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Every person in Canada deserves safe, high-quality healthcare when and where they need it. For the most part, this is our experience.",{"type":15,"attrs":316,"content":317},{"textAlign":53},[318],{"text":319,"type":309},"But we don't always get it right. People may be inadvertently harmed by the services intended to help them.",{"type":321,"content":322},"bullet_list",[323,331,338],{"type":324,"content":325},"list_item",[326],{"type":15,"attrs":327,"content":328},{"textAlign":53},[329],{"text":330,"type":309},"The reality is that unintended harm occurs in a Canadian hospital or home care setting every minute and 18 seconds.",{"type":324,"content":332},[333],{"type":15,"attrs":334,"content":335},{"textAlign":53},[336],{"text":337,"type":309},"Every 13 minutes and 14 seconds, someone dies.",{"type":324,"content":339},[340],{"type":15,"attrs":341,"content":342},{"textAlign":53},[343],{"text":344,"type":309},"Patient safety incidents are the third leading cause of death in Canada.",{"type":15,"attrs":346,"content":347},{"textAlign":53},[348],{"text":349,"type":309},"We observe substantial variation in care by age, gender, race, ethnicity, geography, and socio-economic status. Systemic barriers make accessing high-quality health services more difficult for First Nations, Inuit and Métis, Black communities, racialized and newcomer populations, 2SLGBTQIA+ people, persons with disabilities, those with low income, and many others who face intersecting forms of marginalization. While some jurisdictions have quality and safety plans or frameworks in place, people continue to experience healthcare differently across the country.",{"type":15,"attrs":351,"content":352},{"textAlign":53},[353],{"text":354,"type":309},"These considerations, when added to the heightened need for consistency and coordination in healthcare as a result of the COVID-19 pandemic, prompt us to ask: How can we focus and align quality and safety improvement throughout the country, regardless of jurisdiction?",{"type":303,"attrs":356,"content":357},{"level":305,"textAlign":53},[358],{"text":359,"type":309},"The Framework is the first of its kind in Canada",{"type":15,"attrs":361,"content":362},{"textAlign":53},[363],{"text":364,"type":309},"We can all work together to accelerate quality and patient safety across health systems in Canada by focusing all stakeholders coast to coast on five goals for safe, quality care.",{"type":15,"attrs":366,"content":367},{"textAlign":53},[368],{"text":369,"type":309},"This people-centred framework defines five goal areas designed to drive improvement and to align Canadian legislation, regulations, standards, organizational policies and public engagement on patient safety and quality improvement.",{"type":15,"attrs":371,"content":372},{"textAlign":53},[373],{"text":374,"type":309},"It includes action guides and resources customized for each stakeholder group to support you in putting the goals into practice.","simple-richtext",{"_uid":377,"file":378,"link":383,"label":386,"linkType":387,"component":388,"linkLabel":389},"e7445f83-6b7e-41ad-ae5c-4cae725b62a3",{"id":379,"alt":380,"name":16,"focus":16,"title":380,"source":16,"filename":381,"copyright":16,"fieldtype":290,"meta_data":382,"is_external_url":277},114291353933708,"CPSI 10001 CQPS Framework English FA Online FINAL Ua","https://a-ca.storyblok.com/f/850807391887861/beda9f909b/cpsi-10001-cqps-framework-english-fa-online-final-ua.pdf",{},{"id":16,"url":16,"linktype":384,"fieldtype":385,"cached_url":16},"story","multilink","National Quality and Patient Safety Framework for Health Services","file","banner-link","Download",{"_uid":391,"content":392,"component":375},"1cc5dd82-2290-448d-a570-3a8de8cb8596",{"type":12,"content":393},[394,399,415,420],{"type":303,"attrs":395,"content":396},{"level":305,"textAlign":53},[397],{"text":398,"type":309},"Share your experience",{"type":15,"attrs":400,"content":401},{"textAlign":53},[402,404,413],{"text":403,"type":309},"How have you used the Canadian Quality and Patient Safety Framework to drive quality and safety improvements? Please email ",{"text":405,"type":309,"marks":406},"leadingpractices@healthstandards.org",[407],{"type":408,"attrs":409},"link",{"href":405,"uuid":53,"anchor":53,"custom":410,"target":411,"linktype":412},{},"_blank","email",{"text":414,"type":309}," and share your experience with us for an opportunity to be profiled as a leading practice or a case study.",{"type":303,"attrs":416,"content":417},{"level":305,"textAlign":53},[418],{"text":419,"type":309},"Mapping tool",{"type":15,"attrs":421,"content":422},{"textAlign":53},[423],{"text":424,"type":309},"A mapping tool was developed to help you map your organization's current quality and patient safety improvement initiatives to the goals, objectives and outcomes of the Framework. 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The Framework's ultimate aims are: Improving key quality and safety areas, reducing unwarranted care variation, strengthening high-quality health services that improve patient experience and outcomes.","https://a-ca.storyblok.com/f/850807391887861/3a709b9c7c/five-goals-to-align-cqps-improvement.png",{"alt":438,"title":16,"source":16,"copyright":16},"simple-image","wysiwyg-program",{"id":16,"_uid":444,"title":445,"columns":446,"component":586,"description":587},"d93232b0-5920-4467-8aaa-f2cabbc309ab","Why do we need a framework?",[447,473,505],{"_uid":448,"image":449,"title":451,"content":452,"component":472},"8dc6c6ec-ca3b-4eb8-91e1-878518f784e6",{"id":53,"alt":53,"name":16,"focus":53,"title":53,"source":53,"filename":16,"copyright":53,"fieldtype":290,"meta_data":450},{},"Developed with broad consultation, including with patients and families",[453,467],{"_uid":454,"content":455,"component":375},"da1b6f89-24a9-4289-8ffc-ce59c4b506e3",{"type":12,"content":456},[457,462],{"type":15,"attrs":458,"content":459},{"textAlign":53},[460],{"text":461,"type":309},"The Framework was developed in consultation with members of the public, health leaders, policy makers, board members and health teams (including patients and families). The processes also included numerous committee meetings, international and national environmental scans, key stakeholder interviews, a national public consultation and further targeted consultations with key stakeholder groups.",{"type":15,"attrs":463,"content":464},{"textAlign":53},[465],{"text":466,"type":309},"This comprehensive approach was prioritized to ensure the Framework package reflects both current and emerging trends and the realities of health systems across Canada, regardless of jurisdiction. The accompanying action guides, resources and indicators are curated implementation tools to support all stakeholders with using and implementing the Framework package, regardless of their role or care.",{"_uid":468,"file":469,"component":471},"d5a0bf4f-6124-4306-b50a-f6046782b2be",{"id":379,"alt":380,"name":16,"focus":16,"title":380,"source":16,"filename":381,"copyright":16,"fieldtype":290,"meta_data":470,"is_external_url":277},{},"simple-file-only","wysiwyg-column",{"_uid":474,"image":475,"title":477,"content":478,"component":472},"f0008be9-2ce5-4b31-b34a-1f421d98b64d",{"id":53,"alt":53,"name":16,"focus":53,"title":53,"source":53,"filename":16,"copyright":53,"fieldtype":290,"meta_data":476},{},"Highlights of the Canadian Quality and Patient Safety Framework evaluation",[479,498],{"_uid":480,"content":481,"component":375},"ed8cce08-8808-4688-a1d7-7a5dade6c109",{"type":12,"content":482},[483,488,493],{"type":15,"attrs":484,"content":485},{"textAlign":53},[486],{"text":487,"type":309},"Everyone in Canada deserves safe, high-quality healthcare where and when they need it. Yet inequities and systemic barriers mean that access to this fundamental right is not the same for all. These considerations prompted Healthcare Excellence Canada (HEC) and Health Standards Organization (HSO) to ask: “how can we focus and align quality and safety improvement throughout the country, regardless of jurisdiction?”",{"type":15,"attrs":489,"content":490},{"textAlign":53},[491],{"text":492,"type":309},"The Canadian Quality and Patient Safety Framework for Health Services is the first of its kind in Canada. 