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Sixty-two percent of people in Canada who receive palliative care receive it in an acute care hospital – most likely in the last month of their life.",{"text":363,"type":347,"marks":364},"1",[365],{"type":366},"superscript",{"type":15,"attrs":368,"content":369},{"textAlign":53},[370],{"text":371,"type":347},"Through EPAC, team members have conversations with residents, their families and care partners about their preferences for palliative care. Together they create comprehensive, resident-centred care plans that honour the resident’s wishes, values and choices.",{"type":15,"attrs":373,"content":374},{"textAlign":53},[375],{"text":376,"type":347},"Early identification of care requirements plays a critical role in triggering other components of high-quality palliative care. Offering a common, consistent approach to supporting residents who are near the end-of-life creates opportunities – and provides permission – for death and dying to be openly discussed, normalized and supported.",{"type":15,"attrs":378,"content":379},{"textAlign":53},[380,382,387],{"text":381,"type":347},"EPAC originated from Vancouver Coastal Health’s ",{"text":383,"type":347,"marks":384},"The Daisy Project: embedding a palliative approach in residential settings",[385],{"type":386},"italic",{"text":388,"type":347},", part of the open call for innovations in 2017 by the Canadian Foundation for Healthcare Improvement (CFHI – now Healthcare Excellence Canada). The following year, CFHI worked closely with Jane Webley from Vancouver Coastal Health to launch a collaborative to spread EPAC. Seven teams from five provinces and one territory participated in the collaborative until November 2019, implementing EPAC through a train-the-trainer approach in 22 long-term care homes.",{"type":390,"attrs":391,"content":393},"heading",{"level":392,"textAlign":53},3,[394],{"text":395,"type":347},"How EPAC contributes to better healthcare in Canada",{"type":15,"attrs":397,"content":398},{"textAlign":53},[399],{"text":400,"type":347},"EPAC was part of our ongoing effort to spread and scale proven innovations that deliver high quality care closer to home and the community.",{"type":15,"attrs":402,"content":403},{"textAlign":53},[404],{"text":405,"type":347},"Seventy-five percent of people in Canada who have a preference would prefer to die in their home2– including long-term care homes. By spreading EPAC, we aimed to help increase healthcare providers’ capacity and capability in delivering end-of-life care at home, as well as avoid unnecessary emergency department visits and hospital admissions.",{"type":15,"attrs":407,"content":408},{"textAlign":53},[409],{"text":410,"type":347},"EPAC has been instrumental in successfully shifting the culture and normalizing conversations about end-of-life and living goals. 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The overarching starting point is to identify, discuss, plan (IDP) at least six weeks prior to end-of-life. The four pillars that stand underneath this are:",{"type":444,"attrs":445,"content":447},"ordered_list",{"order":446},1,[448,456,463,470],{"type":449,"content":450},"list_item",[451],{"type":15,"attrs":452,"content":453},{"textAlign":53},[454],{"text":455,"type":347},"Increase staff capacity and confidence: education, tools, resources.",{"type":449,"content":457},[458],{"type":15,"attrs":459,"content":460},{"textAlign":53},[461],{"text":462,"type":347},"Increase knowledge of residents and families: palliative care, disease trajectory, goals of care/serious illness conversation.",{"type":449,"content":464},[465],{"type":15,"attrs":466,"content":467},{"textAlign":53},[468],{"text":469,"type":347},"Psychosocial care for residents and families: impact of loss on survivors, tools, resources.",{"type":449,"content":471},[472,477,479],{"type":15,"attrs":473,"content":474},{"textAlign":53},[475],{"text":476,"type":347},"Psychosocial care for healthcare team: tools, resources.",{"type":15,"attrs":478},{"textAlign":53},{"type":15,"attrs":480,"content":481},{"textAlign":53},[482],{"text":483,"type":347},"Underneath the pillars sits the foundation layer of metrics and reporting.",{"id":16,"_uid":485,"image":486,"component":494},"0ee8cb4a-d03e-47e7-97c5-c2198334ae19",{"id":487,"alt":488,"name":489,"focus":490,"title":491,"source":16,"filename":492,"copyright":16,"fieldtype":283,"meta_data":493,"is_external_url":285},114299146628894,"The EPAC model is a house with four pillars (shown in the diagram below) that are flexible, enabling individual long-term care homes to adopt and adapt them to their unique local needs and strengths. The overarching starting point is to identify, discuss, plan (IDP) at least six weeks prior to end-of-life. The four pillars that stand underneath this are:      Increase staff capacity and confidence: education, tools, resources.    Increase knowledge of residents and families: palliative care, disease trajectory, goals of care/serious illness conversation.    Psychosocial care for residents and families: impact of loss on survivors, tools, resources.    Psychosocial care for healthcare team: tools, resources.  Underneath the pillars sits the foundation layer of metrics and reporting.","The EPAC model is a house with four pillars (shown in the diagram below) that are flexible, enabling individual long-term care homes to adopt and adapt them to their unique local needs and strengths. The overarching starting point is to identify, discuss, plan (IDP) at least six weeks prior to end-of-life. The four pillars that stand underneath this are:\n\n\n\n\n\nIncrease staff capacity and confidence: education, tools, resources.\n\n\n\nIncrease knowledge of residents and families: palliative care, disease trajectory, goals of care/serious illness conversation.\n\n\n\nPsychosocial care for residents and families: impact of loss on survivors, tools, resources.\n\n\n\nPsychosocial care for healthcare team: tools, resources.\n\nUnderneath the pillars sits the foundation layer of metrics and reporting.","1505x1673:1506x1674","2022 EPAC Pillarsdiagram EN","https://a-ca.storyblok.com/f/850807391887861/46aecd0da4/2022-epac-pillarsdiagram-en.png",{"alt":488,"title":491,"source":16,"copyright":16},"single-media",{"id":16,"_uid":496,"content":497,"component":425},"c17bfa9c-133d-4bc6-8771-7331d9d6f5e8",[498],{"_uid":499,"content":500,"component":411},"853a82c8-62a0-4e69-ab3a-bac23c15c2f8",{"type":12,"content":501},[502,507,512,517,522,527],{"type":390,"attrs":503,"content":504},{"level":392,"textAlign":53},[505],{"text":506,"type":347},"The Approach",{"type":15,"attrs":508,"content":509},{"textAlign":53},[510],{"text":511,"type":347},"Through the EPAC Collaborative, we provided teams with support and access to a range of resources to help spread and embed EPAC in their long-term care homes through a train-the-trainer approach.",{"type":15,"attrs":513,"content":514},{"textAlign":53},[515],{"text":516,"type":347},"Long-term care providers can use our four short modules to get started in delivering palliative and end-of-life care through EPAC.",{"type":15,"attrs":518,"content":519},{"textAlign":53},[520],{"text":521,"type":347},"Our interactive four-part module, Giving the Gift of Time: Embedding Palliative Approaches to Care , walks long-term care teams through the journey of a real resident, offering ways to improve end-of-life care.",{"type":15,"attrs":523,"content":524},{"textAlign":53},[525],{"text":526,"type":347},"EPAC Teams",{"type":528,"content":529},"bullet_list",[530,537,544,551,558,565,572],{"type":449,"content":531},[532],{"type":15,"attrs":533,"content":534},{"textAlign":53},[535],{"text":536,"type":347},"Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Mauricie-et-du-Centre-du-Québec, Québec",{"type":449,"content":538},[539],{"type":15,"attrs":540,"content":541},{"textAlign":53},[542],{"text":543,"type":347},"Haliburton Highlands Health Services, Haliburton, Ontario",{"type":449,"content":545},[546],{"type":15,"attrs":547,"content":548},{"textAlign":53},[549],{"text":550,"type":347},"Institute for Continuing Care Education and Research (ICCER), Alberta",{"type":449,"content":552},[553],{"type":15,"attrs":554,"content":555},{"textAlign":53},[556],{"text":557,"type":347},"New Brunswick Association of Nursing Homes",{"type":449,"content":559},[560],{"type":15,"attrs":561,"content":562},{"textAlign":53},[563],{"text":564,"type":347},"Parkwood Seniors Community, Waterloo, Ontario",{"type":449,"content":566},[567],{"type":15,"attrs":568,"content":569},{"textAlign":53},[570],{"text":571,"type":347},"Western Health, Newfoundland and Labrador",{"type":449,"content":573},[574],{"type":15,"attrs":575,"content":576},{"textAlign":53},[577],{"text":578,"type":347},"Yukon Health and Social Services",{"id":16,"_uid":580,"items":581,"component":596},"f4c3d386-c9ff-4227-82c2-3c88cea4e45b",[582],{"_uid":583,"image":584,"quote":586,"author":593,"component":594,"author_title":595},"4c6c09d9-471d-4cef-8256-6ffd02e87e51",{"id":53,"alt":53,"name":16,"focus":53,"title":53,"source":53,"filename":16,"copyright":53,"fieldtype":283,"meta_data":585},{},{"type":12,"content":587},[588],{"type":15,"attrs":589,"content":590},{"textAlign":53},[591],{"text":592,"type":347},"“Earlier conversations about things that matter provide permission for collaborative planning and saying goodbye in a meaningful way, creating lasting memories. I call this the ‘Gift of Time’ that we, as healthcare providers, can offer residents and the people that are important to them.”","Jane Webley","quote-item","Regional Leader, End of Life, Vancouver Coastal Health (2018)","quote",{"_uid":598,"content":599,"component":425},"aab35dd8-21a6-4b9d-bba7-f30ef2653580",[600,624],{"_uid":601,"content":602,"component":411},"1f58f3d2-331c-49ba-a95d-c5b052e368e3",{"type":12,"content":603},[604,609,614,619],{"type":390,"attrs":605,"content":606},{"level":392,"textAlign":53},[607],{"text":608,"type":347},"Embedding Palliative Approaches to Care (EPAC) Learning Modules",{"type":15,"attrs":610,"content":611},{"textAlign":53},[612],{"text":613,"type":347},"Palliative approaches to care improve the quality of life of residents, families and caregivers facing life-limiting illness.",{"type":15,"attrs":615,"content":616},{"textAlign":53},[617],{"text":618,"type":347},"We’ve developed these four short modules to help long-term care teams get started in delivering improved palliative and end-of life care. Through this learning, teams will