing Committee, chaired by MIPS with participants who provide time and sponsorship funds toward the event.
The 2007 Conference Organizing Committee:
Laurie Thompson, Manitoba Institute for Patient Safety (Chair)
Joan Blakley, College of Physicians and Surgeons of Manitoba
Sandra Fedirchuk, Winnipeg Regional Health Authority
Patti Fries, Southeastman Regional Health Authority
Susan Lessard Friesen, Manitoba Pharmaceutical Association
Kristine Hannah, Central Regional Health Authority
Dr. Brent Kvern, Family Physician
Patrick Munoz, Canadian College of Health Service Executives
Elaine Pelletier, Winnipeg Regional Health Authority
Linda Smyrski, Manitoba Health
Jo-Ann Welham, Interlake Regional Health Authority
Diane Wilson-Mate, College of Registered Nurses of Manitoba
Our keynote speaker, Dr. Stavros Prineas, New South Wales, Australia, gave an inspiring keynote address that challenged the audience to examine ways in which providers communicate with colleagues and with patients and families. Practical tips in improving these communications were offered. Dr. Prineas bridged his messages to topics introduced in the breakout sessions following his address. Dr. Mark Fleming, Halifax Nova Scotia, provided an overview of his work with a research project addressing teamwork in a surgical program at St. Boniface General Hospital in Winnipeg. Lessons learned provided practical considerations for future work on building and enhancing teamwork in health care settings. Mr. Louis Sorin, Winnipeg Manitoba, examined the relationship between cultural safety and patient safety, and challenged participants to take a broad perspective on bridging these important concepts in the workplace. Mr. John Lewis, Hamilton Ontario, reflected on the inherent benefits of disclosure. His personal experience with his daughter Claire, who died as a result of errors in her post surgical hospitalization, provided a powerful backdrop to examining how disclosure takes place and how this experience needs to be improved for families as well as for health care providers.
Participants’ feedback to date has been extremely positive. There was an excellent mix of local, national and international leading edge examples of the importance of communicating effectively with patients, families and colleagues in the health care field. Techniques covered front line staff, managers and leaders. Below are links to the handouts from the conference, and a photo gallery of the conference.
Board meeting schedules for 2008
Jan 8, 8:15-11:15 AM
Mar 4, 8:15-11:15 AM
May 6, 8:15-11:15 AM
July - to be determined
Sep 2, 8:15-11:15 AM
Nov 4, 8:15-11:15 AM
Annual General Meeting is June 12, 2008, 5 - 6:30 PM at The Fort Garry.
A Public Forum on Patient Safety
We Grieve, We Listen, We Learn was a powerful, emotional and thought-provoking evening for health care providers and members of the public. Dr. Paul Thomas, former Board Chair, Manitoba Institute for Patient Safety moderated the event and Dr. John Wade, Board Chair, Winnipeg Regional Health Authority gave introductory remarks. The evening featured Mr. John Lewis, Hamilton, Ontario, a registered nurse and co-author of the groundbreaking book, “Beware the Grieving Warrior.” Mr. Lewis shared how he lost his eleven-year-old daughter Claire as a result of a series of systemic and human errors committed during Claire’s post-operative recovery. John provided a detailed account of how the systems and the health care professionals working within these systems failed not only his daughter Claire, but his family as well. The experience led John to become a fierce advocate for the disclosure of adverse events, not only at the corporate level but also at the personal level by health care professionals.
After John’s presentation, he was joined by Dr. Rob Robson, Winnipeg Regional Health Authority and Dr. Stavros Prineas, New South Wales, Australia and the keynote at the Provincial Patient Safety Conference who took questions and addressed comments from the audience.
The goal of the evening was to provide a greater voice for patients and their families in patient safety initiatives as well as foster greater openness to discussing and ultimately learning from adverse events and unfortunate, sometimes tragic, events that happen to patients and their families in health care settings. Approximately 200 people attended the forum. Common themes from comments from the audience included the need for patients and families to be listened to and heard by health care providers, and for openness and transparency in health care interactions. Mr. Lewis’ book is available at leading booksellers.
