Discover and read the best of Twitter Threads about #ptsafety
Most recents (24)
🧵 How well do you know your dopamine antagonists? 💊💊
1/ Using these drugs safely requires that clinicians & patients appreciate their important #AdverseEffects, which are not always well understood
👉🏽ti.ubc.ca/letter139
#MedEd #prescribing #deprescribing #medsafety
1/ Using these drugs safely requires that clinicians & patients appreciate their important #AdverseEffects, which are not always well understood
👉🏽ti.ubc.ca/letter139
#MedEd #prescribing #deprescribing #medsafety
2/ #AdverseEffects may include:
⚠️ Drug-induced #Parkinsonism
-↘️ or slowed movements, rigidity/tremor/unsteadiness, facial expression loss
⚠️ #Akathisia
-intense internal restlessness or desire to move (which may be mistaken for anxiety)
👉🏽Pt videos: ti.ubc.ca/letter139
⚠️ Drug-induced #Parkinsonism
-↘️ or slowed movements, rigidity/tremor/unsteadiness, facial expression loss
⚠️ #Akathisia
-intense internal restlessness or desire to move (which may be mistaken for anxiety)
👉🏽Pt videos: ti.ubc.ca/letter139
3/ #AdverseEffects may include:
⚠️Acute dystonic reaction
-sudden, involuntary, often painful muscle spasm
⚠️Dyskinesia
-repetitive, involuntary movements...can be associated with cognitive decline
👉🏽Pt experience videos: ti.ubc.ca/letter139
#MedEd #ptsafety #drugsafety
⚠️Acute dystonic reaction
-sudden, involuntary, often painful muscle spasm
⚠️Dyskinesia
-repetitive, involuntary movements...can be associated with cognitive decline
👉🏽Pt experience videos: ti.ubc.ca/letter139
#MedEd #ptsafety #drugsafety
🧵 Reducing #PrescribingCascades ⬇️
1/ What are #Prescribing Cascades?
1⃣ A drug is prescribed 💊
2⃣ #AdverseEvent occurs but is misinterpreted as a new medical condition ⚠️
3⃣Another drug is prescribed for the drug-induced adverse event 💊💊
ti.ubc.ca/letter138 #MedEd
1/ What are #Prescribing Cascades?
1⃣ A drug is prescribed 💊
2⃣ #AdverseEvent occurs but is misinterpreted as a new medical condition ⚠️
3⃣Another drug is prescribed for the drug-induced adverse event 💊💊
ti.ubc.ca/letter138 #MedEd
2/ Anticholinergics ➡️ cognitive dysfunction ➡️ drugs for #dementia
#Anticholinergic 💊 block acetylcholinergic neurotransmission in the brain, impairing cognition & memory
Can lead to new Rx or ↗️ acetylcholinesterase inhibitor doses
ti.ubc.ca/letter138 #MedEd #FOAMed
#Anticholinergic 💊 block acetylcholinergic neurotransmission in the brain, impairing cognition & memory
Can lead to new Rx or ↗️ acetylcholinesterase inhibitor doses
ti.ubc.ca/letter138 #MedEd #FOAMed
3/ Drugs for #dementia ➡️ incontinence ➡️ anticholinergics
Conversely, AChE-I can cause urinary or fecal incontinence, that may "cascade" to prescription of an #anticholinergic
👉🏽 full Letter here: ti.ubc.ca/letter138
#MedEd #PrescribingCascades #MedTwitter
Conversely, AChE-I can cause urinary or fecal incontinence, that may "cascade" to prescription of an #anticholinergic
👉🏽 full Letter here: ti.ubc.ca/letter138
#MedEd #PrescribingCascades #MedTwitter
I'm sorry, I can't ignore the open tabs, so I'm back with more inadequate care.
@ASDSpectrumASD St Erme is the third report I've covered from Spectrum this month.
I keep banging on about why @chtycommission don't take action; looks like they are
api.cqc.org.uk/public/v1/repo…
1/
@ASDSpectrumASD St Erme is the third report I've covered from Spectrum this month.