be better equipped to have meaningful end-of-life conversations with residents, families and caregivers – giving them the gift of time to honour the resident’s wishes, values and choices.",{"type":15,"attrs":620,"content":621},{"textAlign":53},[622],{"text":623,"type":347},"Each module has a short video and accompanying resources to help learners reflect on and use what they see and hear in the videos. We’ve based the modules on materials from our Embedding Palliative Approaches to Care (EPAC) Collaborative.",{"_uid":625,"file":626,"link":631,"label":608,"linkType":423,"component":424,"linkLabel":16},"7f6fbe1a-eff3-48e2-b9ea-f9b2f64510d0",{"id":627,"alt":628,"name":16,"focus":16,"title":628,"source":16,"filename":629,"copyright":16,"fieldtype":283,"meta_data":630,"is_external_url":285},114291756984307,"20220215 Epaclearningmodules EN","https://a-ca.storyblok.com/f/850807391887861/3a2853bb50/20220215-epaclearningmodules-en.pdf",{},{"id":16,"url":16,"linktype":420,"fieldtype":421,"cached_url":16},{"_uid":633,"content":634,"component":425},"3e6dac40-349b-46e7-88d1-afa86fd0cbff",[635],{"_uid":636,"content":637,"component":411},"67b16e10-1bee-45ac-b127-a16404099615",{"type":12,"content":638},[639,644,649,654],{"type":390,"attrs":640,"content":641},{"level":392,"textAlign":53},[642],{"text":643,"type":347},"Giving the Gift of Time: Embedding Palliative Approaches to Care",{"type":15,"attrs":645,"content":646},{"textAlign":53},[647],{"text":648,"type":347},"Death and dying is hard to talk about. For residents, families and care partners in long-term care homes, it’s important. It gives them the gift of time. Time to say and experience the things they want to in the time they have. To live for today. And to make informed choices about their care.",{"type":15,"attrs":650,"content":651},{"textAlign":53},[652],{"text":653,"type":347},"We’ve developed an easy to use, interactive module to help long-term care teams have better conversations about end-of-life with residents, families and care partners. Long-term care homes and caregivers participated in creating this evidence-based module, which is broken into four parts.",{"type":15,"attrs":655,"content":656},{"textAlign":53},[657],{"text":658,"type":347},"As we walk through the journey of a real resident, 85-year-old François (a pseudonym), we offer guiding questions – giving the learner a chance to reflect on what they are doing now, and what they can do differently. We also share tips on how team members can take care of themselves and support colleagues too.",[129],[192,200],"hec-page-resource-single","embedding-palliative-approaches-to-care-epac","resources/embedding-palliative-approaches-to-care-epac",-14990,[],103604225865405,{"parent_slug":668,"umbraco_path":669,"umbraco_uuid":670},"resources","/HealthcareExcellenceCanada/Resources/EmbeddingPalliativeApproachesToCareEPAC","995ad68b-1ffc-4970-bbed-bf0d78ada25f","492f572f-d46a-4b4e-92c8-476d5d04ca07","2025-11-18T19:00:56.206Z",[],[675],{"path":676,"name":677,"lang":305,"published":291},"ressources/integration-des-approches-palliatives-aux-soins-epac","Intégration des approches palliatives aux soins (EPAC)",{"name":679,"created_at":680,"published_at":681,"updated_at":682,"id":683,"uuid":684,"content":685,"slug":1507,"full_slug":1508,"sort_by_date":53,"position":1509,"tag_list":1510,"is_startpage":285,"parent_id":666,"meta_data":1511,"group_id":1514,"first_published_at":1515,"release_id":53,"lang":299,"path":53,"alternates":1516,"default_full_slug":1508,"translated_slugs":1517},"Rethinking Patient Safety","2025-11-18T19:04:18.103Z","2026-02-20T16:12:05.013Z","2026-02-20T16:12:05.084Z",113881326087952,"3469e084-177f-495d-a5ec-7a7882bb627e",{"new":285,"seo":686,"_uid":688,"hero":689,"type":174,"topics":695,"Noindex":285,"content":696,"audience":1505,"duration":16,"regional":1506,"component":661},{"title":679,"plugin":328,"description":687},"Everyone contributes to patient safety. Healthcare Excellence Canada’s resources will help you take action that goes beyond preventing harm and fosters safe and inclusive care.","9df650c6-f849-4ef7-8579-542855f73b59",[690],{"_uid":691,"image":692,"title":679,"format":16,"component":339,"description":687,"key_learning":16,"prerequisite":16},"5a880321-301d-468d-a385-c9dfc372e9ac",{"id":693,"filename":694,"fieldtype":283},114294594480802,"https://a-ca.storyblok.com/f/850807391887861/a2c654f2ae/tile-image-510x340px-eng-1-1.png",[91,69,32,76,106,46,98,39],[697,1197,1213,1233,1347,1494],{"_uid":698,"content":699,"component":425},"ecf4010a-4ad9-4df3-aaad-6621fea9d473",[700,813,824,838,847],{"_uid":701,"content":702,"component":411},"aa8ffdd1-ca8a-45f6-b868-c7c377f2d4ae",{"type":12,"content":703},[704,710,715,755,760,765,786,791,796,801],{"type":390,"attrs":705,"content":707},{"level":706,"textAlign":53},2,[708],{"text":709,"type":347},"Safety is much more than the absence of harm",{"type":15,"attrs":711,"content":712},{"textAlign":53},[713],{"text":714,"type":347},"Strengthening patient safety is fundamental to excellent healthcare and has been a recognized priority in Canada for more than 20 years. Historically, patient safety efforts have focused mostly on measuring and responding to physical harm. However, safety is much more than the absence of harm. And as recent data show, we still have a way to go before we get there.",{"type":15,"attrs":716,"content":717},{"textAlign":53},[718,720,729,731,737,739,753],{"text":719,"type":347},"Globally, 10 percent of patients are harmed and over 3 million people die every year from healthcare, ",{"text":721,"type":347,"marks":722},"according to the World Health Organization",[723],{"type":724,"attrs":725},"link",{"href":726,"uuid":53,"anchor":53,"custom":53,"target":727,"linktype":728},"https://www.who.int/news-room/fact-sheets/detail/patient-safety","_blank","url",{"text":730,"type":347},". Closer to home, ",{"text":732,"type":347,"marks":733},"The Canadian Adverse Events study",[734],{"type":724,"attrs":735},{"href":736,"uuid":53,"anchor":53,"custom":53,"target":727,"linktype":728},"https://pubmed.ncbi.nlm.nih.gov/15159366/",{"text":738,"type":347}," of 2004 found an overall rate of patient harm of 7.5% in hospital settings, with 37% of adverse events deemed preventable. More recent data reported by the Canadian Institute for Health Information found ",{"text":740,"type":347,"marks":741},"one in 17 hospital stays in Canada",[742],{"type":724,"attrs":743},{"href":744,"uuid":745,"anchor":53,"custom":746,"target":747,"linktype":420,"story":748},"/resources/hospital-harm-is-everyones-concern","3b0b67e4-3791-4e2d-9008-4c21c4bdf065",{},"_self",{"name":749,"id":750,"uuid":745,"slug":751,"url":752,"full_slug":752,"_stopResolving":291},"Hospital harm is everyone’s concern",116783774126329,"hospital-harm-is-everyones-concern","resources/hospital-harm-is-everyones-concern",{"text":754,"type":347}," involved at least one harmful event in 2022-23. The data highlight the urgency of improving patient safety as rates in recent years have been higher compared to pre-pandemic numbers. The majority of the data available focuses on physical harm rather than all forms which also includes psychological, social and spiritual harm.",{"type":15,"attrs":756,"content":757},{"textAlign":53},[758],{"text":759,"type":347},"Healthcare Excellence Canada plays an important role in shaping the way patient safety is defined and understood. Initially through the work of the Canadian Patient Safety Institute (CPSI) and now as HEC, we are supporting a transformative shift from seeing safety as the absence of harm to a more holistic approach to fostering safe, inclusive care. One of the primary ways we are doing this is by working to apply the leading framework for measuring and monitoring safety, to see what lessons can be learned about its application in Canada.",{"type":390,"attrs":761,"content":762},{"level":392,"textAlign":53},[763],{"text":764,"type":347},"A framework for expanding the definition of safety",{"type":15,"attrs":766,"content":767},{"textAlign":53},[768,770,776,778,784],{"text":769,"type":347},"The release of the ",{"text":771,"type":347,"marks":772},"Measurement and Monitoring Safety Framework (MMSF)",[773],{"type":724,"attrs":774},{"href":775,"uuid":53,"anchor":53,"custom":53,"target":727,"linktype":728},"https://www.health.org.uk/publications/the-measurement-and-monitoring-of-safety",{"text":777,"type":347}," catalyzed a major change in the way safety is defined and practised and has informed and influenced Healthcare Excellence Canada’s approach. Created by Professor Charles Vincent and colleagues at ",{"text":779,"type":347,"marks":780},"The Health Foundation",[781],{"type":724,"attrs":782},{"href":783,"uuid":53,"anchor":53,"custom":53,"target":727,"linktype":728},"https://www.health.org.uk/",{"text":785,"type":347}," in 2013, the MMSF proposed shifting away from focusing on the absence of harm towards adopting a broader view of safety. This new view examined the sources of resilience and capabilities that enable safe care and endorsed a less reactive approach to improving safety.",{"type":390,"attrs":787,"content":788},{"level":706,"textAlign":53},[789],{"text":790,"type":347},"Shifting from rethinking towards acting on patient safety",{"type":15,"attrs":792,"content":793},{"textAlign":53},[794],{"text":795,"type":347},"How we act to create safer care is just as important as how we conceptualize it. That’s why Healthcare Excellence Canada has developed the following resources to help you rethink and act to improve patient safety in healthcare settings.",{"type":390,"attrs":797,"content":798},{"level":392,"textAlign":53},[799],{"text":800,"type":347},"Rethinking Patient Safety Discussion Guide",{"type":15,"attrs":802,"content":803},{"textAlign":53},[804,806,811],{"text":805,"type":347},"Healthcare Excellence Canada published ",{"text":807,"type":347,"marks":808},"Rethinking Patient Safety, a Discussion Guide for Patients, Healthcare Providers and Leaders",[809],{"type":810},"bold",{"text":812,"type":347}," during Canadian Patient Safety Week 2023 to encourage everyone across the continuum of care to enable safer care. The guide explains Healthcare Excellence Canada’s approach to patient safety that fosters a curious mindset and shifts away from seeing safety as simply the absence of harm. This resource also aims to spur discussions around patient safety and what is means for