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",{"type":303,"attrs":545,"content":546},{"level":517,"textAlign":53},[547],{"text":548,"type":309},"Goal 3: Accessible care",{"type":321,"content":550},[551],{"type":324,"content":552},[553],{"type":15,"attrs":554,"content":555},{"textAlign":53},[556],{"text":557,"type":309},"People have timely and equitable access to quality health services.",{"type":303,"attrs":559,"content":560},{"level":517,"textAlign":53},[561],{"text":562,"type":309},"Goal 4: Appropriate care",{"type":321,"content":564},[565],{"type":324,"content":566},[567],{"type":15,"attrs":568,"content":569},{"textAlign":53},[570],{"text":571,"type":309},"Care is evidence-based and people-centred.",{"type":303,"attrs":573,"content":574},{"level":517,"textAlign":53},[575],{"text":576,"type":309},"Goal 5: Integrated care",{"type":321,"content":578},[579],{"type":324,"content":580},[581],{"type":15,"attrs":582,"content":583},{"textAlign":53},[584],{"text":585,"type":309},"Health services are continuous and well-coordinated, promoting smooth transitions.","wysiwyg-double-column",{"type":12,"content":588},[589,594,607,626],{"type":15,"attrs":590,"content":591},{"textAlign":53},[592],{"text":593,"type":309},"To truly align efforts across Canada toward better and safer care we must prioritize coordinated action. Collective action across jurisdictions in Canada is needed now more than ever before. The Canadian Quality & Patient Safety Framework (the Framework) is the roadmap that can align the country as we work to safely enhance health services. It is already being used in many jurisdictions at different levels.",{"type":15,"attrs":595,"content":596},{"textAlign":53},[597,605],{"text":598,"type":309,"marks":599},"Read case studies",[600],{"type":408,"attrs":601},{"href":602,"uuid":53,"anchor":53,"custom":603,"target":411,"linktype":604},"https://healthstandards.org/patient-safety-in-action-new-case-studies/",{},"url",{"text":606,"type":309}," to learn how organizations have been using the framework to improve patient safety in their organizations.",{"type":15,"attrs":608,"content":609},{"textAlign":53},[610,615,622],{"text":611,"type":309,"marks":612},"For any questions, comments or to share your experience using the Framework, please contact ",[613],{"type":614},"italic",{"text":616,"type":309,"marks":617},"qualityservicesforall@healthstandards.org",[618,621],{"type":408,"attrs":619},{"href":616,"uuid":53,"anchor":53,"custom":620,"target":411,"linktype":412},{},{"type":614},{"text":623,"type":309,"marks":624},".",[625],{"type":614},{"type":15,"attrs":627},{"textAlign":53},{"id":16,"_uid":629,"content":630,"component":442},"db71f955-42e9-4db6-b82f-89a18e37addc",[631,650,658],{"_uid":632,"content":633,"component":375},"2252b45f-91c9-46f3-b508-c073105ef5e7",{"type":12,"content":634},[635,645],{"type":303,"attrs":636,"content":638},{"level":637,"textAlign":53},3,[639],{"text":640,"type":309,"marks":641},"How you can use The Canadian Quality & Patient Safety Framework for Health Services",[642],{"type":643,"attrs":644},"textStyle",{"color":16},{"type":15,"attrs":646,"content":647},{"textAlign":53},[648],{"text":649,"type":309},"We all have different roles to play in healthcare in Canada. Along with members of the public, health teams (including patients), health leaders, board members and policy makers, this Framework outlines the essential role of families, caregivers and care partners in enabling quality health services and patient safety.",{"_uid":651,"file":652,"link":654,"label":656,"linkType":408,"component":388,"linkLabel":657},"98a69a2c-7135-4e50-9907-0d36660fc681",{"id":53,"alt":53,"name":16,"focus":53,"title":53,"source":53,"filename":16,"copyright":53,"fieldtype":290,"meta_data":653},{},{"id":16,"url":655,"target":411,"linktype":604,"fieldtype":385,"cached_url":655},"https://a-ca.storyblok.com/f/850807391887861/beda9f909b/cpsi-10001-cqps-framework-english-fa-online-final-ua.pdf#page=13","Action Guides","Download the guides",{"_uid":659,"content":660,"component":375},"a0c576aa-fd7e-49f4-bb4b-a350608796e9",{"type":12,"content":661},[662,667],{"type":15,"attrs":663,"content":664},{"textAlign":53},[665],{"text":666,"type":309},"The Framework provides custom action guides to 5 stakeholder groups.",{"type":321,"content":668},[669,680,691,705,716],{"type":324,"content":670},[671],{"type":15,"attrs":672,"content":673},{"textAlign":53},[674],{"text":675,"type":309,"marks":676},"Public action guide Public",[677],{"type":408,"attrs":678},{"href":679,"uuid":53,"anchor":53,"custom":53,"target":411,"linktype":604},"https://a-ca.storyblok.com/f/850807391887861/beda9f909b/cpsi-10001-cqps-framework-english-fa-online-final-ua.pdf#page=15",{"type":324,"content":681},[682],{"type":15,"attrs":683,"content":684},{"textAlign":53},[685],{"text":686,"type":309,"marks":687},"Health Teams",[688],{"type":408,"attrs":689},{"href":690,"uuid":53,"anchor":53,"custom":53,"target":411,"linktype":604},"https://a-ca.storyblok.com/f/850807391887861/beda9f909b/cpsi-10001-cqps-framework-english-fa-online-final-ua.pdf#page=20",{"type":324,"content":692},[693],{"type":15,"attrs":694,"content":695},{"textAlign":53},[696],{"text":697,"type":309,"marks":698},"Health Leaders",[699,703],{"type":408,"attrs":700},{"href":701,"uuid":53,"anchor":53,"custom":702,"target":411,"linktype":290},"https://a-ca.storyblok.com/f/850807391887861/beda9f909b/cpsi-10001-cqps-framework-english-fa-online-final-ua.pdf#page=29",{},{"type":704},"underline",{"type":324,"content":706},[707],{"type":15,"attrs":708,"content":709},{"textAlign":53},[710],{"text":711,"type":309,"marks":712},"Board Members",[713],{"type":408,"attrs":714},{"href":715,"uuid":53,"anchor":53,"custom":53,"target":411,"linktype":604},"https://a-ca.storyblok.com/f/850807391887861/beda9f909b/cpsi-10001-cqps-framework-english-fa-online-final-ua.pdf#page=38",{"type":324,"content":717},[718],{"type":15,"attrs":719,"content":720},{"textAlign":53},[721],{"text":722,"type":309,"marks":723},"Policy Makers",[724],{"type":408,"attrs":725},{"href":726,"uuid":53,"anchor":53,"custom":53,"target":411,"linktype":604},"https://a-ca.storyblok.com/f/850807391887861/beda9f909b/cpsi-10001-cqps-framework-english-fa-online-final-ua.pdf#page=45",{"id":16,"_uid":728,"title":729,"columns":730,"component":586,"description":823},"9f7b8dfa-5096-4808-be2f-be953c7e6bdb","Tracking Your Success",[731,793],{"_uid":732,"image":733,"title":735,"content":736,"component":472},"6057db20-4b79-4be9-9d85-4c4ddc7f414b",{"id":53,"alt":53,"name":16,"focus":53,"title":53,"source":53,"filename":16,"copyright":53,"fieldtype":290,"meta_data":734},{},"Key Indicators to track your progress",[737],{"_uid":738,"content":739,"component":375},"3ce3ea89-5e93-4402-b67a-200d569808ec",{"type":12,"content":740},[741,746,751,788],{"type":15,"attrs":742,"content":743},{"textAlign":53},[744],{"text":745,"type":309},"The Canadian Quality and Patient Safety Framework package includes key indicators to help you track progress towards improving quality and patient safety. The indicators should help you create appropriate performance measures for each objective. Each indicator‒when measured using a national, jurisdictional, or local data source‒will offer insight into your success in improving quality and patient safety.",{"type":15,"attrs":747,"content":748},{"textAlign":53},[749],{"text":750,"type":309},"We aimed to create an indicator set that is both comprehensive and practical. Each indicator was selected based on:",{"type":321,"content":752},[753,760,767,774,781],{"type":324,"content":754},[755],{"type":15,"attrs":756,"content":757},{"textAlign":53},[758],{"text":759,"type":309},"Its relevance to the objective.",{"type":324,"content":761},[762],{"type":15,"attrs":763,"content":764},{"textAlign":53},[765],{"text":766,"type":309},"How comprehensively it reflects the objective.",{"type":324,"content":768},[769],{"type":15,"attrs":770,"content":771},{"textAlign":53},[772],{"text":773,"type":309},"The existence of data sources that can be used to measure the indicator.",{"type":324,"content":775},[776],{"type":15,"attrs":777,"content":778},{"textAlign":53},[779],{"text":780,"type":309},"The adaptability of the indicator to various local contexts.",{"type":324,"content":782},[783],{"type":15,"attrs":784,"content":785},{"textAlign":53},[786],{"text":787,"type":309},"The availability of national data to facilitate interjurisdictional comparisons.",{"type":15,"attrs":789,"content":790},{"textAlign":53},[791],{"text":792,"type":309},"We also strived to keep the total