Safe space

Colourful photo of Dr. Carol-Anne Moulton and Dr. Tim Jackson

Carol-Anne Moulton (L) and Dr. Tim Jackson (R) lead UHN’s safety and quality benchmarking program.

UHN’s safety and quality program ensures patients get the best care possible.

By Bryan Borzykowski

Every day at around 7 a.m., a small group of nurses and anesthesiologists gather in front of the operating room to talk about how to make the day’s surgeries go smoothly. They then regroup later to debrief on what went right – and wrong. The idea is to ensure that all the things that went well are repeated in the future, while the things that didn’t go as smoothly are acknowledged and improved upon.

It’s all part of the Sprott Department of Surgery’s quality and patient safety benchmarking program, which University Health Network (UHN) began putting in place in 2010. Until then, there was no way of knowing whether patients received better outcomes at UHN than they did at other medical centres or whether the institution’s rates of infections or deaths were too high.

That wasn’t right, says Dr. Tim Jackson, Operating Room Medical Director at Toronto Western Hospital, general surgeon in the Sprott Department of Surgery, and the Medtronic Chair in Minimally Invasive Surgery. “You need to measure quality,” explains Dr. Jackson, who helped create the quality improvement program that UHN now follows. “It’s good for patients –it reduces complications – and it’s good for surgeons, who can get data on their performance and then think about how they can do better.”

More efficient operators

Over the past several years, Dr. Jackson and Dr. Carol-Anne Moulton, Operating Room Medical Director at Toronto General Hospital and Princess Margaret Cancer Centre, and a general surgeon in the Sprott Department of Surgery, have, along with others, measured a variety of surgical-related processes and procedures, from how many times doctors wash their hands to whether blood transfusions are done properly. As part of the program, every death or surgery-related complication gets discussed. “Everything is reviewed, and we look at whether we could have done anything differently,” explains Dr. Moulton.

There are several goals: to give patients the best care possible, but also to make sure doctors are doing their jobs efficiently and cost effectively, while still putting safety first, says Dr. Moulton.

UHN wants to make sure it’s keeping up with other top hospitals, too. It participates in four North America-wide programs, including the American College of Surgeons National Surgical Quality Improvement Program, in which results on more than 80 measures are entered into a database and then compared against hundreds of other institutions.

The program has helped Sprott Surgery dramatically reduced its rate of infection, for instance, while UHN is doing as expected or better than expected on a number of measures.

One reason so much progress has been made, and why Drs. Jackson and Moulton are confident they can continue raising the quality of Sprott Surgery’s work even further, is because of UHN’s culture: everyone wants to improve. “All of us want to know how we can better our own craft,” says Dr. Jackson. “That’s exciting to see –how energized people get by looking at these reports.”

This article originally appeared in the Sprott Department of Surgery magazine.

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