you.",{"_uid":814,"file":815,"link":817,"label":800,"linkType":724,"component":424,"linkLabel":823},"163f74cd-8ed4-47bd-be65-745efb6a722d",{"id":53,"alt":53,"name":16,"focus":53,"title":53,"source":53,"filename":16,"copyright":53,"fieldtype":283,"meta_data":816},{},{"id":818,"url":16,"linktype":420,"fieldtype":421,"cached_url":819,"story":820},"515a6db5-7990-4f67-b458-811cab7e99cf","resources/rethinking-patient-safety-discussion-guide",{"name":800,"id":821,"uuid":818,"slug":822,"url":819,"full_slug":819,"_stopResolving":291},113880292322786,"rethinking-patient-safety-discussion-guide","Learn more",{"_uid":825,"content":826,"component":411},"9860c1c5-eafc-4943-bcc5-0c94b4e127a3",{"type":12,"content":827},[828,833],{"type":390,"attrs":829,"content":830},{"level":392,"textAlign":53},[831],{"text":832,"type":347},"How Safe is Your Care?",{"type":15,"attrs":834,"content":835},{"textAlign":53},[836],{"text":837,"type":347},"The release of \"How Safe is Your Care? Measurement and monitoring of safety through the eyes of patients and their care partners\" provides important insights into how patients and their care partners see safety. The report offers guidance on how to effectively engage patients and care partners in all aspects of measurement and monitoring of safety and provides recommendations outlining how to strengthen provider and patient partnerships in support of safer care.",{"_uid":839,"file":840,"link":845,"label":846,"linkType":423,"component":424,"linkLabel":16},"d4595014-4524-4d17-9f41-36a05c1fd4a6",{"id":841,"alt":842,"name":16,"focus":16,"title":842,"source":16,"filename":843,"copyright":16,"fieldtype":283,"meta_data":844,"is_external_url":285},114293584038291,"20220525 Howsafeisyourcare FINAL EN","https://a-ca.storyblok.com/f/850807391887861/bc9df4166f/20220525-howsafeisyourcare-final-en.pdf",{},{"id":16,"url":16,"linktype":420,"fieldtype":421,"cached_url":16},"How Safe is Your Care? Measurement and monitoring of safety through the eyes of patients and their care partners",{"_uid":848,"content":849,"component":411},"fb2cf783-9aa4-45d8-abc8-ac894bb6160c",{"type":12,"content":850},[851,856,876,894,912,927,942,958,975,984,1004,1018,1049,1058,1181,1189],{"type":390,"attrs":852,"content":853},{"level":706,"textAlign":53},[854],{"text":855,"type":347},"A timeline of patient safety",{"type":15,"attrs":857,"content":858},{"textAlign":53},[859,861,874],{"text":860,"type":347},"Important work has taken place to evolve our understanding of patient safety, what it means to different stakeholders, and how to foster it. While there has been tremendous progress, more work is needed to refine this understanding and address harm. As early adopters and leaders on the MMSF in Canada, Healthcare Excellence Canada and partners have a role to play in this effort—one that we hope you will join—so that we can truly ",{"text":862,"type":347,"marks":863},"transform to the presence of safety",[864],{"type":724,"attrs":865},{"href":866,"uuid":867,"anchor":53,"custom":868,"target":747,"linktype":420,"story":869},"/updates/are-we-safe-or-just-lucky","19a25cf2-515c-4f1a-8e4a-cca4111ca274",{},{"name":870,"id":871,"uuid":867,"slug":872,"url":873,"full_slug":873,"_stopResolving":291},"Are we safe or just lucky?",123415441417262,"are-we-safe-or-just-lucky","updates/are-we-safe-or-just-lucky",{"text":875,"type":347},". Together.",{"type":15,"attrs":877,"content":878},{"textAlign":53},[879,883,885,892],{"text":880,"type":347,"marks":881},"1999: ",[882],{"type":810},{"text":884,"type":347},"A report titled ",{"text":886,"type":347,"marks":887},"To Err is Human: Building a Safer Health System",[888,891],{"type":724,"attrs":889},{"href":890,"uuid":53,"anchor":53,"custom":53,"target":727,"linktype":728},"https://pubmed.ncbi.nlm.nih.gov/25077248/",{"type":386},{"text":893,"type":347}," was published by the Institute of Medicine. The report explores patient deaths due to medical error and concludes that the problem is not necessarily people, but the system in which people work.",{"type":15,"attrs":895,"content":896},{"textAlign":53},[897,901,903,910],{"text":898,"type":347,"marks":899},"2001: ",[900],{"type":810},{"text":902,"type":347},"The Institute of Medicine in the US releases ",{"text":904,"type":347,"marks":905},"Closing the Quality Chasm: A New Health System for the 21st Century",[906,909],{"type":724,"attrs":907},{"href":908,"uuid":53,"anchor":53,"custom":53,"target":727,"linktype":728},"https://pubmed.ncbi.nlm.nih.gov/25057539/",{"type":386},{"text":911,"type":347},". This report outlined the Six Aims for Improvement (Safety, Timeliness, Effectiveness, Efficiency, Equity, Patient-Centredness).",{"type":15,"attrs":913,"content":914},{"textAlign":53},[915,919,925],{"text":916,"type":347,"marks":917},"2004: ",[918],{"type":810},{"text":920,"type":347,"marks":921},"The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada",[922,924],{"type":724,"attrs":923},{"href":736,"uuid":53,"anchor":53,"custom":53,"target":727,"linktype":728},{"type":386},{"text":926,"type":347}," by Baker, Norton et al., is the first Canadian study to provide a national estimate of the incidence of adverse events. The study found that 7.5% of 100 admissions resulted in an adverse event, of which 36.9% were preventable.",{"type":15,"attrs":928,"content":929},{"textAlign":53},[930,934,935,940],{"text":931,"type":347,"marks":932},"2013: ",[933],{"type":810},{"text":769,"type":347},{"text":936,"type":347,"marks":937},"Measurement and Monitoring of Safety Framework (MMSF)",[938],{"type":724,"attrs":939},{"href":775,"uuid":53,"anchor":53,"custom":53,"target":727,"linktype":728},{"text":941,"type":347}," catalyzed a major change in the way safety is defined and practiced. Created by Charles Vincent and colleagues at The Health Foundation, the MMSF presented an approach for shifting away from focusing on the absence of harm towards adopting a broader view of safety.",{"type":15,"attrs":943,"content":944},{"textAlign":53},[945,949,956],{"text":946,"type":347,"marks":947},"2015: ",[948],{"type":810},{"text":950,"type":347,"marks":951},"Beyond the Quick Fix: Strategies for Improving Patient Safety",[952,955],{"type":724,"attrs":953},{"href":954,"uuid":53,"anchor":53,"custom":53,"target":727,"linktype":728},"https://tspace.library.utoronto.ca/handle/1807/80119?mode=full",{"type":386},{"text":957,"type":347}," published by the Institute of Health Policy, Management and Evaluation at the University of Toronto concluded that despite the growing understanding of the safety threats and efforts made to identify safety practices, there is still effort needed to broaden and link efforts to improve care and care environments.",{"type":15,"attrs":959,"content":960},{"textAlign":53},[961,965,967,973],{"text":962,"type":347,"marks":963},"2016: ",[964],{"type":810},{"text":966,"type":347},"The Canadian Institute for Health Information (CIHI) releases the ",{"text":968,"type":347,"marks":969},"Hospital Harm Indicator",[970],{"type":724,"attrs":971},{"href":972,"uuid":53,"anchor":53,"custom":53,"target":727,"linktype":728},"https://www.cihi.ca/en/indicators/hospital-harm",{"text":974,"type":347},". This indicator measures the rate of acute care hospitalizations with at least one occurrence of unintended harm during a hospital stay that could potentially have been prevented.",{"type":15,"attrs":976,"content":977},{"textAlign":53},[978,982],{"text":979,"type":347,"marks":980},"2017: ",[981],{"type":810},{"text":983,"type":347},"The Canadian Patient Safety Institute (CPSI), now Healthcare Excellence Canada, began working with healthcare teams from across the country to advance our knowledge and experience of the MMSF in Canada.",{"type":15,"attrs":985,"content":986},{"textAlign":53},[987,991,993,1002],{"text":988,"type":347,"marks":989},"2023: ",[990],{"type":810},{"text":992,"type":347},"Healthcare Excellence Canada and Patients for Patient Safety Canada released ",{"text":994,"type":347,"marks":995},"Rethinking Patient Safety: A Discussion Guide for Patients, Healthcare Providers and Leaders",[996,1001],{"type":724,"attrs":997},{"href":998,"uuid":818,"anchor":53,"custom":999,"target":747,"linktype":420,"story":1000},"/resources/rethinking-patient-safety-discussion-guide",{},{"name":800,"id":821,"uuid":818,"slug":822,"url":819,"full_slug":819,"_stopResolving":291},{"type":386},{"text":1003,"type":347}," which summarizes learnings and ideas suggesting a new way of approaching patient safety.",{"type":390,"attrs":1005,"content":1007},{"level":706,"textAlign":1006},"left",[1008,1014],{"text":1009,"type":347,"marks":1010},"Measurement and Monitoring of Safety Framework",[1011],{"type":1012,"attrs":1013},"textStyle",{"color":16},{"text":1015,"type":347,"marks":1016}," ",[1017],{"type":810},{"type":15,"attrs":1019,"content":1020},{"textAlign":1006},[1021,1025,1032,1037,1043,1048],{"text":769,"type":347,"marks":1022},[1023],{"type":1012,"attrs":1024},{"color":16},{"text":1026,"type":347,"marks":1027},"Measurement and Monitoring Safety Framework (MMSF) in 2013",[1028,1030],{"type":724,"attrs":1029},{"href":775,"uuid":53,"anchor":53,"custom":53,"target":727,"linktype":728},{"type":1012,"attrs":1031},{"color":16},{"text":1033,"type":347,"marks":1034}," catalyzed a major change in the way safety is defined and practiced and has informed and influenced Heathcare Excellence Canada’s approach. Created by Professor Charles Vincent and colleagues at ",[1035],{"type":1012,"attrs":1036},{"color":16},{"text":779,"type":347,"marks":1038},[1039,1041],{"type":724,"attrs":1040},{"href":783,"uuid":53,"anchor":53,"custom":53,"target":727,"linktype":728},{"type":1012,"attrs":1042},{"color":16},{"text":1044,"type":347,"marks":1045},", the MMSF proposed shifting away from focusing on the absence of harm towards adopting a broader view of safety. This new view examined the sources of resilience and capabilities that enable safe care and endorsed a less reactive approach to improving safety. ",[1046],{"type":1012,"attrs":1047},{"color":16},{"text":1015,"type":347},{"type":15,"attrs":1050,"content":1051},{"textAlign":1006},[1052,1057],{"text":1053,"type":347,"marks":1054},"The MMSF offers many advantages when it comes to how we think about safety. It:   ",[1055],{"type":1012,"attrs":1056},{"color":16},{"text":1015,"type":347},{"type":528,"content":1059},[1060,1071,1082,1093,1104,1115,1126,1137,1148,1159,1170],{"type":449,"content":1061},[1062],{"type":15,"attrs":1063,"content":1064},{"textAlign":53},[1065,1070],{"text":1066,"type":347,"marks":1067},"creates a more holistic view of safety. ",[1068],{"type":1012,"attrs":1069},{"color":16},{"text":1015,"type":347},{"type":449,"content":1072},[1073],{"type":15,"attrs":1074,"content":1075},{"textAlign":53},[1076,1081],{"text":1077,"type":347,"marks":1078},"changes our safety focus – moving away from a focus on past harm. ",[1079],{"type":1012,"attrs":1080},{"color":16},{"text":1015,"type":347},{"type":449,"content":1083},[1084],{"type":15,"attrs":1085,"content":1086},{"textAlign":53},[1087,1092],{"text":1088,"type":347,"marks":1089},"provides a shared and consistent understanding of safety. ",[1090],{"type":1012,"attrs":1091},{"color":16},{"text":1015,"type":347},{"type":449,"content":1094},[1095],{"type":15,"attrs":1096,"content":1097},{"textAlign":53},[1098,1103],{"text":1099,"type":347,"marks":1100},"changes the way we think about safety. ",[1101],{"type":1012,"attrs":1102},{"color":16},{"text":1015,"type":347},{"type":449,"content":1105},[1106],{"type":15,"attrs":1107,"content":1108},{"textAlign":53},[1109,1114],{"text":1110,"type":347,"marks":1111},"helps us move away from managing risk to managing safety. ",[1112],{"type":1012,"attrs":1113},{"color":16},{"text":1015,"type":347},{"type":449,"content":1116},[1117],{"type":15,"attrs":1118,"content":1119},{"textAlign":53},[1120,1125],{"text":1121,"type":347,"marks":1122},"moves us from assurance and accountability reporting to a \"practice of inquiry.