number of recommended indicators low. In total, the Framework contains 18 indicators across 13 objectives. In most cases, an objective can be tracked by a single indicator.",{"_uid":794,"image":795,"title":797,"content":798,"component":472},"907f429d-ee22-4e34-9127-98fa9126678c",{"id":53,"alt":53,"name":16,"focus":53,"title":53,"source":53,"filename":16,"copyright":53,"fieldtype":290,"meta_data":796},{},"Measuring your success",[799],{"_uid":800,"content":801,"component":375},"7b1e4704-7c0f-437c-8a1b-20a78fad700a",{"type":12,"content":802},[803,808,813,818],{"type":15,"attrs":804,"content":805},{"textAlign":53},[806],{"text":807,"type":309},"The indicators should help you create appropriate performance measures for each objective. Each indicator‒when measured using a national, jurisdictional, or local data source‒will offer insight into your success in improving quality and patient safety.",{"type":15,"attrs":809,"content":810},{"textAlign":53},[811],{"text":812,"type":309},"The indicators are not required to be measured using a specific data source. You should identify data sources for each indicator that are suitable to your context. We have, however, identified example data sources you can use as a guide in developing your own measures and for cross-jurisdictional comparisons. We encourage you to build measures for indicators with data that best represent your own context and jurisdiction.",{"type":15,"attrs":814,"content":815},{"textAlign":53},[816],{"text":817,"type":309},"As you measure the indicators, we encourage you to look for ways to compare results across various sociodemographic and geographic groups‒including underserved populations. These comparisons can help you see whether objectives are being met equitably across these sub-groups. Some of the indicators are worded in a way that encourages these comparisons. You should look for ways to measure equity wherever possible.",{"type":15,"attrs":819,"content":820},{"textAlign":53},[821],{"text":822,"type":309},"Finally, this set of indicators, along with the example data sources, is intended to be a ‘living document.’ Some sectors, such as the acute care sector, are better represented by currently available data and‒as a result‒better represented in our recommended data sources. 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Equity in Access to Palliative Care Collaborative Evaluation Framework","2025-11-18T19:00:40.709Z","2026-02-23T18:47:17.300Z","2026-02-23T18:47:17.333Z",113880435613191,{"new":277,"seo":916,"_uid":918,"hero":919,"type":174,"topics":934,"Noindex":277,"content":935,"audience":1053,"duration":16,"regional":1054,"component":850},{"title":910,"plugin":280,"description":917},"This framework provides a flexible roadmap for evaluating initiatives aimed at improving access to equity-oriented palliative care.","8d1424b2-b70c-4edb-95a9-2754cc3796f4",[920],{"_uid":921,"file":922,"image":931,"title":910,"format":16,"component":292,"description":917,"key_learning":16,"prerequisite":16},"f9352e9c-c500-493d-8b6e-29edb8eb0820",[923],{"_uid":924,"file":925,"label":910,"component":930},"a30643d9-7684-4371-b787-c8531dcee997",{"id":926,"alt":927,"name":16,"focus":16,"title":927,"source":16,"filename":928,"copyright":16,"fieldtype":290,"meta_data":929,"is_external_url":277},114292606814367,"IEAPC Evaluation Framework English WEB Final Ver 3","https://a-ca.storyblok.com/f/850807391887861/e763804b85/ieapc-evaluation-framework-english-web-final-ver-3.pdf",{},"simple-file",{"id":932,"filename":933,"fieldtype":290},114297456569708,"https://a-ca.storyblok.com/f/850807391887861/084049412e/general-image-three.jpg",[91,46,62],[936],{"_uid":937,"content":938,"component":442},"05dbd818-73d3-4225-88be-5bf792261e71",[939,995,1048],{"_uid":940,"content":941,"component":375},"be7519cd-e21a-46b0-8b9e-1d322d8054eb",{"type":12,"content":942},[943,948,953,990],{"type":15,"attrs":944,"content":945},{"textAlign":53},[946],{"text":947,"type":309},"The Improving Equity in Access to Palliative Care Evaluation Framework is a flexible roadmap for evaluating initiatives to improve access to equity-oriented palliative care.",{"type":15,"attrs":949,"content":950},{"textAlign":53},[951],{"text":952,"type":309},"The framework uses a decolonized approach to evaluating programs. Culture and context guide the evaluation’s key questions, design, data collection, analysis and knowledge sharing. This means valuing all data sources equally, including:",{"type":321,"content":954},[955,962,969,976,983],{"type":324,"content":956},[957],{"type":15,"attrs":958,"content":959},{"textAlign":53},[960],{"text":961,"type":309},"Qualitative methods",{"type":324,"content":963},[964],{"type":15,"attrs":965,"content":966},{"textAlign":53},[967],{"text":968,"type":309},"Quantitative methods",{"type":324,"content":970},[971],{"type":15,"attrs":972,"content":973},{"textAlign":53},[974],{"text":975,"type":309},"Indigenous knowledge translation",{"type":324,"content":977},[978],{"type":15,"attrs":979,"content":980},{"textAlign":53},[981],{"text":982,"type":309},"Expressive arts",{"type":324,"content":984},[985],{"type":15,"attrs":986,"content":987},{"textAlign":53},[988],{"text":989,"type":309},"The use of metaphors",{"type":15,"attrs":991,"content":992},{"textAlign":53},[993],{"text":994,"type":309},"The framework provides sample measures and examples of how to evaluate programs aimed at improving access to equity-oriented palliative care.",{"_uid":996,"content":997,"component":375},"6da5c57b-5ea9-4ded-8c3f-80a5224d18ea",{"type":12,"content":998},[999,1004,1009,1014,1030,1035],{"type":15,"attrs":1000,"content":1001},{"textAlign":53},[1002],{"text":1003,"type":309},"Decolonization is the process of returning power to Indigenous Peoples, supporting self-determination and self-governance and respecting nation-to-nation governance. In a program evaluation context, decolonization means confronting and challenging colonial evaluation practices and reflecting on the structure of evaluation (questions, design, data collection, analysis, knowledge sharing) and how project teams will tell the story.",{"type":15,"attrs":1005,"content":1006},{"textAlign":53},[1007],{"text":1008,"type":309},"Decolonization in program evaluation also includes recognizing Indigenous data sovereignty as a cornerstone of cultural resurgence and nation (re)building, which involves collecting data and using it with the intent to benefit First Nations, Inuit and Métis Peoples, families and communities. An urgent priority of decolonization is to eliminate discrimination and racism (includes anti-Indigenous racism) in the healthcare system and its effects on people experiencing homelessness or vulnerable housing.",{"type":303,"attrs":1010,"content":1011},{"level":305,"textAlign":53},[1012],{"text":1013,"type":309},"Who this framework is for",{"type":15,"attrs":1015,"content":1016},{"textAlign":53},[1017,1019,1028],{"text":1018,"type":309},"This framework was created to support organizations participating in the ",{"text":1020,"type":309,"marks":1021},"Improving Equity in Access to Palliative Care",[1022],{"type":408,"attrs":1023},{"href":1024,"uuid":1025,"anchor":53,"custom":1026,"target":1027,"linktype":384},"/programs/improving-equity-in-access-to-palliative-care","a57a448f-4a8b-4c06-b2ad-a5872f325f97",{},"_self",{"text":1029,"type":309}," collaborative to evaluate their initiatives. 