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Slide Presentation Recordings from the 7th Annual Winter School, February 7-11, 2016

Posted on March 24, 2016, in order of appearance.

Margaret Murphy, External Lead Advisor, WHO Patients for Patient Safety Programme
Using her family experience of healthcare Margaret, will identify issues which need to be addressed together with the essential core values which need to be present when striving to achieve excellence in healthcare.

With reference to international experts, Margaret’s presentation will highlight that robust systems, adherence to guidance and protocols together with meaningful engagement with family and patient are essential ingredients to deliver on the public’s expectation that care be safe, quality assured and above all, compassionate. She will advance the case for transparency and open disclosure in the respectful management of adverse events. Margaret’s personal wish list serves as a useful check list for professionals in practice.

The presentation will also use the story as a motivator and catalyst for improvement, creating an awareness of the need to establish a congruence between real life experience, the evidence base and academic course material.

Todd Pawlicki, Professor and Vice Chair for Medical Physics, Department of Radiation Medicine and Applied Sciences University of California at San Diego
A complex sociotechnical system is one that relies on that has tightly coupled interdependencies between humans, equipment and software as part of operations. Complex sociotechnical systems are notoriously challenging related to issues of safety. However, there are some organizations that despite being complex sociotechnical systems operate nearly error-free over long periods of time.

Research into these organizations reveal a consistent set of characteristics that promote safety. Organizations that subscribe to those characteristics are known as High-Reliability Organizations (HRO). The different disciplines of radiation medicine are complex sociotechnical systems and may benefit from the HRO approach to safety. HRO Theory is primarily focuses on organizational factors of safety.

The organization structure of an HRO is not too stringent or hierarchical so that the system can adapt to changing conditions or other unanticipated uncertainties. Teamwork is another important factor where the organization should not be too specialized without overlap. It is important to develop a shared understanding of the problems and challenges faced. The HRO has an open communication practice where workers are allowed to respectfully question one another on issues of safety. Lastly, information migration and fluid decision-making is a key part of HRO. The idea is that the highest ranking person is not always the person to make the best decision.

These aspects of HROs are explained as part of this presentation.

Mona Udowicz, Director of Quality, Safety and Patient Experience, CancerControl Alberta, Alberta Health Services
Quality and safety in healthcare can be improved when organizations openly and transparently share with their staff, patients and families about the organization’s goals, results and where they are focusing to improve care.

Ask any patient or front line staff member what your organization should work on to make that organization safer and they will give you a list, what they don’t know is what will be done to address it. This presentation will provide a general overview of the dimensions of Quality and Safety in a Radiation Medicine program. It will also articulate why the inclusion of patient and family advisors in quality and safety initiatives is so critical to success of any quality program.

The presentation will then go onto describe how the curriculum for Winter School 2016 was developed and how the presentations, workshops and speakers are integrated to provide a comprehensive view to a quality program.


Peter E. Gabriel, Associate Professor of Clinical Radiation Oncology, Perelman Center for Advanced Medicine, Philadelphia, Pennsylvania
Clinical informatics is the interdisciplinary scientific field concerned with the optimal use of information, often aided by technology, to improve health care. Radiation oncology is a technology- and data-rich specialty, and opportunities abound to apply informatics tools and techniques to improve the capture, management, and effective use of information within the field.

In this lecture, Dr. Gabriel will describe several examples of practical informatics interventions employed at the Penn Medicine Department of Radiation Oncology in pursuit of better safety monitoring, quality assurance, clinical care, and research. Specifically, he will describe the design and implementation of an incident reporting system, a chart rounds peer review management system, an EHR-based toxicity monitoring system, a custom clinical treatment summary interface, and a clinical data warehouse.

At the end of this lecture, attendees should have ideas for practical informatics interventions that may be feasible at their own institutions. Attendees will be able to appreciate the key challenges and decisions involved with implementing solutions similar to those used at Penn, as well as the most important informatics concepts and principles that can help their efforts succeed.