\" ",[1123],{"type":1012,"attrs":1124},{"color":16},{"text":1015,"type":347},{"type":449,"content":1127},[1128],{"type":15,"attrs":1129,"content":1130},{"textAlign":53},[1131,1136],{"text":1132,"type":347,"marks":1133},"empowers everyone to take a proactive role in safety. ",[1134],{"type":1012,"attrs":1135},{"color":16},{"text":1015,"type":347},{"type":449,"content":1138},[1139],{"type":15,"attrs":1140,"content":1141},{"textAlign":53},[1142,1147],{"text":1143,"type":347,"marks":1144},"promotes a culture of collective responsibility for safety. ",[1145],{"type":1012,"attrs":1146},{"color":16},{"text":1015,"type":347},{"type":449,"content":1149},[1150],{"type":15,"attrs":1151,"content":1152},{"textAlign":53},[1153,1158],{"text":1154,"type":347,"marks":1155},"promotes an understanding that staff and patient safety go hand in hand. ",[1156],{"type":1012,"attrs":1157},{"color":16},{"text":1015,"type":347},{"type":449,"content":1160},[1161],{"type":15,"attrs":1162,"content":1163},{"textAlign":53},[1164,1169],{"text":1165,"type":347,"marks":1166},"places value on soft intelligence (e.g. listening, observing and perceiving).   ",[1167],{"type":1012,"attrs":1168},{"color":16},{"text":1015,"type":347},{"type":449,"content":1171},[1172],{"type":15,"attrs":1173,"content":1174},{"textAlign":53},[1175,1180],{"text":1176,"type":347,"marks":1177},"recognizes the value that patients and caregivers have in creating safety. ",[1178],{"type":1012,"attrs":1179},{"color":16},{"text":1015,"type":347},{"type":390,"attrs":1182,"content":1183},{"level":392,"textAlign":1006},[1184],{"text":1185,"type":347,"marks":1186},"How it works ",[1187],{"type":1012,"attrs":1188},{"color":16},{"type":15,"attrs":1190,"content":1191},{"textAlign":1006},[1192],{"text":1193,"type":347,"marks":1194},"MMSF is made up of five dimensions that healthcare leaders, providers, patients and families can use to understand and improve patient safety. The framework assesses and evaluates safety from \"ward to board\" by providing a comprehensive and accurate real-time view of patient safety. It helps users move from \"assurance\" to \"inquiry\" by shifting away from a focus on past cases of harm towards current performance, future risks and organizational resiliency.   ",[1195],{"type":1012,"attrs":1196},{"color":16},{"_uid":1198,"items":1199,"component":596},"87523179-6e6d-461e-8d4c-92d66373e0c8",[1200],{"_uid":1201,"image":1202,"quote":1204,"author":1211,"component":594,"author_title":1212},"6520e012-4669-4bad-8caf-73e926b50727",{"id":53,"alt":53,"name":16,"focus":53,"title":53,"source":53,"filename":16,"copyright":53,"fieldtype":283,"meta_data":1203},{},{"type":12,"content":1205},[1206],{"type":15,"attrs":1207,"content":1208},{"textAlign":53},[1209],{"text":1210,"type":347},"\"The framework for the Measurement and Monitoring of Safety helps people rethink their understanding of safety in their own clinical environment,\" says Dr. Baker. \"What we saw during the demonstration project is that staff were really engaged by this idea that they can have an active role in promoting and maintaining safety.\"","Dr. G. Ross Baker","PhD, Professor, Institute of Health Policy Management and Evaluation, University of Toronto  ",{"id":16,"_uid":1214,"content":1215,"component":425},"42e298e1-7e88-40aa-91c6-245a3ed1ca70",[1216,1225],{"_uid":1217,"content":1218,"component":411},"d168f704-36b1-4cd9-8443-6345f345c66d",{"type":12,"content":1219},[1220],{"type":15,"attrs":1221,"content":1222},{"textAlign":53},[1223],{"text":1224,"type":347},"Armed with a series of valuable questions, you can make better decisions about the safety of the care you provide. The primary questions are:",{"_uid":1226,"image":1227,"component":1232},"18e48b18-8da1-4d06-b18d-c7af91deabf7",{"id":1228,"alt":1229,"name":16,"focus":16,"title":16,"source":16,"filename":1230,"copyright":16,"fieldtype":283,"meta_data":1231,"is_external_url":285},114300191903786,"A diagram consisting of one dark grey circle in the centre with the text, “Safety measurement and monitoring,” surrounding by five petal-shape objects in various colours connected by a larger circle outline, containing the text “Past harm: Has patient care been safe in the past?” “Reliability: Are our clinical systems and processes reliable?” “Sensitivity to operations: Is care safe today?” “Anticipation and preparedness: Will care be safe in the future?” and “Integration and learning: Are we responding and improving?”","https://a-ca.storyblok.com/f/850807391887861/0a134b9440/2022-safetymeasurementandmonitoring-en.png",{"alt":1229,"title":16,"source":16,"copyright":16},"simple-image",{"_uid":1234,"content":1235,"component":425},"3c630d12-c036-408c-9b4d-93e05a5c5afc",[1236],{"_uid":1237,"content":1238,"component":411},"91fa781f-844d-4361-add1-e2d1cf1aea6b",{"type":12,"content":1239},[1240,1245,1250,1255,1260,1265,1271,1297,1302,1307,1319,1323],{"type":390,"attrs":1241,"content":1242},{"level":392,"textAlign":53},[1243],{"text":1244,"type":347},"Applying the framework in Canada",{"type":15,"attrs":1246,"content":1247},{"textAlign":53},[1248],{"text":1249,"type":347},"In 2017, the Canadian Patient Safety Institute (which amalgamated with the Canadian Foundation for Healthcare Improvement to form Healthcare Excellence Canada in 2021), began working with healthcare teams from across the country to advance our knowledge and experience of the MMSF in Canada. Following a successful demonstration project led by Dr. G. Ross Baker at the University of Toronto, a subsequent learning collaborative was launched in 2018 with 11 teams from seven provinces. With expert faculty and mentoring over 18 months, each team used the MMSF to develop a more comprehensive approach to delivering safer care.",{"type":15,"attrs":1251,"content":1252},{"textAlign":53},[1253],{"text":1254,"type":347},"An evaluation in 2020 concluded that the collaborative successfully built the capacity of teams to understand and implement the MMSF in their local settings. Participants reported positive impacts on stakeholder groups' knowledge and behaviours, healthcare processes and patient outcomes.",{"type":15,"attrs":1256,"content":1257},{"textAlign":53},[1258],{"text":1259,"type":347},"\"We started out in the safety world really worrying about past harm and I think that was really important because it raised peoples' understanding about the magnitude of the safety issues. But it is insufficient because people don't go to work thinking about past incidents; they go to work thinking about the patients they are going to see today. So that is part of the shift now is that we are putting safety into a much more relevant context for the staff on their units doing their daily jobs. I think we can still build on that. We can build a broader sense of how units function, and how units interact with other units.\"",{"type":15,"attrs":1261,"content":1262},{"textAlign":53},[1263],{"text":1264,"type":347},"- Dr. G. Ross Baker, PhD, Professor, Institute of Health Policy Management and Evaluation, University of Toronto",{"type":390,"attrs":1266,"content":1268},{"level":1267,"textAlign":53},4,[1269],{"text":1270,"type":347},"Learn more:",{"type":528,"content":1272},[1273,1285],{"type":449,"content":1274},[1275],{"type":15,"attrs":1276,"content":1277},{"textAlign":53},[1278],{"text":1279,"type":347,"marks":1280},"Measurement and Monitoring of Safety Framework: a qualitative study of implementation through a Canadian learning collaborative | BMJ Quality & Safety",[1281],{"type":724,"attrs":1282},{"href":1283,"uuid":53,"anchor":53,"custom":1284,"target":727,"linktype":728},"https://qualitysafety.bmj.com/content/32/8/470",{},{"type":449,"content":1286},[1287],{"type":15,"attrs":1288,"content":1289},{"textAlign":53},[1290],{"text":1291,"type":347,"marks":1292},"Measurement and Monitoring of Safety Framework (MMSF): learning from its implementation in Canada | BMJ Quality & Safety",[1293],{"type":724,"attrs":1294},{"href":1295,"uuid":53,"anchor":53,"custom":1296,"target":727,"linktype":728},"https://qualitysafety.bmj.com/content/32/8/441",{},{"type":390,"attrs":1298,"content":1299},{"level":392,"textAlign":53},[1300],{"text":1301,"type":347},"Measuring and monitoring safety: A patient and care partner perspective",{"type":15,"attrs":1303,"content":1304},{"textAlign":53},[1305],{"text":1306,"type":347},"The evaluation showed that the MMSF improved safety practices and was well-received by frontline teams, senior leaders and board members. Limited attention, however, had been paid to how patients engage with this wider view of safety.",{"type":15,"attrs":1308,"content":1309},{"textAlign":53},[1310,1312,1317],{"text":1311,"type":347},"The release of ",{"text":846,"type":347,"marks":1313},[1314,1316],{"type":724,"attrs":1315},{"href":843,"uuid":53,"anchor":53,"custom":53,"target":727,"linktype":728},{"type":386},{"text":1318,"type":347}," provides important insights into how patients and their care partners see safety. The report offers guidance on how to effectively engage patients and care partners in all aspects of measurement and monitoring of safety and provides recommendations outlining how to strengthen provider