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",{"type":12,"content":1100},[1101,1106],{"type":15,"attrs":1102,"content":1103},{"textAlign":53},[1104],{"text":1105,"type":309},"Eight key actions offer a shared pathway for advancing equity in healthcare:",{"type":1107,"attrs":1108,"content":1110},"ordered_list",{"order":1109},1,[1111,1118,1125,1132,1139,1146,1153,1160],{"type":324,"content":1112},[1113],{"type":15,"attrs":1114,"content":1115},{"textAlign":53},[1116],{"text":1117,"type":309},"Build a more inclusive organization",{"type":324,"content":1119},[1120],{"type":15,"attrs":1121,"content":1122},{"textAlign":53},[1123],{"text":1124,"type":309},"Collect and use equity-focused data",{"type":324,"content":1126},[1127],{"type":15,"attrs":1128,"content":1129},{"textAlign":53},[1130],{"text":1131,"type":309},"Equip team members with critical skills",{"type":324,"content":1133},[1134],{"type":15,"attrs":1135,"content":1136},{"textAlign":53},[1137],{"text":1138,"type":309},"Practice ongoing and responsive accountability",{"type":324,"content":1140},[1141],{"type":15,"attrs":1142,"content":1143},{"textAlign":53},[1144],{"text":1145,"type":309},"Co-develop services to meet community needs",{"type":324,"content":1147},[1148],{"type":15,"attrs":1149,"content":1150},{"textAlign":53},[1151],{"text":1152,"type":309},"Improve how services are delivered",{"type":324,"content":1154},[1155],{"type":15,"attrs":1156,"content":1157},{"textAlign":53},[1158],{"text":1159,"type":309},"Catalyze equitable policy",{"type":324,"content":1161},[1162],{"type":15,"attrs":1163,"content":1164},{"textAlign":53},[1165],{"text":1166,"type":309},"Shift power and create space for communities to lead",{"type":12,"content":1168},[1169],{"type":15},[46,76,91],[1172,1249,1338,1421,1476,1535,1566],{"id":16,"_uid":1173,"content":1174,"component":442},"8fda2d3d-96d8-4fef-9eee-db6fb38c0230",[1175,1219,1227,1234],{"_uid":1176,"content":1177,"component":375},"f5b55a36-d8c1-4932-bead-c600916cba07",{"type":12,"content":1178},[1179,1184,1189,1194],{"type":303,"attrs":1180,"content":1181},{"level":305,"textAlign":53},[1182],{"text":1183,"type":309},"Overview",{"type":15,"attrs":1185,"content":1186},{"textAlign":53},[1187],{"text":1188,"type":309},"Healthcare Excellence Canada (HEC) is committed to building a future where everyone has access to safe and high-quality healthcare. Achieving this vision requires confronting deep-rooted causes and systemic barriers that lead to inequities in healthcare services, quality and health outcomes.",{"type":15,"attrs":1190,"content":1191},{"textAlign":53},[1192],{"text":1193,"type":309},"Health equity means everyone can reach their full health potential, regardless of their identity or social circumstances. Yet, healthcare systems can reinforce inequities through outdated policies and practices, bias, stigma and stereotypes. Addressing these challenges requires deeper understanding of the interconnections between patient safety, equity, and patient experiences, and collaboration with the health, social and community care sectors.",{"type":15,"attrs":1195,"content":1196},{"textAlign":53},[1197,1199,1207,1209,1217],{"text":1198,"type":309},"The Health Equity Framework reaffirms our commitment to ",{"text":1200,"type":309,"marks":1201},"culturally safe and equitable care",[1202],{"type":408,"attrs":1203},{"href":1204,"uuid":1205,"anchor":53,"custom":1206,"target":1027,"linktype":384},"/about-us/our-strategy","11dc12df-642c-41f2-8ded-5fc599e84e2f",{},{"text":1208,"type":309},", and offers a roadmap for action. 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Here’s how it came together:",{"type":321,"content":1442},[1443,1450,1457,1464],{"type":324,"content":1444},[1445],{"type":15,"attrs":1446,"content":1447},{"textAlign":53},[1448],{"text":1449,"type":309},"HEC formed an advisory group to explore equity, diversity and inclusion in healthcare. This group met over the course of several months to review research, identify equity-focused innovations and provide guidance on organizing the framework’s key themes.",{"type":324,"content":1451},[1452],{"type":15,"attrs":1453,"content":1454},{"textAlign":53},[1455],{"text":1456,"type":309},"A larger group of partners gathered in Tkaronto to refine the framework and discuss how to put its eight actions into practice. 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Improving safety requires an organizational culture that enables and prioritizes patient safety. The importance of culture change needs to be brought to the forefront, rather than taking a back seat to other safety activities.",{"type":15,"attrs":1932,"content":1933},{"textAlign":53},[1934],{"text":1935,"type":309},"The National Patient Safety Consortium Education Working Group verified the critical role senior leadership plays in ensuring patient safety is an organizational priority. A working group of partners, led by the Canadian Patient Safety Institute (now Healthcare Excellence Canada), Canadian College of Health Leaders (CCHL), HealthCareCAN and the Healthcare Insurance Reciprocal of Canada (HIROC), joined together to establish a framework and advance this work.",{"type":303,"attrs":1937,"content":1938},{"level":305,"textAlign":53},[1939],{"text":1940,"type":309},"Testimonials",{"type":15,"attrs":1942,"content":1943},{"textAlign":53},[1944],{"text":1945,"type":309},"\"Patient safety and healthcare quality are advanced when boards and senior leaders are committed to it and are able to show evidence of that commitment. Missing until now is a concise \"how to\" guide. The Patient Safety bundle for Leaders fills that gap.\"",{"type":15,"attrs":1947,"content":1948},{"textAlign":53},[1949,1953],{"text":1950,"type":309,"marks":1951},"Catherine Gaulton",[1952],{"type":1337},{"text":1954,"type":309},", CEO, HIROC",{"type":15,"attrs":1956,"content":1957},{"textAlign":53},[1958],{"text":1959,"type":309,"marks":1960},"\"Leadership is critical to developing a patient safety culture and building leadership capacity requires a vision of the knowledge, skills and behaviours necessary to achieve this. The Patient Safety Leadership Bundle provides this and will be a practical tool for health leaders across the healthcare continuum to assess their personal capabilities. It will also provide both organizations and the system, as a whole, a checklist for what's missing from our collective leadership education toolkits so that we can strategically respond to these needs. HealthCareCAN is committed to the spread of this tool across the country as part of a cultural shift to safety and a drive towards high-reliability culture.\"",[1961],{"type":614},{"type":15,"attrs":1963,"content":1964},{"textAlign":53},[1965,1969,1971,1975,1977],{"text":1966,"type":309,"marks":1967},"Dale Schierbeck",[1968],{"type":1337},{"text":1970,"type":309},", Vice-President, Learning & Development, HealthCare",{"text":1972,"type":309,"marks":1973},"CAN",[1974],{"type":614},{"type":1976},"hard_break",{"text":1978,"type":309,"marks":1979},"and Co-Chair, Patient Safety Education for Leaders Working",[1980],{"type":614},{"type":15,"attrs":1982,"content":1983},{"textAlign":53},[1984],{"text":1985,"type":309},"\"The drive to quality and patient safety must start at the top with the board of directors – they are a critical enabler of culture change. It has been well-recognized that taking a passive role in this fundamental responsibility is not an option. Governors need insight into best practice principles and a corresponding framework to help guide them in this important task – this bundle delivers that.\"",{"type":15,"attrs":1987,"content":1988},{"textAlign":53},[1989,1993,1995,1996],{"text":1990,"type":309,"marks":1991},"Elizabeth Martin",[1992],{"type":1337},{"text":1994,"type":309},", Board Chair, HIROC;",{"type":1976},{"text":1997,"type":309},"former Board member, Sunnybrook Health Sciences Centre",{"type":15,"attrs":1999,"content":2000},{"textAlign":53},[2001],{"text":2002,"type":309,"marks":2003},"\"Preventable harm must remain a focus for all Boards as they consider their organization's commitment to the people they care for. The depth of information and insight contained within the Patient Safety Culture Bundle will assist all leaders, boards and organizations to fully appreciate the importance culture plays in achieving these goals. Armed with this knowledge, the dedicated people within healthcare organizations can be supported to deliver consistently safe care.\"",[2004],{"type":614},{"type":15,"attrs":2006,"content":2007},{"textAlign":53},[2008,2012,2014,2015],{"text":2009,"type":309,"marks":2010},"Ruthe Anne Conyngham",[2011],{"type":1337},{"text":2013,"type":309},", Faculty, Canadian Patient Safety Institute;",{"type":1976},{"text":2016,"type":309},"Member, Cancer Quality Council of Ontario",{"type":15,"attrs":2018,"content":2019},{"textAlign":53},[2020],{"text":2021,"type":309,"marks":2022},"\"For years, senior leaders have promoted the use of checklists to support evidence-informed clinical practice. Now leaders have their own checklist to support a safety culture. The Patient Safety Leadership Bundle will be an invaluable resource to help leaders walk the talk and lead by example\"",[2023],{"type":614},{"type":15,"attrs":2025,"content":2026},{"textAlign":53},[2027,2031,2033,2034],{"text":2028,"type":309,"marks":2029},"Maura Davies",[2030],{"type":1337},{"text":2032,"type":309},", Former President and CEO, Saskatoon Health Region;",{"type":1976},{"text":2035,"type":309},"President, Maura Davies Healthcare Consulting Inc.",{"type":15,"attrs":2037,"content":2038},{"textAlign":53},[2039],{"text":2040,"type":309,"marks":2041},"\"The patient safety and quality culture bundle is a key resource that provides useful guidance for senior leaders on the critical knowledge and actions needed to support improvements in safety culture and outcomes.