Improving appropriateness of antipsychotic use in long-term care

Antipsychotic use in LTC

When prescribed appropriately – to treat psychosis related to a psychiatric condition like schizophrenia – antipsychotic medications can improve a patient’s quality of life. However, too often it appears antipsychotics are being prescribed to residents of Long-Term Care Homes (LTCH) to control behavioral symptoms of dementia (such as verbal or physical aggression) without a concurrent

Health care must learn to embrace failure

Danielle Martin & Joshua Tepper

Forty is the new thirty. Orange is the new black. And failure is the new success. It seems these days that no success story is complete without a failure (or two) along the way: the bankruptcy that gave birth to a successful company; the entrepreneur who lost it all just before hitting the Fortune 500.

More is better when it comes to hospital staff satisfaction surveys

Devitt and Martin

Staff satisfaction surveys are a vital tool when trying to improve employee engagement.  The connection between workplace health and quality patient outcomes is well documented. Yet, according to National Research Corporation Canada (NRCC), only two Ontario hospitals using their tool survey more frequently than once every year or two. Can an organization effectively focus on

Safe surgery checklists: the Canadian experience

Safe surgery checklist

Each year there are patients who wake up from surgery to find an operation has been done on the wrong part of their body. These wrong-site surgeries are an example of “never events” – incidents that simply should not happen if all safety measures are taken. Nevertheless, these events take place each year in countries with

Should hospital staff satisfaction survey results be public?

Patients and their families were treated with “callous indifference.” Water was left out of reach. Soiled bed sheets weren’t changed, sometimes, for months. The abuses that took place between 2005 and 2008 in an England hospital shocked the country. A 139-day public inquiry revealed that there were many signs leading up to the abuse. If acted

Medical education must include quality improvement and patient safety

Zafira Bhaloo

Entering medical school is like settling in a new country, you have to learn the language, adapt to the culture and figure out how to succeed. As medical students, we study the pathophysiology, clinical presentation, diagnosis and management of diseases. We learn how to effectively communicate with patients to get their stories and pair these

Can Kaiser Permanente’s success be replicated in Canada?

Michael Schull

I recently attended a briefing of Ontario health system stakeholders by representatives of the famed Kaiser Permanente Health System, often called America’s leading nonprofit integrated health plan. Kaiser Permanente representatives are regularly invited to Ontario to provide advice (and maybe hope) to the rest of us that health system reforms could produce the same sort

Pulling back the curtain on Canada’s rising C-section rate

Caesarian sections (C-sections) are among the most common surgical procedures performed on women of child-bearing age. Canada’s C-section rate has increased dramatically in the past two decades. The national C-section rate  has increased from 17% of all births in 1995 to nearly 27% in  2010. In Ontario, nearly 29% of births in 2011/12 were by C-section, with a similar rate in Alberta of

Complacency putting Canadian health care at risk


As the United States attempts to overhaul health care and improve access for more of its citizens a US Senate committee recently met in Washington and invited several international experts to share perspectives on their own health care systems.  Toronto physician Dr. Danielle Martin very nicely represented the Canadian perspective. It was an articulate presentation

When quality trumps service, patients lose out

Shawn Whatley

The Ontario government deserves applause for tackling global funding for hospitals. “Global budgets provide[d] little incentive for hospitals to focus on efficiency, innovation, improving access, coordinating care across facilities and sectors or improving quality.” In 2012, the Ontario Ministry of Health announced its commitment to patient-based funding. It promised to deliver patients: • Shorter wait

Rethinking health outcomes in the era of multiple concurrent chronic conditions

Health outcomes

Modern health care is very much concerned with outcomes. The language of outcomes is common  in policy development, clinical work, and research. For example, Health Quality Ontario states that the overall quality aims are: Better outcomes, better experience, better value for money. In the context of clinical care, outcomes are broadly considered to be the

Can quality be assured for diagnostic imaging?


News headlines from across Canada are periodically dominated by scandals and errors in diagnostic imaging. The list grows each year, with errors exposed from coast to coast. The narrative follows the same arc – an error is discovered in an area of diagnostic imaging. A radiologist – generally the physician involved in the interpretation of

Fewer hospital staff on weekends puts some patients at risk

Fewer hospital staff on weekends puts some patients at risk

In the modern economy, many industries, such as aviation, retail and manufacturing, no longer slow down over weekends. Yet hospitals have mostly resisted this trend, even though demand for many forms of health care is no less on weekends than on weekdays. While most hospitals are open every day of the week, many operate with