and patient partnerships in support of safer care.",{"type":390,"attrs":1320,"content":1321},{"level":1267,"textAlign":53},[1322],{"text":1270,"type":347},{"type":528,"content":1324},[1325,1336],{"type":449,"content":1326},[1327],{"type":15,"attrs":1328,"content":1329},{"textAlign":53},[1330],{"text":1331,"type":347,"marks":1332},"‘Safety is about partnership’: Safety through the lens of patients and caregivers",[1333],{"type":724,"attrs":1334},{"href":1335,"uuid":53,"anchor":53,"custom":53,"target":727,"linktype":728},"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.13939",{"type":449,"content":1337},[1338],{"type":15,"attrs":1339,"content":1340},{"textAlign":53},[1341],{"text":1342,"type":347,"marks":1343},"Reconceptualizing Patient Safety Beyond Harm: Insights From a Mixed-Methods Qualitative Inquiry",[1344],{"type":724,"attrs":1345},{"href":1346,"uuid":53,"anchor":53,"custom":53,"target":727,"linktype":728},"https://journals.lww.com/jncqjournal/abstract/9900/reconceptualizing_patient_safety_beyond_harm_.122.aspx",{"id":16,"_uid":1348,"items":1349,"title":1476,"component":1477,"description":1478},"f9756087-feb3-444a-979e-dd64fde0e851",[1350,1371,1386,1461],{"_uid":1351,"title":1352,"ctaLeft":1353,"ctaRight":1354,"component":1355,"columnLeft":1356,"columnRight":1359},"29dbd715-39cd-4bf0-a9d8-53b7b6777bf5","Executive summary",[],[],"accordion-item-columns",{"type":12,"content":1357},[1358],{"type":15},{"type":12,"content":1360},[1361,1366],{"type":15,"attrs":1362,"content":1363},{"textAlign":53},[1364],{"text":1365,"type":347},"The Measurement and Monitoring of Safety Framework (MMSF) consists of five dimensions, and a series of prompting key questions, that guide users to comprehensively and conceptually view safety. These five dimensions and related questions address: past harm, reliability, sensitivity to operations, anticipation and preparedness, and integration and learning. ",{"type":15,"attrs":1367,"content":1368},{"textAlign":1006},[1369],{"text":1370,"type":347},"In October 2018, the Canadian Patient Safety Institute (CPSI), now Healthcare Excellence Canada, launched a patient safety improvement project under the leadership of Maryanne D'Arpino of CPSI (Executive Lead) and Dr. G. Ross Baker at the University of Toronto (Academic Lead). This program, a learning collaborative with expert faculty and mentorship, aimed to enable the implementation of the MMSF amongst 11 teams from seven provinces across Canada over an 18-month period with the aim of each team developing a more comprehensive approach to safety and the delivery of safer care. This report presents findings from an evaluation study funded by CPSI that aimed to examine the effectiveness of this Collaborative.",{"_uid":1372,"title":1373,"ctaLeft":1374,"ctaRight":1375,"component":1355,"columnLeft":1376,"columnRight":1379},"d9f19cdb-2f20-42bf-bb33-a6da9cd5aecf","Methods",[],[],{"type":12,"content":1377},[1378],{"type":15},{"type":12,"content":1380},[1381],{"type":15,"attrs":1382,"content":1383},{"textAlign":53},[1384],{"text":1385,"type":347},"This study used a qualitative approach based on interview, observation and documentary data collection methods. In-depth semi-structured interviews were conducted with team members. One-day site visit observations were conducted at five sites; observations of learning sessions were conducted and relevant documents were collected. Thirty-six team members participated in the interviews. A total of 29 hours was spent at site visits; in addition to approximately 33 hours in learning session 3, the closing congress and all-team virtual meetings. ",{"_uid":1387,"title":1388,"ctaLeft":1389,"ctaRight":1390,"component":1355,"columnLeft":1391,"columnRight":1394},"ed56d671-ca2b-4a1c-b2e9-6fa064be6608","Key findings",[],[],{"type":12,"content":1392},[1393],{"type":15},{"type":12,"content":1395},[1396],{"type":528,"content":1397},[1398,1405,1412,1419,1426,1433,1440,1447,1454],{"type":449,"content":1399},[1400],{"type":15,"attrs":1401,"content":1402},{"textAlign":53},[1403],{"text":1404,"type":347},"Overall participants provided positive feedback about the in-person learning sessions. They particularly valued the expert presenters, multifaceted approaches used to teach the MMSF, and the structure created for learning within and between participating teams. ",{"type":449,"content":1406},[1407],{"type":15,"attrs":1408,"content":1409},{"textAlign":53},[1410],{"text":1411,"type":347},"While some participants felt 'overwhelmed' at the amount of information in the first learning session, the majority felt positive about the framework from the outset. The first learning session set in place the need for a shift in thinking about safety from an absence of harm to presence of safety, to thinking about changing culture, and that it would take time to understand and implement the MMSF. ",{"type":449,"content":1413},[1414],{"type":15,"attrs":1415,"content":1416},{"textAlign":53},[1417],{"text":1418,"type":347},"The coaching by CPSI senior program managers played key roles in participants' understanding and implementation of the MMSF. The coaches were responsive and accessible between site visits. They provided ongoing education and support; and were instrumental in providing the feedback necessary for ongoing implementation of the MMSF. Some participants would have wanted more coaching and more clarity about coaching and team accountability expectations. ",{"type":449,"content":1420},[1421],{"type":15,"attrs":1422,"content":1423},{"textAlign":53},[1424],{"text":1425,"type":347},"Team members used a range of teaching strategies and methods to support the implementation of MMSF into practice. These included teaching about the framework to groups of stakeholders (e.g. healthcare providers and senior leadership). ",{"type":449,"content":1427},[1428],{"type":15,"attrs":1429,"content":1430},{"textAlign":53},[1431],{"text":1432,"type":347},"Quality improvement (QI) consultants, physicians and boards began teaching about the framework by integrating its language into day- to- day communication and using it to discuss specific safety or patient care issues. Team members made decisions about how to teach the framework to stakeholder groups, taking into consideration issues such as availability, number of people involved, professional roles and interest. There were different perceptions about the effectiveness of teaching the MMSF and whether it’s necessary to teach the framework itself or if it’s sufficient to teach and implement tools and processes informed by the framework. ",{"type":449,"content":1434},[1435],{"type":15,"attrs":1436,"content":1437},{"textAlign":53},[1438],{"text":1439,"type":347},"Teams were encouraged to focus on MMSF implementation strategies that were context specific and allowed for the integration of the framework into the daily clinical and administrative work of the units or targeted areas. Teams consequently used a variety of strategies. These included the use of the MMSF to inform the following processes and activities: safety huddles, health care processes, safety incidents and reports; meetings; communication; patient and family focused initiatives; and board and senior leadership level activities. Each strategy had success in targeting different stakeholders and effecting change in different ways. ",{"type":449,"content":1441},[1442],{"type":15,"attrs":1443,"content":1444},{"textAlign":53},[1445],{"text":1446,"type":347},"The MMSF teams consisted of individuals with varied professional backgrounds and roles at local, regional and provincial levels. This variability allowed for sharing of diverse perspectives and multiple avenues to teach, implement and spread the MMSF. However, variability in engagement with the collaborative and movement out and into the teams over the 18 months were challenges. A small number of teams had patient, family and board representation who were seen to bring valuable perspectives to the team and its work. Physicians were a more difficult group to engage. ",{"type":449,"content":1448},[1449],{"type":15,"attrs":1450,"content":1451},{"textAlign":53},[1452],{"text":1453,"type":347},"The majority of participants were supportive of wider spread of the MMSF yet there was variability in their opportunities for spread beyond their implementation site(s). While a small number remained focused at the original site of implementation, the other teams demonstrated varying levels of spread: unplanned spread; planned individual or team efforts which led to pockets of uptake in the organization or region; planned and coordinated widespread efforts to spread the MMSF across an organization and region. Challenges to spread included limited dedicated resources, uncertain authority to influence spread, the need for alignment with wider-level processes and frameworks and healthcare organizational and regional restructuring. ",{"type":449,"content":1455},[1456],{"type":15,"attrs":1457,"content":1458},{"textAlign":53},[1459],{"text":1460,"type":347},"The majority of participants reported positive impacts from MMSF implementation. These included changes in thinking about safety which impacted on behaviours and practices; healthcare staff engagement in prevention, identification and management of safety issues; patient, resident and family engagement in safety; and improvements in healthcare processes",{"_uid":1462,"title":1463,"ctaLeft":1464,"ctaRight":1465,"component":1355,"columnLeft":1466,"columnRight":1469},"0c8e5e08-02c5-49ca-a7ee-376109724f12","Conclusions and implications",[],[],{"type":12,"content":1467},[1468],{"type":15},{"type":12,"content":1470},[1471],{"type":15,"attrs":1472,"content":1473},{"textAlign":53},[1474],{"text":1475,"type":347},"The MMSF collaborative was successful in teaching the teams about the MMSF and coaching them to implement the framework in their local settings. Participants perceived the MMSF work as having positive impacts on stakeholder groups' knowledge and behaviours and on healthcare processes and patient outcomes. 