\"",[2042],{"type":614},{"type":15,"attrs":2044,"content":2045},{"textAlign":53},[2046,2050,2052,2053,2055,2056,2058,2059],{"text":2047,"type":309,"marks":2048},"Ross Baker",[2049],{"type":1337},{"text":2051,"type":309},", Ph.D., Professor and Program Lead, Quality Improvement and Patient Safety,",{"type":1976},{"text":2054,"type":309},"Institute of Health Policy, Management and Evaluation,",{"type":1976},{"text":2057,"type":309},"Dalla Lana School of Public Health,",{"type":1976},{"text":2060,"type":309},"University of Toronto",{"type":15,"attrs":2062,"content":2063},{"textAlign":53},[2064],{"text":2065,"type":309,"marks":2066},"\"One of many actions resulting from the work of National Patient Safety Consortium is the Safety Bundle for Leaders/CEOs, which demonstrates the critical role senior leadership plays in ensuring patient safety is an organizational priority. The Safety Bundle will help identify the best practices, skills, tools and resources healthcare leaders can deploy to advance patient safety and facilitate the spread of this knowledge within their organizations.\"",[2067],{"type":614},{"type":15,"attrs":2069,"content":2070},{"textAlign":53},[2071,2075],{"text":2072,"type":309,"marks":2073},"Chris Power",[2074],{"type":1337},{"text":2076,"type":309},", Chief Executive Officer, Canadian Patient Safety Institute",{"type":15,"attrs":2078,"content":2079},{"textAlign":53},[2080],{"text":2081,"type":309,"marks":2082},"\"The Board is ultimately accountable for the performance of the organization. The \"Patient Safety Culture Bundle\" is an excellent resource to assist the Board in improving organizational culture and advancing its patient safety agenda.\"",[2083],{"type":614},{"type":15,"attrs":2085,"content":2086},{"textAlign":53},[2087,2091,2093,2094,2096,2097],{"text":2088,"type":309,"marks":2089},"Joan Dawe",[2090],{"type":1337},{"text":2092,"type":309},", Peer facilitator Effective Governance for Quality and Patient Safety",{"type":1976},{"text":2095,"type":309},"Education Program; Past Chair, Eastern Health Regional Authority;",{"type":1976},{"text":2098,"type":309},"Past Chair, Health and Community Services, St. John's Region",{"type":15,"attrs":2100,"content":2101},{"textAlign":53},[2102],{"text":2103,"type":309,"marks":2104},"\"The Board, CEO and Senior Leaders all play critical roles in setting the tone and championing the importance of a safety culture in their organizations. Engaging staff in this effort starts at the top and demands attention and concerted ongoing effort. It requires support for and engagement with front line staff and respect for what they do, and equally important, engaging those being served and the shared knowledge this experience generates for improving care processes. This work is complex and the Bundle will serve as a useful guide for the scope of effort required to improve safety and eliminate harm.\"",[2105],{"type":614},{"type":15,"attrs":2107,"content":2108},{"textAlign":53},[2109,2113,2115,2119],{"text":2110,"type":309,"marks":2111},"Ray Racette",[2112],{"type":1337},{"text":2114,"type":309},", former ",{"text":2116,"type":309,"marks":2117},"CEO",[2118],{"type":1337},{"text":2120,"type":309}," Canadian College of Health 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collaborations?",{"type":324,"content":2426},[2427],{"type":15,"attrs":2428,"content":2429},{"textAlign":53},[2430],{"text":2431,"type":309},"Align with national/international standards (e.g. accreditation, regulatory, professional, industry)?",{"_uid":2433,"title":2434,"ctaLeft":2435,"ctaRight":2436,"component":1484,"columnLeft":2437,"columnRight":2440},"c90106a0-0a51-4377-882c-b8a489746517","Enacting",[],[],{"type":12,"content":2438},[2439],{"type":15},{"type":12,"content":2441},[2442,2447],{"type":15,"attrs":2443,"content":2444},{"textAlign":53},[2445],{"text":2446,"type":309},"Frontline actions that improve patient safety",{"type":321,"content":2448},[2449,2472,2495,2525],{"type":324,"content":2450},[2451,2456],{"type":15,"attrs":2452,"content":2453},{"textAlign":53},[2454],{"text":2455,"type":309},"Care settings and managers",{"type":321,"content":2457},[2458,2465],{"type":324,"content":2459},[2460],{"type":15,"attrs":2461,"content":2462},{"textAlign":53},[2463],{"text":2464,"type":309},"Integrated, unit/setting-based safety practices (e.g. daily briefings, visual management, local problem solving)?",{"type":324,"content":2466},[2467],{"type":15,"attrs":2468,"content":2469},{"textAlign":53},[2470],{"text":2471,"type":309},"Managers/physician leaders foster psychological safety (speaking up)?",{"type":324,"content":2473},[2474,2479],{"type":15,"attrs":2475,"content":2476},{"textAlign":53},[2477],{"text":2478,"type":309},"Care processes",{"type":321,"content":2480},[2481,2488],{"type":324,"content":2482},[2483],{"type":15,"attrs":2484,"content":2485},{"textAlign":53},[2486],{"text":2487,"type":309},"Standardized work/care processes where appropriate?",{"type":324,"content":2489},[2490],{"type":15,"attrs":2491,"content":2492},{"textAlign":53},[2493],{"text":2494,"type":309},"Communication/patient hand-off protocols (e.g. between shifts/units, across care continuum)?",{"type":324,"content":2496},[2497,2502],{"type":15,"attrs":2498,"content":2499},{"textAlign":53},[2500],{"text":2501,"type":309},"Patient and family engagement/co-production of care",{"type":321,"content":2503},[2504,2511,2518],{"type":324,"content":2505},[2506],{"type":15,"attrs":2507,"content":2508},{"textAlign":53},[2509],{"text":2510,"type":309},"Patients/families partners in all aspects of care (e.g. planning, decision-making, family presence policy, rounds, access to health record/test results)?",{"type":324,"content":2512},[2513],{"type":15,"attrs":2514,"content":2515},{"textAlign":53},[2516],{"text":2517,"type":309},"Patients/families involved in local safety/quality initiatives?",{"type":324,"content":2519},[2520],{"type":15,"attrs":2521,"content":2522},{"textAlign":53},[2523],{"text":2524,"type":309},"Disclosure and apology protocols?",{"type":324,"content":2526},[2527,2532],{"type":15,"attrs":2528,"content":2529},{"textAlign":53},[2530],{"text":2531,"type":309},"Situational awareness/resilience",{"type":321,"content":2533},[2534,2541],{"type":324,"content":2535},[2536],{"type":15,"attrs":2537,"content":2538},{"textAlign":53},[2539],{"text":2540,"type":309},"Processes for real-time/early detection of safety risks and patient deterioration (by staff/patients families/physicians)?",{"type":324,"content":2542},[2543],{"type":15,"attrs":2544,"content":2545},{"textAlign":53},[2546],{"text":2547,"type":309},"Protocols for escalation of care concerns (by 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communication?",{"type":324,"content":2582},[2583],{"type":15,"attrs":2584,"content":2585},{"textAlign":53},[2586],{"text":2587,"type":309},"Team-based training, drills?",{"type":324,"content":2589},[2590,2595],{"type":15,"attrs":2591,"content":2592},{"textAlign":53},[2593],{"text":2594,"type":309},"Incident reporting/management/analysis",{"type":321,"content":2596},[2597,2604],{"type":324,"content":2598},[2599],{"type":15,"attrs":2600,"content":2601},{"textAlign":53},[2602],{"text":2603,"type":309},"Effective risk/incident reporting system for events related to patients/families and staff/physicians (e.g. near misses, never events, mortality/morbidity reviews)?",{"type":324,"content":2605},[2606],{"type":15,"attrs":2607,"content":2608},{"textAlign":53},[2609],{"text":2610,"type":309},"Structured processes for responding to and learning from safety events/critical incidents (e.g. systems analysis, patient/family/staff/physician involvement and support)?",{"type":324,"content":2612},[2613,2618],{"type":15,"attrs":2614,"content":2615},{"textAlign":53},[2616],{"text":2617,"type":309},"Safety/quality measurement/reporting",{"type":321,"content":2619},[2620,2627,2634],{"type":324,"content":2621},[2622],{"type":15,"attrs":2623,"content":2624},{"textAlign":53},[2625],{"text":2626,"type":309},"Regular