Cheryl Connors, The Armstrong Institute for Patient Safety and Quality, John Hopkins Hospital
Healthcare is a complex, stressful macro-system made up of many micro-systems in which a variety of people work (doctors, nurses, pharmacists, therapists, etc…). Healthcare has become increasingly stressful due to the acuity of the patients, advancing technology, and limited resources. At times, in this complicated environment, patient care does not go as planned and outcomes are poor which can result in traumatized care providers also known as “second victims”.

An organizational assessment at Johns Hopkins Hospital identified that most care providers have felt like a “second victim” during their career. The assessment also identified that these care providers wanted support from a peer any time of day or night demonstrating the need and desire for peer support. The Resilience In Stressful Events (RISE) Team was established to provide timely support to employees who encounter stressful patient related events. Understanding the key steps to implementing a successful program, as well as sustaining a program can benefit your organization.

Esther Green, Director, Person Centered Perspective, Canadian Partnership Against Cancer
The practice of involving and engaging patients and family in health system planning and policy making has evolved over the last decade. Many organizations, such as the Canadian Partnership Against Cancer have developed engagement strategies and implemented initiatives to ensure that there are processes to consult and involve individuals who experience the health care system.

The concept of Patient/Family Engagement has been implemented by CPAC over the past several years. Within the 2012-2017 Strategic Framework, CPAC identified embedding a person-centred perspective throughout cancer control as a key priority of work. One aspect of this area of work was the engagement of patient/family advisors on Advisory Groups, Expert Panels, and Working Groups.

This interactive presentation will focus on a comprehensive approach to patient/family engagement that includes: a framework for engagement; clear definitions, principles and processes of engagement; and challenges that may arise. Critical to patient/family engagement is the need for culture change within health care; the essence of this is to move from a perspective of ‘doing to’ or ‘doing for’ to doing with; partnering with patients/families is a significant change for health care providers; and meaningful engagement is important for patient/family advisors.

At the end of the session, participants will be able to:
Describe the importance of engaging individuals and family in health system and cancer control system planning
Discuss promising practices and policies to accelerate a person centered Cancer Control System

Example patient partnerships that work- Laurie Hendren, McGill University

Karine Vigneault, Patient Partnership Coordinator, Quality, Patient Safety and Performance Department, McGill University Health Centre
Since 2014, the McGill University Health Centre (MUHC) has developed an integrated and effective approach to patient participation in the design, implementation and evaluation of quality improvement (QI) projects. A key component of this approach is the utilization of a structured process for the selection and the training of patient advisors and professionals. We will discuss this process along with some barriers and facilitators to the implementation this approach.

Ensuring organizational recognition of patient advisors’ contribution is probably the most important challenge to the spread and sustainability of this approach but there are other potential barriers that have to be acknowledged, for instance the existence of a gap between patient advisors’ expectations and the pace of organization change.

Amongst the facilitating factors that will be discussed are the presence of an external facilitator trained in patient engagement and QI, the co-building of the project objective, and the use of rules of engagement. We will also highlight facilitating factors at an organization level, including a clear engagement from the leadership and the use of stories to foster cultural change.

Panel discussion - role and future of patient partnership in Radiation Oncology

Salman Arif, from the Hamilton Health Sciences- Juravinski Cancer Centre for his project "A Multimedia Patient Education Initiative- Accessing the Perceptions of Patients and Radiation Therapists"

Heather Giovannetti from the Jack Ady Cancer Centre/CancerControl AB for her project "Applying Human Factors Principles to Dynamic Documents in ARIA-RO"

Dr Kathy Rock, Princess Margaret Hospital -UHN, Automated Quality Assurance at Breast Cancer Rounds – A process to improve efficiency and quality of patient care. Dr Rock's co-authors are: Aisling Barry (Princess Margaret Hospital -UHN), Chris Mcintosh (Princess Margaret Hospital -UHN), Tom Purdie (Princess Margaret Hospital -UHN), Anne Koch (Princess Margaret Hospital -UHN).

Todd Pawlicki, University of California at San Diego and Mona Udowicz MRT, CancerControl Alberta

Margaret Murphy, WHO Patients for Patient Safety Programme, Todd Pawlicki, University of California at San Diego, Mona Udowicz MRT, CancerControl Alberta
Round up of the Canadian Winter School Program