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But finding innovative ways to work together will benefit everyone.",{"type":15,"attrs":1878,"content":1879},{"textAlign":53},[1880],{"text":1881,"type":347},"Engagement with patients and families includes:",{"type":528,"content":1883},[1884,1891,1898],{"type":449,"content":1885},[1886],{"type":15,"attrs":1887,"content":1888},{"textAlign":53},[1889],{"text":1890,"type":347},"Program and service design and delivery",{"type":449,"content":1892},[1893],{"type":15,"attrs":1894,"content":1895},{"textAlign":53},[1896],{"text":1897,"type":347},"Monitoring, evaluating, policy and priority setting",{"type":449,"content":1899},[1900],{"type":15,"attrs":1901,"content":1902},{"textAlign":53},[1903],{"text":1904,"type":347},"Governance",{"type":15,"attrs":1906,"content":1907},{"textAlign":53},[1908],{"text":1909,"type":347},"Providers, patients and leaders all have a role to play.",{"type":15,"attrs":1911,"content":1912},{"textAlign":53},[1913],{"text":1914,"type":347},"Providers may need to let go of control, change behaviours to actively listen to what patients are saying and take additional time to understand the patient perspective. They’ll also need more effective ways to brainstorm ideas together, build trust and incorporate different perspectives.",{"type":15,"attrs":1916,"content":1917},{"textAlign":53},[1918],{"text":1919,"type":347},"Patients need to be encouraged to participate more actively in decisions about their care.",{"type":15,"attrs":1921,"content":1922},{"textAlign":53},[1923],{"text":1924,"type":347},"Leaders must support all of this work by revising their practices to embed patient engagement in their procedures, policies and structures.",{"type":15,"attrs":1926,"content":1927},{"textAlign":53},[1928],{"text":1929,"type":347},"We invite you to join us in advancing patient safety through patient and family engagement.",{"_uid":1931,"content":1932,"component":411},"a9684446-7c7f-48ab-9cf5-527fac055163",{"type":12,"content":1933},[1934,1939,1944,1949,1954,1959,1996,2001,2006,2011,2062],{"type":15,"attrs":1935,"content":1936},{"textAlign":53},[1937],{"text":1938,"type":347},"We update this resource regularly. To ensure you are accessing the most up-to-date version, we recommend that you bookmark this page for future reference.",{"type":390,"attrs":1940,"content":1941},{"level":706,"textAlign":53},[1942],{"text":1943,"type":347},"What is the purpose of the guide?",{"type":15,"attrs":1945,"content":1946},{"textAlign":53},[1947],{"text":1948,"type":347},"The purpose of this guide is to help patients and families, providers and leaders work more effectively together to improve patient safety. The guide is an extensive resource that is based on evidence and leading practices.",{"type":390,"attrs":1950,"content":1951},{"level":706,"textAlign":53},[1952],{"text":1953,"type":347},"Who is this guide for?",{"type":15,"attrs":1955,"content":1956},{"textAlign":53},[1957],{"text":1958,"type":347},"This guide is for anyone involved with patient safety and interested in engagement, including:",{"type":528,"content":1960},[1961,1968,1975,1982,1989],{"type":449,"content":1962},[1963],{"type":15,"attrs":1964,"content":1965},{"textAlign":53},[1966],{"text":1967,"type":347},"Patients and families interested in how to partner in their own care to ensure safety",{"type":449,"content":1969},[1970],{"type":15,"attrs":1971,"content":1972},{"textAlign":53},[1973],{"text":1974,"type":347},"Patient partners interested in how to help improve patient safety",{"type":449,"content":1976},[1977],{"type":15,"attrs":1978,"content":1979},{"textAlign":53},[1980],{"text":1981,"type":347},"Providers interested in creating collaborative care relationships with patients and families",{"type":449,"content":1983},[1984],{"type":15,"attrs":1985,"content":1986},{"textAlign":53},[1987],{"text":1988,"type":347},"Managers and leaders responsible for patient engagement, patient safety and/or quality improvement",{"type":449,"content":1990},[1991],{"type":15,"attrs":1992,"content":1993},{"textAlign":53},[1994],{"text":1995,"type":347},"Anyone interested in partnering with patients to develop care programs and systems.",{"type":15,"attrs":1997,"content":1998},{"textAlign":53},[1999],{"text":2000,"type":347},"While the guide focuses primarily on patient safety, many engagement practices apply to other areas, including quality, research and education. The guide is designed to support patient engagement across the healthcare sector.",{"type":390,"attrs":2002,"content":2003},{"level":706,"textAlign":53},[2004],{"text":2005,"type":347},"What is included in the guide?",{"type":15,"attrs":2007,"content":2008},{"textAlign":53},[2009],{"text":2010,"type":347},"In this guide you will find:",{"type":528,"content":2012},[2013,2020,2027,2034,2041,2048,2055],{"type":449,"content":2014},[2015],{"type":15,"attrs":2016,"content":2017},{"textAlign":53},[2018],{"text":2019,"type":347},"Evidence-based guidance",{"type":449,"content":2021},[2022],{"type":15,"attrs":2023,"content":2024},{"textAlign":53},[2025],{"text":2026,"type":347},"Practical patient engagement practices",{"type":449,"content":2028},[2029],{"type":15,"attrs":2030,"content":2031},{"textAlign":53},[2032],{"text":2033,"type":347},"Consolidated information, resources and tools",{"type":449,"content":2035},[2036],{"type":15,"attrs":2037,"content":2038},{"textAlign":53},[2039],{"text":2040,"type":347},"Supporting evidence and examples from across Canada",{"type":449,"content":2042},[2043],{"type":15,"attrs":2044,"content":2045},{"textAlign":53},[2046],{"text":2047,"type":347},"Experiences from patients and families, providers and leaders",{"type":449,"content":2049},[2050],{"type":15,"attrs":2051,"content":2052},{"textAlign":53},[2053],{"text":2054,"type":347},"Probing questions about how to strengthen current approaches",{"type":449,"content":2056},[2057],{"type":15,"attrs":2058,"content":2059},{"textAlign":53},[2060],{"text":2061,"type":347},"Strategies and policies to meet standards and organizational practice requirements.",{"type":15,"attrs":2063,"content":2064},{"textAlign":53},[2065,2069,2071,2073,2076],{"text":2066,"type":347,"marks":2067},"Citation:",[2068],{"type":810},{"type":2070},"hard_break",{"text":2072,"type":347},"Patient Engagement Action Team. 2017.",{"text":1820,"type":347,"marks":2074},[2075],{"type":386},{"text":2077,"type":347},". HEC. Last modified December 2019.",{"_uid":2079,"file":2080,"link":2082,"label":1841,"linkType":423,"component":424,"linkLabel":16},"a3f2c980-14c0-4b6c-ad10-c391293bdd68",{"id":1837,"alt":1838,"name":16,"focus":16,"title":1838,"source":16,"filename":1839,"copyright":16,"fieldtype":283,"meta_data":2081,"is_external_url":285},{},{"id":16,"url":16,"linktype":420,"fieldtype":421,"cached_url":16},{"_uid":2084,"title":2085,"component":2086,"description":2087,"partners_list":2094},"e7bfa257-dd22-4b1a-9ebf-bbd8c17ff8dc","Partners","partners-list",{"type":12,"content":2088},[2089],{"type":15,"attrs":2090,"content":2091},{"textAlign":53},[2092],{"text":2093,"type":347},"Because of the key role accreditation plays in establishing patient engagement as a core feature of healthcare, the guide is closely aligned with the standards established by the Health Standards Organization (HSO)/Accreditation Canada. Throughout the guide, the HSO logo indicates the points of alignment.",[2095,2105,2114],{"_uid":2096,"link":2097,"image":2098,"component":2103,"partner_name":2104},"db49a4ff-6287-45da-a291-e7157a3e2bc6",[],{"id":2099,"alt":2100,"name":16,"focus":16,"title":2100,"source":16,"filename":2101,"copyright":16,"fieldtype":283,"meta_data":2102,"is_external_url":285},114299152314143,"Atlantic Collaborative Logo","https://a-ca.storyblok.com/f/850807391887861/c05f0ccb5b/atlantic-collaborative-logo.jpg",{},"partners-item","Atlantic Collaborative",{"_uid":2106,"link":2107,"image":2108,"component":2103,"partner_name":2113},"076872ad-9254-4a8d-b634-7a5b1b7f5e0c",[],{"id":2109,"alt":2110,"name":16,"focus":16,"title":2110,"source":16,"filename":2111,"copyright":16,"fieldtype":283,"meta_data":2112,"is_external_url":285},114299156221729,"Helth Quality Ontario Logo","https://a-ca.storyblok.com/f/850807391887861/8d747eae6e/helth-quality-ontario-logo.jpg",{},"Health Quality Ontario",{"_uid":2115,"link":2116,"image":2117,"component":2103,"partner_name":2122},"9580a49a-02f8-497e-af59-8ac30786c6d2",[],{"id":2118,"alt":2119,"name":16,"focus":16,"title":2119,"source":16,"filename":2120,"copyright":16,"fieldtype":283,"meta_data":2121,"is_external_url":285},114300519825531,"Pfpsc","https://a-ca.storyblok.com/f/850807391887861/87607b8c76/pfpsc.png",{},"Patients for Patient Safety Canada",{"id":2124,"_uid":2125,"content":2126,"component":425},"Glossary","1deae1cc-8408-44e6-9484-be902445a00e",[2127],{"_uid":2128,"content":2129,"component":411},"9bb6f300-25f7-4586-8d21-6b452e878d14",{"type":12,"content":2130},[2131,2136,2146,2155,2164,2173,2182,2191,2200,2223,2228,2254,2263,2272,2281,2290,2299,2306,2330,2346,2355,2364,2373,2396,2405,2414,2423,2431,2465,2478,2487,2544,2553,2562,2571,2578,2591,2604,2613,2622,2646,2659,2668,2673],{"type":390,"attrs":2132,"content":2133},{"level":706,"textAlign":53},[2134],{"text":2135,"type":347},"Glossary of Terms",{"type":15,"attrs":2137,"content":2138},{"textAlign":53},[2139,2141,2144],{"text":2140,"type":347},"This Glossary defines and describes the terms used in the ",{"text":1820,"type":347,"marks":2142},[2143],{"type":810},{"text":2145,"type":347},". When appropriate, use your organization's preferred or commonly used terms.",{"type":15,"attrs":2147,"content":2148},{"textAlign":53},[2149,2153],{"text":2150,"type":347,"marks":2151},"Accreditation: ",[2152],{"type":810},{"text":2154,"type":347},"A self-assessment and external peer assessment process used by health and social service organizations to accurately assess performance levels against established standards, and to implement ways to continuously improve.",{"type":15,"attrs":2156,"content":2157},{"textAlign":53},[2158,2162],{"text":2159,"type":347,"marks":2160},"Culture of safety: ",[2161],{"type":810},{"text":2163,"type":347},"Culture is \"the way we do things around here.