measurement of safety culture; patient/family complaints; and staff/physician engagement (by unit/setting and organization)?",{"type":324,"content":2628},[2629],{"type":15,"attrs":2630,"content":2631},{"textAlign":53},[2632],{"text":2633,"type":309},"Retrospective/prospective safety and quality process and outcome measures?",{"type":324,"content":2635},[2636],{"type":15,"attrs":2637,"content":2638},{"textAlign":53},[2639],{"text":2640,"type":309},"Regular, transparent reporting of safety/quality plan results?",{"type":324,"content":2642},[2643,2648],{"type":15,"attrs":2644,"content":2645},{"textAlign":53},[2646],{"text":2647,"type":309},"Operational improvements",{"type":321,"content":2649},[2650],{"type":324,"content":2651},[2652],{"type":15,"attrs":2653,"content":2654},{"textAlign":53},[2655],{"text":2656,"type":309},"Structured methods, infrastructure to improve reliability, streamline operations (e.g. PDSA, lean, human factors engineering, prospective risk analysis)?","How can you use the Patient Safety Culture “Bundle”? ",{"type":12,"content":2659},[2660,2665],{"type":15,"attrs":2661,"content":2662},{"textAlign":53},[2663],{"text":2664,"type":309},"The key components required for a Patient Safety Culture are identified under three pillars.",{"type":15,"attrs":2666,"content":2667},{"textAlign":53},[2668],{"text":2669,"type":309},"Adapted from: Singer & Vogus (2013). Reducing hospital errors: Interventions that build safety culture. ARPH 34:373-96 JANUARY 2018",{"_uid":2671,"items":2672,"title":834,"component":1531,"description":3747},"ebd2f041-18f8-48f8-b84b-5efd37257a29",[2673],{"_uid":2674,"title":2675,"ctaLeft":2676,"ctaRight":2677,"component":1484,"columnLeft":2678,"columnRight":2681},"3ac89885-aee2-4328-addf-62c5a787340f","Expand to see the full list of resources",[],[],{"type":12,"content":2679},[2680],{"type":15},{"type":12,"content":2682},[2683,2696,2705,2741,2753,2762,2774,2783,2792,2804,2813,2825,2834,2846,2855,2867,2876,2888,2897,2909,2918,2930,2939,2951,3021,3108,3195,3207,3228,3250,3259,3282,3304,3326,3335,3358,3380,3402,3411,3434,3457,3479,3502,3511,3520,3529,3552,3573,3595,3617,3626,3649,3671,3694,3716,3738],{"type":303,"attrs":2684,"content":2685},{"level":305,"textAlign":1430},[2686,2692],{"text":2687,"type":309,"marks":2688},"Singer and Vogus – Interventions That Build Safety Culture (2013)",[2689,2691],{"type":643,"attrs":2690},{"color":16},{"type":1337},{"text":2693,"type":309,"marks":2694}," ",[2695],{"type":1337},{"type":15,"attrs":2697,"content":2698},{"textAlign":1430},[2699,2704],{"text":2700,"type":309,"marks":2701},"Piecemeal initiatives to improve a patient safety culture are inadequate; improving a patient safety culture requires sequential, iterative and simultaneous interventions that:",[2702],{"type":643,"attrs":2703},{"color":16},{"text":2693,"type":309},{"type":1107,"attrs":2706,"content":2707},{"order":1109},[2708,2719,2730],{"type":324,"content":2709},[2710],{"type":15,"attrs":2711,"content":2712},{"textAlign":53},[2713,2718],{"text":2714,"type":309,"marks":2715},"Enable: e.g., \"transformational\" leadership; critical role of senior leaders; leadership characteristics; human resources; information technology (IT); external regulators",[2716],{"type":643,"attrs":2717},{"color":16},{"text":2693,"type":309},{"type":324,"content":2720},[2721],{"type":15,"attrs":2722,"content":2723},{"textAlign":53},[2724,2729],{"text":2725,"type":309,"marks":2726},"Enact: e.g., teamwork; communication; mindfulness; patient involvement; reporting; coordination between areas /at transitions",[2727],{"type":643,"attrs":2728},{"color":16},{"text":2693,"type":309},{"type":324,"content":2731},[2732],{"type":15,"attrs":2733,"content":2734},{"textAlign":53},[2735,2740],{"text":2736,"type":309,"marks":2737},"Elaborate: e.g., learning (e.g., reports, complaints, morbidity and mortality rounds); education; monitoring (prospective, retrospective, concurrent); operational improvements (industrial techniques, infrastructure).",[2738],{"type":643,"attrs":2739},{"color":16},{"text":2693,"type":309},{"type":303,"attrs":2742,"content":2743},{"level":305,"textAlign":1430},[2744,2750],{"text":2745,"type":309,"marks":2746},"Baker – Beyond the Quick Fix (2015)",[2747,2749],{"type":643,"attrs":2748},{"color":16},{"type":1337},{"text":2693,"type":309,"marks":2751},[2752],{"type":1337},{"type":15,"attrs":2754,"content":2755},{"textAlign":1430},[2756,2761],{"text":2757,"type":309,"marks":2758},"Recommendations: Patient safety /quality improvement strategy; board monitoring of performance; measurement (organizational and microsystem levels); event reporting and analysis (focus on gaps and feasible recommendations); investments in work climate; patients and care givers included in patient safety and quality improvement; investments in patient safety /quality improvement infrastructure; leadership development; collaboration across organizations; pan-Canadian information systems.",[2759],{"type":643,"attrs":2760},{"color":16},{"text":2693,"type":309},{"type":303,"attrs":2763,"content":2764},{"level":305,"textAlign":1430},[2765,2771],{"text":2766,"type":309,"marks":2767},"Canadian Patient Safety Institute – Patient Safety Culture",[2768,2770],{"type":643,"attrs":2769},{"color":16},{"type":1337},{"text":2693,"type":309,"marks":2772},[2773],{"type":1337},{"type":15,"attrs":2775,"content":2776},{"textAlign":1430},[2777,2782],{"text":2778,"type":309,"marks":2779},"Dimensions: informed; reporting; learning; just; flexible.",[2780],{"type":643,"attrs":2781},{"color":16},{"text":2693,"type":309},{"type":15,"attrs":2784,"content":2785},{"textAlign":1430},[2786,2791],{"text":2787,"type":309,"marks":2788},"Contributors: leadership; patient/family engagement; teamwork and communication; openness to reporting; learning; resources; priority of safety versus production; education and training.",[2789],{"type":643,"attrs":2790},{"color":16},{"text":2693,"type":309},{"type":303,"attrs":2793,"content":2794},{"level":305,"textAlign":1430},[2795,2801],{"text":2796,"type":309,"marks":2797},"British Columbia – Culture Change Toolbox: Components of Patient Safety Culture (2013)",[2798,2800],{"type":643,"attrs":2799},{"color":16},{"type":1337},{"text":2693,"type":309,"marks":2802},[2803],{"type":1337},{"type":15,"attrs":2805,"content":2806},{"textAlign":1430},[2807,2812],{"text":2808,"type":309,"marks":2809},"Teamwork and communication; safety climate; psychological safety; organizational fairness; just culture; stress recognition; working conditions; leadership; learning and improvement; patients as partners; transparency.",[2810],{"type":643,"attrs":2811},{"color":16},{"text":2693,"type":309},{"type":303,"attrs":2814,"content":2815},{"level":305,"textAlign":1430},[2816,2822],{"text":2817,"type":309,"marks":2818},"American College of Healthcare Executives (ACHE) / Institute for Healthcare Improvement (IHI) / National Patient Safety Foundation (NPSF) – Leadership Blueprint for Culture of Safety (2017)",[2819,2821],{"type":643,"attrs":2820},{"color":16},{"type":1337},{"text":2693,"type":309,"marks":2823},[2824],{"type":1337},{"type":15,"attrs":2826,"content":2827},{"textAlign":1430},[2828,2833],{"text":2829,"type":309,"marks":2830},"Six leadership domains: vision; trust, respect and inclusion; board engagement; leadership development; just culture; behaviour expectations.",[2831],{"type":643,"attrs":2832},{"color":16},{"text":2693,"type":309},{"type":303,"attrs":2835,"content":2836},{"level":305,"textAlign":1430},[2837,2843],{"text":2838,"type":309,"marks":2839},"IHI Whitepaper – Patient Safety (2006)",[2840,2842],{"type":643,"attrs":2841},{"color":16},{"type":1337},{"text":2693,"type":309,"marks":2844},[2845],{"type":1337},{"type":15,"attrs":2847,"content":2848},{"textAlign":1430},[2849,2854],{"text":2850,"type":309,"marks":2851},"Patient safety strategy/aims; senior leader communication and awareness building (e.g., walk-rounds); engage stakeholders (board, leaders, physicians, staff, patients/families) in patient safety; implement \"just\" culture; focus on process redesign/improved reliability (e.g., evidence-based standardization, human factors); leader/ manager/staff accountability  (e.g., for safety reporting, reliable processes/\"daily work\") and aligned incentives for patient safety; patient safety infrastructure (staff and committees); assess patient safety  culture; measure/track patient safety (e.g. mortality, trigger tool); support patients/families impacted by errors.",[2852],{"type":643,"attrs":2853},{"color":16},{"text":2693,"type":309},{"type":303,"attrs":2856,"content":2857},{"level":305,"textAlign":1430},[2858,2864],{"text":2859,"type":309,"marks":2860},"IHI Whitepaper – 7 Leadership Leverage Points (2008)",[2861,2863],{"type":643,"attrs":2862},{"color":16},{"type":1337},{"text":2693,"type":309,"marks":2865},[2866],{"type":1337},{"type":15,"attrs":2868,"content":2869},{"textAlign":1430},[2870,2875],{"text":2871,"type":309,"marks":2872},"System-level aims; executable strategy; leadership attention; patients /families; Chief Financial Officer (CFO) as quality champion; engage physicians; improvement capability.",[2873],{"type":643,"attrs":2874},{"color":16},{"text":2693,"type":309},{"type":303,"attrs":2877,"content":2878},{"level":305,"textAlign":1430},[2879,2885],{"text":2880,"type":309,"marks":2881},"IHI Whitepaper – High-Impact Leadership (2013)",[2882,2884],{"type":643,"attrs":2883},{"color":16},{"type":1337},{"text":2693,"type":309,"marks":2886},[2887],{"type":1337},{"type":15,"attrs":2889,"content":2890},{"textAlign":1430},[2891,2896],{"text":2892,"type":309,"marks":2893},"Person-centredness (e.g., patient involvement/stories); front-line engagement (e.g., regular presence at frontlines, visible champion, lead projects); relentless focus (e.g., talk about vision every day, align schedule with high-priority initiatives; designate resources); transparency; build will to improve (e.g., communicate and model desired behaviours, openness, swift action against undesired behaviour); boundary-lessness (e.g., systems thinking, harvest ideas from and partner with other organizations).",[2894],{"type":643,"attrs":2895},{"color":16},{"text":2693,"type":309},{"type":303,"attrs":2898,"content":2899},{"level":305,"textAlign":1430},[2900,2906],{"text":2901,"type":309,"marks":2902},"IHI Whitepaper – Sustaining Improvement (2016)",[2903,2905],{"type":643,"attrs":2904},{"color":16},{"type":1337},{"text":2693,"type":309,"marks":2907},[2908],{"type":1337},{"type":15,"attrs":2910,"content":2911},{"textAlign":1430},[2912,2917],{"text":2913,"type":309,"marks":2914},"Quality control, improvement, culture; standardization; accountability (standard work); visual management; problem solving; escalation; integration; prioritization; daily work; policy; transparency; trust.",[2915],{"type":643,"attrs":2916},{"color":16},{"text":2693,"type":309},{"type":303,"attrs":2919,"content":2920},{"level":305,"textAlign":1430},[2921,2927],{"text":2922,"type":309,"marks":2923},"IHI Whitepaper – Safe, Reliable and Effective Care (2017)",[2924,2926],{"type":643,"attrs":2925},{"color":16},{"type":1337},{"text":2693,"type":309,"marks":2928},[2929],{"type":1337},{"type":15,"attrs":2931,"content":2932},{"textAlign":1430},[2933,2938],{"text":2934,"type":309,"marks":2935},"Leadership; psychological safety; accountability (act in safe and respectful manner); teamwork and communication; negotiation; continuous learning; improvement and measurement; reliability; transparency.",[2936],{"type":643,"attrs":2937},{"color":16},{"text":2693,"type":309},{"type":303,"attrs":2940,"content":2941},{"level":305,"textAlign":1430},[2942,2948],{"text":2943,"type":309,"marks":2944},"Key Concepts",[2945,2947],{"type":643,"attrs":2946},{"color":16},{"type":1337},{"text":2693,"type":309,"marks":2949},[2950],{"type":1337},{"type":321,"content":2952},[2953,2970,2987,3004],{"type":324,"content":2954},[2955],{"type":15,"attrs":2956,"content":2957},{"textAlign":53},[2958,2964,2969],{"text":2959,"type":309,"marks":2960},"Safety science ",[2961,2963],{"type":643,"attrs":2962},{"color":16},{"type":1337},{"text":2965,"type":309,"marks":2966},"– focusses on contributing factors and underlying causes of risk and harm, including errors and human factors. It includes many disciplines not typically considered part of healthcare. Recognizes the fundamental importance of system design in driving workforce behaviour. In other industries, such as aviation, safety experts accept that human error must be expected, anticipated, and its effects mitigated. Safety science and human factors engineering is used to design systems to prevent errors, and to mitigate harm when errors occur. (Berwick et al., 2015).",[2967],{"type":643,"attrs":2968},{"color":16},{"text":2693,"type":309},{"type":324,"content":2971},[2972],{"type":15,"attrs":2973,"content":2974},{"textAlign":53},[2975,2981,2986],{"text":2976,"type":309,"marks":2977},"Implementation science ",[2978,2980],{"type":643,"attrs":2979},{"color":16},{"type":1337},{"text":2982,"type":309,"marks":2983},"– supplements patient safety science; focusses on identifying and implementing valuable practices and lessons learned, and scaling up/translation across the organization and system. (Berwick et al., 2015).",[2984],{"type":643,"attrs":2985},{"color":16},{"text":2693,"type":309},{"type":324,"content":2988},[2989],{"type":15,"attrs":2990,"content":2991},{"textAlign":53},[2992,2998,3003],{"text":2993,"type":309,"marks":2994},"Just culture ",[2995,2997],{"type":643,"attrs":2996},{"color":16},{"type":1337},{"text":2999,"type":309,"marks":3000},"– a culture that recognizes that individual practitioners should not be held accountable for system failings over which they have no control. A just culture recognizes many individual or \"active\" errors represent predictable interactions between humans and the systems in which they work. A just culture also does not tolerate conscious disregard of clear risks to patients or gross misconduct. (Berwick et al., 2015).",[3001],{"type":643,"attrs":3002},{"color":16},{"text":2693,"type":309},{"type":324,"content":3005},[3006],{"type":15,"attrs":3007,"content":3008},{"textAlign":53},[3009,3015,3020],{"text":3010,"type":309,"marks":3011},"Psychological safety ",[3012,3014],{"type":643,"attrs":3013},{"color":16},{"type":1337},{"text":3016,"type":309,"marks":3017},"– an environment where: anyone can ask questions without looking stupid; anyone can ask for feedback without looking incompetent; anyone can be respectfully critical without appearing negative; anyone can suggest innovative ideas without being perceived as disruptive. (Frankel, 2017).",[3018],{"type":643,"attrs":3019},{"color":16},{"text":2693,"type":309},{"type":321,"content":3022},[3023,3040,3057,3074,3091],{"type":324,"content":3024},[3025],{"type":15,"attrs":3026,"content":3027},{"textAlign":53},[3028,3034,3039],{"text":3029,"type":309,"marks":3030},"Staff safety/health",[3031,3033],{"type":643,"attrs":3032},{"color":16},{"type":1337},{"text":3035,"type":309,"marks":3036}," – A precursor to providing high quality care are staff that are free from physical harm during daily work. (Perlo, 2017)",[3037],{"type":643,"attrs":3038},{"color":16},{"text":2693,"type":309},{"type":324,"content":3041},[3042],{"type":15,"attrs":3043,"content":3044},{"textAlign":53},[3045,3051,3056],{"text":3046,"type":309,"marks":3047},"Patient and family engagement ",[3048,3050],{"type":643,"attrs":3049},{"color":16},{"type":1337},{"text":3052,"type":309,"marks":3053},"– recognized as a primary area of focus in patient safety and quality; includes engagement at three levels: direct care (diagnosis, treatment decisions, monitoring), organizational design and governance (planning, patient advisory councils, quality improvement projects), policy making (public health, research priorities, resource allocation). (Carman, 2013).",[3054],{"type":643,"attrs":3055},{"color":16},{"text":2693,"type":309},{"type":324,"content":3058},[3059],{"type":15,"attrs":3060,"content":3061},{"textAlign":53},[3062,3068,3073],{"text":3063,"type":309,"marks":3064},"Disruptive behaviour ",[3065,3067],{"type":643,"attrs":3066},{"color":16},{"type":1337},{"text":3069,"type":309,"marks":3070},"– any behaviour that shows disrespect for others or any interpersonal interactions that impede the delivery of patient care; this behaviour poses a threat to patient safety. (AHRQ PS Net, 2017).",[3071],{"type":643,"attrs":3072},{"color":16},{"text":2693,"type":309},{"type":324,"content":3075},[3076],{"type":15,"attrs":3077,"content":3078},{"textAlign":53},[3079,3085,3090],{"text":3080,"type":309,"marks":3081},"High reliability/resilience ",[3082,3084],{"type":643,"attrs":3083},{"color":16},{"type":1337},{"text":3086,"type":309,"marks":3087},"– reliable/mindful