\" Culture refers to people's shared values (what is important) and beliefs (what is held to be true), which interact with an organization's structure or system to produce behavioural norms (what people do).",{"type":15,"attrs":2165,"content":2166},{"textAlign":53},[2167,2171],{"text":2168,"type":347,"marks":2169},"Positive safety culture: ",[2170],{"type":810},{"text":2172,"type":347},"Communication is open and honest, there is mutual respect and trust among providers and patients, people are comfortable reporting safety concerns, and there are fair and just processes in place to examine, address, and learn from failures.",{"type":15,"attrs":2174,"content":2175},{"textAlign":53},[2176,2180],{"text":2177,"type":347,"marks":2178},"Disclosure: ",[2179],{"type":810},{"text":2181,"type":347},"A formal process to openly discuss a patient safety incident with the patient, their family, and members of the healthcare organization.",{"type":15,"attrs":2183,"content":2184},{"textAlign":53},[2185,2189],{"text":2186,"type":347,"marks":2187},"Engagement: ",[2188],{"type":810},{"text":2190,"type":347},"An approach to encourage the people most impacted to participate actively in defining their issues of concern, and help decide, plan, deliver, implement, evaluate, and improve initiatives, processes, and/or policies. Ongoing engagement involves developing and sustaining constructive relationships, building strong, active partnerships at various levels across the healthcare system, and holding a meaningful dialogue with partners. Types of engagement include surveys, consultations, and shared decision making, as described in the spectrum of engagement. Effective engagement is goal-focused, decision-oriented and values-based.",{"type":15,"attrs":2192,"content":2193},{"textAlign":53},[2194,2198],{"text":2195,"type":347,"marks":2196},"Patient engagement: ",[2197],{"type":810},{"text":2199,"type":347},"An approach to involve patients, families, and/or patient partners in:",{"type":528,"content":2201},[2202,2209,2216],{"type":449,"content":2203},[2204],{"type":15,"attrs":2205,"content":2206},{"textAlign":53},[2207],{"text":2208,"type":347},"Their own healthcare",{"type":449,"content":2210},[2211],{"type":15,"attrs":2212,"content":2213},{"textAlign":53},[2214],{"text":2215,"type":347},"The design, delivery, evaluation of health services",{"type":449,"content":2217},[2218],{"type":15,"attrs":2219,"content":2220},{"textAlign":53},[2221],{"text":2222,"type":347},"A way that fits their circumstances",{"type":15,"attrs":2224,"content":2225},{"textAlign":53},[2226],{"text":2227,"type":347},"Patients' experiential knowledge is recognized; and power is shared in ongoing, meaningful, constructive relationships at all system levels:",{"type":528,"content":2229},[2230,2240,2247],{"type":449,"content":2231},[2232],{"type":15,"attrs":2233,"content":2234},{"textAlign":53},[2235],{"text":2236,"type":347,"marks":2237},"Direct care",[2238],{"type":1012,"attrs":2239},{"color":16},{"type":449,"content":2241},[2242],{"type":15,"attrs":2243,"content":2244},{"textAlign":53},[2245],{"text":2246,"type":347},"Healthcare organization (service design, governance)",{"type":449,"content":2248},[2249],{"type":15,"attrs":2250,"content":2251},{"textAlign":53},[2252],{"text":2253,"type":347},"Health system (setting priorities and policies)",{"type":15,"attrs":2255,"content":2256},{"textAlign":53},[2257,2261],{"text":2258,"type":347,"marks":2259},"Public engagement: ",[2260],{"type":810},{"text":2262,"type":347},"involving the public/ citizens before or after they access the healthcare system (e.g. make healthy and informed decisions regarding care)",{"type":15,"attrs":2264,"content":2265},{"textAlign":53},[2266,2270],{"text":2267,"type":347,"marks":2268},"Spectrum (continuum, levels) of engagement: ",[2269],{"type":810},{"text":2271,"type":347},"The range of ways patient engagement takes place. It can span from input and consultation to shared leadership, accountability, and decision making.",{"type":15,"attrs":2273,"content":2274},{"textAlign":53},[2275,2279],{"text":2276,"type":347,"marks":2277},"Evaluation: ",[2278],{"type":810},{"text":2280,"type":347},"Collecting, analyzing, and using data and information to understand how a project, program, or policy is progressing and/or what is its impact on individuals, organizations, and/or society. Evaluation often measures success or importance in relation to goals, objectives, and needs.",{"type":15,"attrs":2282,"content":2283},{"textAlign":53},[2284,2288],{"text":2285,"type":347,"marks":2286},"Incident analysis (or root cause analysis): ",[2287],{"type":810},{"text":2289,"type":347},"Structured, rigorous, often legally-protected and confidential process to review a patient safety incident. It identifies what happened, how, why it happened, what can be done to reduce the risk of recurrence and make care safer, and what was learned. It examines the whole system of care to identify the factors that contributed to the patient safety incident.",{"type":15,"attrs":2291,"content":2292},{"textAlign":53},[2293,2297],{"text":2294,"type":347,"marks":2295},"Incident management: ",[2296],{"type":810},{"text":2298,"type":347},"Various actions and processes required immediately and on an ongoing basis following a patient safety incident. It includes immediate response, disclosure, incident analysis, sharing and learning.",{"type":15,"attrs":2300,"content":2301},{"textAlign":53},[2302],{"text":2303,"type":347,"marks":2304},"Patient and family:",[2305],{"type":810},{"type":528,"content":2307},[2308,2319],{"type":449,"content":2309},[2310],{"type":15,"attrs":2311,"content":2312},{"textAlign":53},[2313,2317],{"text":2314,"type":347,"marks":2315},"Patient",[2316],{"type":810},{"text":2318,"type":347},": Person who is receiving, has received, or has requested health services. It refers to all other terms for patient, including client, resident, person, and individual.",{"type":449,"content":2320},[2321],{"type":15,"attrs":2322,"content":2323},{"textAlign":53},[2324,2328],{"text":2325,"type":347,"marks":2326},"Family:",[2327],{"type":810},{"text":2329,"type":347},"Person(s) whom the patient wishes to be involved in their care, and act on their behalf or interests. Family is defined by the patient. This person speaks up on behalf of the patient with the patient's input.",{"type":15,"attrs":2331,"content":2332},{"textAlign":53},[2333,2337,2339,2344],{"text":2334,"type":347,"marks":2335},"Note: ",[2336],{"type":810},{"text":2338,"type":347},"because of the inconsistent terminology some use the term ",{"text":2340,"type":347,"marks":2341},"\"those most impacted",[2342,2343],{"type":810},{"type":386},{"text":2345,"type":347},"\" instead of patient.",{"type":15,"attrs":2347,"content":2348},{"textAlign":53},[2349,2353],{"text":2350,"type":347,"marks":2351},"Patient partner (or advisor)",[2352],{"type":810},{"text":2354,"type":347},": An individual who experienced care in the healthcare system (as a patient, family member or caregiver) and who, as part of a patient group (e.g., patient/family council), engages in shaping decisions, policies, and/or practices at all system levels.",{"type":15,"attrs":2356,"content":2357},{"textAlign":53},[2358,2362],{"text":2359,"type":347,"marks":2360},"Patient representative: ",[2361],{"type":810},{"text":2363,"type":347},"An employee working in a healthcare setting who helps patients and families with their specific concerns, and answers their questions while in a healthcare facility. This person is the link between patients/ families, and providers/ organization.",{"type":15,"attrs":2365,"content":2366},{"textAlign":53},[2367,2371],{"text":2368,"type":347,"marks":2369},"Person (Patient, family) Centred Care: ",[2370],{"type":810},{"text":2372,"type":347},"An approach to care where patients and healthcare professionals partner to:",{"type":528,"content":2374},[2375,2382,2389],{"type":449,"content":2376},[2377],{"type":15,"attrs":2378,"content":2379},{"textAlign":53},[2380],{"text":2381,"type":347},"Give patients a voice in the design and delivery of the care and services they receive",{"type":449,"content":2383},[2384],{"type":15,"attrs":2385,"content":2386},{"textAlign":53},[2387],{"text":2388,"type":347},"Allow patients to be proactive in their healthcare journey for better health outcome; and",{"type":449,"content":2390},[2391],{"type":15,"attrs":2392,"content":2393},{"textAlign":53},[2394],{"text":2395,"type":347},"Improve the experience of patients",{"type":15,"attrs":2397,"content":2398},{"textAlign":53},[2399,2403],{"text":2400,"type":347,"marks":2401},"People-centred care: ",[2402],{"type":810},{"text":2404,"type":347},"An approach to care that consciously adopts individuals', carers', families' and communities' perspectives as participants in, and beneficiaries of, trusted health systems that are organized around the comprehensive needs of people rather than individual diseases, and respects their preferences. People-centred care is broader than patient and person-centred care, encompassing not only clinical encounters, but also including attention to the health of people in their communities and their crucial role in shaping health policy and health services.",{"type":15,"attrs":2406,"content":2407},{"textAlign":53},[2408,2412],{"text":2409,"type":347,"marks":2410},"Patient empowerment (or activation): ",[2411],{"type":810},{"text":2413,"type":347},"Helping patients gain control over their own lives and increase their capacity to act on issues that they themselves define as important. Aspects of empowerment include self-efficacy, self-awareness, confidence, coping skills, and health literacy.",{"type":15,"attrs":2415,"content":2416},{"textAlign":53},[2417,2421],{"text":2418,"type":347,"marks":2419},"Patient experience: ",[2420],{"type":810},{"text":2422,"type":347},"The sum of all interactions, shaped by an organization's culture, that influence patient perceptions, across the continuum of care.",{"type":15,"attrs":2424,"content":2425},{"textAlign":53},[2426,2429],{"text":78,"type":347,"marks":2427},[2428],{"type":810},{"text":2430,"type":347},": The pursuit of the reduction and mitigation of unsafe acts within the health care system, as well as the use of best practices shown to lead to optimal patient outcomes. Patient safety is one of the dimensions of quality.",{"type":528,"content":2432},[2433,2444,2451,2458],{"type":449,"content":2434},[2435],{"type":15,"attrs":2436,"content":2437},{"textAlign":53},[2438,2442],{"text":2439,"type":347,"marks":2440},"Patient safety incident: ",[2441],{"type":810},{"text":2443,"type":347},"An event or circumstance which could have resulted, or did result, in unnecessary harm to a patient. It includes:",{"type":449,"content":2445},[2446],{"type":15,"attrs":2447,"content":2448},{"textAlign":53},[2449],{"text":2450,"type":347},"Near miss: A patient safety incident that did not reach the patient. 