organizations are:  preoccupied with failure (look for small signals of failure vs. preoccupation with success); reluctant to simplify interpretations (acknowledge complexity); sensitive to operations (aware of what is happening at frontlines); committed to resilience (acting quickly when things go wrong, e.g., patient deterioration); and defer to experts (vs. authority). (Weick & Sutcliffe, 2015).",[3088],{"type":643,"attrs":3089},{"color":16},{"text":2693,"type":309},{"type":324,"content":3092},[3093],{"type":15,"attrs":3094,"content":3095},{"textAlign":53},[3096,3102,3107],{"text":3097,"type":309,"marks":3098},"Patient safety measurement ",[3099,3101],{"type":643,"attrs":3100},{"color":16},{"type":1337},{"text":3103,"type":309,"marks":3104},"– five dimensions: past harm (incidents, mortality); reliability (compliance); sensitivity to operations (walk-rounds, staffing levels, escalation); anticipation and preparedness (risk registers, safety culture scores, absenteeism); integration and learning (automated alerts, board dashboards). (Vincent, 2016).",[3105],{"type":643,"attrs":3106},{"color":16},{"text":2693,"type":309},{"type":321,"content":3109},[3110,3127,3144,3161,3178],{"type":324,"content":3111},[3112],{"type":15,"attrs":3113,"content":3114},{"textAlign":53},[3115,3121,3126],{"text":3116,"type":309,"marks":3117},"Frontline leadership/distributed leadership",[3118,3120],{"type":643,"attrs":3119},{"color":16},{"type":1337},{"text":3122,"type":309,"marks":3123}," – recognized as a key driver for change in healthcare; local leaders translate senior leader priorities/values into action at the microsystem level; they have great impact on unit cultures and learning processes. (IHI, 2016).",[3124],{"type":643,"attrs":3125},{"color":16},{"text":2693,"type":309},{"type":324,"content":3128},[3129],{"type":15,"attrs":3130,"content":3131},{"textAlign":53},[3132,3138,3143],{"text":3133,"type":309,"marks":3134},"Physician leadership",[3135,3137],{"type":643,"attrs":3136},{"color":16},{"type":1337},{"text":3139,"type":309,"marks":3140}," – recognized as a key driver for change in healthcare; six strategies for engaging physicians: discover common purpose; reframe values and beliefs; segment the engagement plan; use engaging improvement methods; show courage; adopt an engaging style. (Reinertsen, 2007).",[3141],{"type":643,"attrs":3142},{"color":16},{"text":2693,"type":309},{"type":324,"content":3145},[3146],{"type":15,"attrs":3147,"content":3148},{"textAlign":53},[3149,3155,3160],{"text":3150,"type":309,"marks":3151},"Staff engagement",[3152,3154],{"type":643,"attrs":3153},{"color":16},{"type":1337},{"text":3156,"type":309,"marks":3157}," – A joyful, engaged workforce will have: physical and psychological safety; meaning and purpose; choice and autonomy; recognition and rewards; participative management; camaraderie and teamwork; daily improvement; wellness and resilience; real-time measurement. (Perlo, 2017)",[3158],{"type":643,"attrs":3159},{"color":16},{"text":2693,"type":309},{"type":324,"content":3162},[3163],{"type":15,"attrs":3164,"content":3165},{"textAlign":53},[3166,3172,3177],{"text":3167,"type":309,"marks":3168},"Teamwork/communication ",[3169,3171],{"type":643,"attrs":3170},{"color":16},{"type":1337},{"text":3173,"type":309,"marks":3174},"– gaps in communication and/or poor teamwork are frequently noted as contributing factors to many patient safety events. Strong teams which train together and have established and reliable communication practices will have superior patient safety performance. (Baker, 2015).",[3175],{"type":643,"attrs":3176},{"color":16},{"text":2693,"type":309},{"type":324,"content":3179},[3180],{"type":15,"attrs":3181,"content":3182},{"textAlign":53},[3183,3189,3194],{"text":3184,"type":309,"marks":3185},"Industry-wide standardization/alignment ",[3186,3188],{"type":643,"attrs":3187},{"color":16},{"type":1337},{"text":3190,"type":309,"marks":3191},"– A key feature in other high-risk industries is alignment across the sector related to key priorities, national/international standards and regulation of safety-critical practices and technologies. (Dixon-Woods, 2016, Berwick et al., 2015).",[3192],{"type":643,"attrs":3193},{"color":16},{"text":2693,"type":309},{"type":303,"attrs":3196,"content":3197},{"level":305,"textAlign":1430},[3198,3204],{"text":3199,"type":309,"marks":3200},"Environmental Scan",[3201,3203],{"type":643,"attrs":3202},{"color":16},{"type":1337},{"text":2693,"type":309,"marks":3205},[3206],{"type":1337},{"type":15,"attrs":3208,"content":3209},{"textAlign":1430},[3210,3215,3223,3227],{"text":3211,"type":309,"marks":3212},"ACHE, NPSF Lucian Leape Institute. (2017). ",[3213],{"type":643,"attrs":3214},{"color":16},{"text":3216,"type":309,"marks":3217},"Leading a culture of safety: a blueprint for success",[3218,3221],{"type":408,"attrs":3219},{"href":3220,"uuid":53,"anchor":53,"custom":53,"target":411,"linktype":604},"https://www.ihi.org/resources/Pages/Publications/Leading-a-Culture-of-Safety-A-Blueprint-for-Success.aspx",{"type":643,"attrs":3222},{"color":16},{"text":623,"type":309,"marks":3224},[3225],{"type":643,"attrs":3226},{"color":16},{"text":2693,"type":309},{"type":15,"attrs":3229,"content":3230},{"textAlign":1430},[3231,3236,3245,3249],{"text":3232,"type":309,"marks":3233},"AHRQ PS Net. (2017). ",[3234],{"type":643,"attrs":3235},{"color":16},{"text":3237,"type":309,"marks":3238},"Disruptive and unprofessional behavior",[3239,3243],{"type":408,"attrs":3240},{"href":3241,"uuid":53,"anchor":53,"custom":3242,"target":411,"linktype":604},"https://psnet.ahrq.gov/primers/primer/15/disruptive-and-unprofessional-behavior",{},{"type":643,"attrs":3244},{"color":16},{"text":623,"type":309,"marks":3246},[3247],{"type":643,"attrs":3248},{"color":16},{"text":2693,"type":309},{"type":15,"attrs":3251,"content":3252},{"textAlign":1430},[3253,3258],{"text":3254,"type":309,"marks":3255},"Baker R.  (2015). Beyond the quick fix – strategies for improving patient safety. Institute of Health Policy, Management and Evaluation at the University of Toronto.",[3256],{"type":643,"attrs":3257},{"color":16},{"text":2693,"type":309},{"type":15,"attrs":3260,"content":3261},{"textAlign":1430},[3262,3267,3276,3281],{"text":3263,"type":309,"marks":3264},"Baker R, Norton P, et al. (2004). ",[3265],{"type":643,"attrs":3266},{"color":16},{"text":3268,"type":309,"marks":3269},"The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada",[3270,3274],{"type":408,"attrs":3271},{"href":3272,"uuid":53,"anchor":53,"custom":3273,"target":411,"linktype":604},"http://www.cmaj.ca/content/170/11/1678.full",{},{"type":643,"attrs":3275},{"color":16},{"text":3277,"type":309,"marks":3278},". CMAJ. 170(11):1678-86.",[3279],{"type":643,"attrs":3280},{"color":16},{"text":2693,"type":309},{"type":15,"attrs":3283,"content":3284},{"textAlign":1430},[3285,3290,3299,3303],{"text":3286,"type":309,"marks":3287},"BC Patient Safety and Quality Council. (2013). ",[3288],{"type":643,"attrs":3289},{"color":16},{"text":3291,"type":309,"marks":3292},"Culture change toolbox",[3293,3297],{"type":408,"attrs":3294},{"href":3295,"uuid":53,"anchor":53,"custom":3296,"target":411,"linktype":604},"https://bcpsqc.ca/wp-content/uploads/2018/03/culture-toolkit_web.pdf",{},{"type":643,"attrs":3298},{"color":16},{"text":623,"type":309,"marks":3300},[3301],{"type":643,"attrs":3302},{"color":16},{"text":2693,"type":309},{"type":15,"attrs":3305,"content":3306},{"textAlign":1430},[3307,3312,3320,3325],{"text":3308,"type":309,"marks":3309},"Berwick D, Shojania K, et al. (2015). ",[3310],{"type":643,"attrs":3311},{"color":16},{"text":3313,"type":309,"marks":3314},"Free from harm: accelerating patient safety improvement fifteen years after To Err Is Human",[3315,3318],{"type":408,"attrs":3316},{"href":3317,"uuid":53,"anchor":53,"custom":53,"target":411,"linktype":604},"https://www.ihi.org/resources/Pages/Publications/Free-from-Harm-Accelerating-Patient-Safety-Improvement.aspx",{"type":643,"attrs":3319},{"color":16},{"text":3321,"type":309,"marks":3322},". National Patient Safety Foundation.",[3323],{"type":643,"attrs":3324},{"color":16},{"text":2693,"type":309},{"type":15,"attrs":3327,"content":3328},{"textAlign":1430},[3329,3334],{"text":3330,"type":309,"marks":3331},"Berwick D, Feely D. (2017). WIHI: the next wave of patient safety. 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