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Other terms sometimes still used to describe a harmful incident are: adverse event or critical incident.",{"type":528,"content":2466},[2467],{"type":449,"content":2468},[2469],{"type":15,"attrs":2470,"content":2471},{"textAlign":53},[2472,2476],{"text":2473,"type":347,"marks":2474},"Patient safety science: ",[2475],{"type":810},{"text":2477,"type":347},"Methods to acquire and apply safety knowledge to create highly reliable systems that approach \"fail-safe\" conditions (i.e., those in which the operator cannot perform the function improperly). Past effort has been directed toward developing defences, which are barriers that prevent an unsafe act from resulting in harm. 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The term does not include the family members providing care (family caregivers or care partners).",{"type":15,"attrs":2554,"content":2555},{"textAlign":53},[2556,2560],{"text":2557,"type":347,"marks":2558},"Quality of care: ",[2559],{"type":810},{"text":2561,"type":347},"The degree to which healthcare services produce the desired health outcomes and measure up to current evidence and knowledge. The attributes most often used to describe quality care are safe, patient-centred, accessible, appropriate, effective, efficient, and equitable. Each province or organization may have their own quality frameworks.",{"type":15,"attrs":2563,"content":2564},{"textAlign":53},[2565,2569],{"text":2566,"type":347,"marks":2567},"Quality Improvement: ",[2568],{"type":810},{"text":2570,"type":347},"A systematic approach to making changes that lead to better patient outcomes and stronger health system performance. It involves applying quality improvement science, which provides a robust structure, tools, and processes to assess and accelerate efforts for testing, implementing, and spreading good practices.",{"type":15,"attrs":2572,"content":2573},{"textAlign":53},[2574],{"text":2575,"type":347,"marks":2576},"Information",[2577],{"type":810},{"type":528,"content":2579},[2580],{"type":449,"content":2581},[2582],{"type":15,"attrs":2583,"content":2584},{"textAlign":53},[2585,2589],{"text":2586,"type":347,"marks":2587},"Qualitative information",[2588],{"type":810},{"text":2590,"type":347},": Descriptive information, such as patient stories, notes from interviews or focus group discussions, and observation notes. Qualitative information can be systematically analyzed to identify issues of interest.",{"type":528,"content":2592},[2593],{"type":449,"content":2594},[2595],{"type":15,"attrs":2596,"content":2597},{"textAlign":53},[2598,2602],{"text":2599,"type":347,"marks":2600},"Quantitative information",[2601],{"type":810},{"text":2603,"type":347},": Information that measures characteristics using a numeric value (e.g., gender, income, marital status, etc.). The numeric values can be statistically analyzed to identify issues of interest.",{"type":15,"attrs":2605,"content":2606},{"textAlign":53},[2607,2611],{"text":2608,"type":347,"marks":2609},"Stakeholder: ",[2610],{"type":810},{"text":2612,"type":347},"A person who has a vested interest in engagement outcomes and who could be affected by any decisions taken or changes made. Stakeholders could include: patients, families, caregivers, providers, administrative staff, suppliers, organizational partners, the community, the public and others.",{"type":15,"attrs":2614,"content":2615},{"textAlign":53},[2616,2620],{"text":2617,"type":347,"marks":2618},"System levels: ",[2619],{"type":810},{"text":2621,"type":347},"The healthcare system is comprised of many sub-systems operating at different levels (e.g., outside of the organization, within the organization and/or program level, at point of care) each with specific goals, resources (e.g., human, financial, equipment), and formal or informal processes.",{"type":528,"content":2623},[2624,2635],{"type":449,"content":2625},[2626],{"type":15,"attrs":2627,"content":2628},{"textAlign":53},[2629,2633],{"text":2630,"type":347,"marks":2631},"Point of care: ",[2632],{"type":810},{"text":2634,"type":347},"direct care (patient and family receiving care and providers and others who deliver care and services)",{"type":449,"content":2636},[2637],{"type":15,"attrs":2638,"content":2639},{"textAlign":53},[2640,2644],{"text":2641,"type":347,"marks":2642},"Organization: ",[2643],{"type":810},{"text":2645,"type":347},"program/ unit/service and facility/organization/ health region (service design and delivery, strategy, system planning, organizational design, governance)",{"type":528,"content":2647},[2648],{"type":449,"content":2649},[2650],{"type":15,"attrs":2651,"content":2652},{"textAlign":53},[2653,2657],{"text":2654,"type":347,"marks":2655},"System: ",[2656],{"type":810},{"text":2658,"type":347},"the sum of all the organizations, institutions, and resources that deliver health care services to meet the health needs of a target population (policy, planning, resourcing, research, education, accreditation)",{"type":15,"attrs":2660,"content":2661},{"textAlign":53},[2662,2666],{"text":2663,"type":347,"marks":2664},"Validated tool/survey/questionnaire: ",[2665],{"type":810},{"text":2667,"type":347},"A measurement tool that has been tested for reliability (produces consistent results) and validity (produces true results).",{"type":390,"attrs":2669,"content":2670},{"level":706,"textAlign":53},[2671],{"text":2672,"type":347},"References",{"type":528,"content":2674},[2675,2696,2703,2718,2733,2745,2752,2767,2782,2789],{"type":449,"content":2676},[2677],{"type":15,"attrs":2678,"content":2679},{"textAlign":53},[2680,2682,2694],{"text":2681,"type":347},"Healthcare Excellence Canada. ",{"text":2683,"type":347,"marks":2684},"Patient Safety and Incident Management Toolkit",[2685],{"type":724,"attrs":2686},{"href":2687,"uuid":2688,"anchor":53,"custom":2689,"target":747,"linktype":420,"story":2690},"/resources/patient-safety-and-incident-management-toolkit","a435d8be-066f-4225-b67f-87e078ea10e8",{},{"name":2683,"id":2691,"uuid":2688,"slug":2692,"url":2693,"full_slug":2693,"_stopResolving":291},113880277560800,"patient-safety-and-incident-management-toolkit","resources/patient-safety-and-incident-management-toolkit",{"text":2695,"type":347},". Glossary. 2015.",{"type":449,"content":2697},[2698],{"type":15,"attrs":2699,"content":2700},{"textAlign":53},[2701],{"text":2702,"type":347},"Carman KL, Dardess P, Maurer M, Sofaer S, Adams K, Bechtel C, Sweeney J. Patient and family engagement: a framework for understanding the elements and developing interventions and policies. Health Aff (Millwood). 2013 Feb;32(2):223-31",{"type":449,"content":2704},[2705],{"type":15,"attrs":2706,"content":2707},{"textAlign":53},[2708,2710,2716],{"text":2709,"type":347},"Charles Vincent, René Amalberti. Safer Healthcare. ",{"text":2711,"type":347,"marks":2712},"Strategies for the Real World",[2713],{"type":724,"attrs":2714},{"href":2715,"uuid":53,"anchor":53,"custom":53,"target":727,"linktype":728},"https://link.springer.com/book/10.1007/978-3-319-25559-0",{"text":2717,"type":347},". Springer, Cham. 2016.",{"type":449,"content":2719},[2720],{"type":15,"attrs":2721,"content":2722},{"textAlign":53},[2723,2725,2731],{"text":2724,"type":347},"Emanuel LL, Taylor L, Hain A, Combes JR, Hatlie MJ, Karsh B, Lau DT, Shalowitz J, Shaw T, Walton M, eds. ",{"text":2726,"type":347,"marks":2727},"The Patient Safety Education Program – Canada (PSEP – Canada) Curriculum",[2728],{"type":724,"attrs":2729},{"href":2730,"uuid":53,"anchor":53,"custom":53,"target":727,"linktype":728},"https://era.library.ualberta.ca/items/1f8210e1-d99b-47a2-ada3-4df6e8e4c4eb",{"text":2732,"type":347},". © PSEP – Canada, 2016.",{"type":449,"content":2734},[2735],{"type":15,"attrs":2736,"content":2737},{"textAlign":53},[2738,2740],{"text":2739,"type":347},"European Patients Forum. Patient Empowerment: ",{"text":2741,"type":347,"marks":2742},"https://www.eu-patient.eu/policy/Policy/patient-empowerment/",[2743],{"type":724,"attrs":2744},{"href":2741,"uuid":53,"anchor":53,"custom":53,"target":727,"linktype":728},{"type":449,"content":2746},[2747],{"type":15,"attrs":2748,"content":2749},{"textAlign":53},[2750],{"text":2751,"type":347},"Health Quality Council of Alberta. The Alberta Quality Matrix for Health.",{"type":449,"content":2753},[2754],{"type":15,"attrs":2755,"content":2756},{"textAlign":53},[2757,2759,2765],{"text":2758,"type":347},"Health Quality Ontario. ",{"text":2760,"type":347,"marks":2761},"Quality Matters: Realizing Excellent Care for All",[2762],{"type":724,"attrs":2763},{"href":2764,"uuid":53,"anchor":53,"custom":53,"target":727,"linktype":728},"http://www.hqontario.ca/Portals/0/documents/health-quality/realizing-excellent-care-for-all-en.pdf",{"text":2766,"type":347},". 2015.",{"type":449,"content":2768},[2769],{"type":15,"attrs":2770,"content":2771},{"textAlign":53},[2772,2774,2780],{"text":2773,"type":347},"Institute for Patient- and Family-Centered Care. ",{"text":2775,"type":347,"marks":2776},"What is patient and family centred care",[2777],{"type":724,"attrs":2778},{"href":2779,"uuid":53,"anchor":53,"custom":53,"target":727,"linktype":728},"http://www.ipfcc.org/about/pfcc.html",{"text":2781,"type":347},".",{"type":449,"content":2783},[2784],{"type":15,"attrs":2785,"content":2786},{"textAlign":53},[2787],{"text":2788,"type":347},"The Beryl Institute. Defining Patient Experience.",{"type":449,"content":2790},[2791],{"type":15,"attrs":2792,"content":2793},{"textAlign":53},[2794,2796,2800,2802,2807],{"text":2795,"type":347},"World Health Organization Secretariat. ",{"text":2797,"type":347,"marks":2798},"Framework on Integrated, People-Centred Health Services",[2799],{"type":386},{"text":2801,"type":347},". World Health Organization; 2016. 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resource?",{"type":15,"attrs":3453,"content":3454},{"textAlign":53},[3455],{"text":3456,"type":347},"An expert panel consisting of parents and multi-disciplinary providers created the Severe Illness Getting Noticed Sooner (SIGNS)-for-Kids as a public health tool to help parents and caregivers identify and articulate the manifestations of severe illness in children.",{"type":15,"attrs":3458,"content":3459},{"textAlign":53},[3460],{"text":3461,"type":347},"We would like to acknowledge the contributions of the expert panel members of the SIGNS for Kids Consortium:",{"type":15,"attrs":3463,"content":3464},{"textAlign":53},[3465],{"text":3466,"type":347},"Christopher Parshuram MB.ChB, D.Phil., Kristen Middaugh RN, BScN, Dawn Hartfield BSc Med, MPH, MD, FRCPC , Joelle Fawcett-Arsenault PHEc (parent representative), Melissa Jones BA MA (parent representative), Gregory Moore MD, MSt (c), FRCPC, Karen Dryden-Palmer MSN, RN, Simran Singh RN, BScN, ENC, Ann Bayliss MD, FRCPC, David Bayfield 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