I keep banging on about why @chtycommission don't take action; looks like they are
api.cqc.org.uk/public/v1/repo…
1/
On 14 July @ChtyCommission issued a press release saying they were opening an inquiry due to safeguarding concerns gov.uk/government/new…
They're not a safeguarding regulator and make clear substantive safeguarding matters will be investigated by regulators and/or police
2/
They're not a safeguarding regulator and make clear substantive safeguarding matters will be investigated by regulators and/or police
2/
Now we just need @ChtyCommission to open inquiries into some of the large national charities with failing provision and poor campaigning records, rather than just the smaller local ones - more here
But I guess it's good they're looking at Spectrum
3/
But I guess it's good they're looking at Spectrum
3/
THREAD: Bring it down safely! ↘️💊
1/6 6⃣tweets about our new TI Therapeutics Letter 134: Finding the lowest effective dose for non-opioid #analgesics
👉🏾 Full Letter: ti.ubc.ca/letter134
#MedEd #medsafety #prescribing #BetterPrescribing
1/6 6⃣tweets about our new TI Therapeutics Letter 134: Finding the lowest effective dose for non-opioid #analgesics
👉🏾 Full Letter: ti.ubc.ca/letter134
#MedEd #medsafety #prescribing #BetterPrescribing
2/6 Consistent evidence that minority of pts get clinically meaningful pain relief from any dose of:
✅#Cyclobenzaprine (at best 1/4)
✅#Duloxetine (at best 1/6)
✅#Gabapentin / #Pregabalin (at best 1/6)
👉🏾ti.ubc.ca/letter134
#MedEd #ptsafety #BetterPrescribing #prescribing
✅#Cyclobenzaprine (at best 1/4)
✅#Duloxetine (at best 1/6)
✅#Gabapentin / #Pregabalin (at best 1/6)
👉🏾ti.ubc.ca/letter134
#MedEd #ptsafety #BetterPrescribing #prescribing
3/6 Gabapentin, pregabalin, duloxetine:
A 2021 Canadian systematic review found NNT (numbers needed to treat) of 6-7 for "clinically meaningful benefit" (defined as ≥30% reduction in pain or pain & function)
👉🏾ti.ubc.ca/letter134
#MedEd #BetterPrescribing #deprescribing
A 2021 Canadian systematic review found NNT (numbers needed to treat) of 6-7 for "clinically meaningful benefit" (defined as ≥30% reduction in pain or pain & function)
👉🏾ti.ubc.ca/letter134
#MedEd #BetterPrescribing #deprescribing
THREAD: SGLT2 inhibitors for #diabetes
1/5 Dr. Jamie Falk @jamisonfalk presented "A Deep Dive into #SGLT2i: What Comes to the Surface for Individuals with Diabetes"
👉🏽Watch the presentation here: bit.ly/3FRCEoM 🧑🏾💻
#T2DM #medsafety #FOAMed #MedEd
1/5 Dr. Jamie Falk @jamisonfalk presented "A Deep Dive into #SGLT2i: What Comes to the Surface for Individuals with Diabetes"
👉🏽Watch the presentation here: bit.ly/3FRCEoM 🧑🏾💻
#T2DM #medsafety #FOAMed #MedEd
2/5 #AdverseEffects for #SGLT2i to be aware of: genital infections, hypovolemia, DKA, amputations
✅Check out the image ⬇️ for the risk estimates
✅Watch @JamisonFalk's presentation here: bit.ly/3FRCEoM🧑🏾💻
#T2DM #medsafety #FOAMed #MedEd #diabetes #ptsafety
✅Check out the image ⬇️ for the risk estimates
✅Watch @JamisonFalk's presentation here: bit.ly/3FRCEoM🧑🏾💻
#T2DM #medsafety #FOAMed #MedEd #diabetes #ptsafety
3/5 Evidence to date for #SGLT2i:
The first of the two new classes of medications for type II diabetes to reduce ↘️ risk of CV #AdverseEvents and mortality
✅Watch @JamisonFalk's presentation here: bit.ly/3FRCEoM🧑🏾💻
#T2DM #medsafety #FOAMed #MedEd #diabetes
The first of the two new classes of medications for type II diabetes to reduce ↘️ risk of CV #AdverseEvents and mortality
✅Watch @JamisonFalk's presentation here: bit.ly/3FRCEoM🧑🏾💻
#T2DM #medsafety #FOAMed #MedEd #diabetes
THREAD:5⃣things to know from 5 recent TI Therapeutics Letters👩🏽🔬
1/5: How to choose a good #mirtazapine dose? 🤔
Mirtazapine has a dose response 💊for harm but NOT for efficacy: harm ↗️ after 30mg/day but efficacy doesn't: bit.ly/361LU9E
#MedEd #deprescribing #ptsafety
1/5: How to choose a good #mirtazapine dose? 🤔
Mirtazapine has a dose response 💊for harm but NOT for efficacy: harm ↗️ after 30mg/day but efficacy doesn't: bit.ly/361LU9E
#MedEd #deprescribing #ptsafety
2/5: Want to learn about recent @GovCanHealth #medsafety or international warnings for medications?
Read our Therapeutics Letter on international drug safety advisories: bit.ly/3wc0ar8 ⚠️ 💊
#drugsafety #SegPac #ptsafety
Read our Therapeutics Letter on international drug safety advisories: bit.ly/3wc0ar8 ⚠️ 💊
#drugsafety #SegPac #ptsafety
3/5: Do you like receiving feedback on your #prescribing?👩🏽⚕️💊
Read about Personal Prescribing Portraits: bit.ly/3hkf8WO
#MedEd #deprescribing
Read about Personal Prescribing Portraits: bit.ly/3hkf8WO
#MedEd #deprescribing
THREAD - What if we could track and record repeat Adverse Drug Events? 🤔 💊
1/6: Register for our May 12 #BestEvidence webinar, as @corinne_hohl talks about Assessing the Impact of Information Continuity on Health Outcomes: bit.ly/3ap4FGO #MedEd
1/6: Register for our May 12 #BestEvidence webinar, as @corinne_hohl talks about Assessing the Impact of Information Continuity on Health Outcomes: bit.ly/3ap4FGO #MedEd
2/6: Why do Adverse Drug Events (ADEs) matter?
Each year in British Columbia, ADEs account for:
👉240,000 emergency dept (ED) visits
👉480,000 days in hospital
👉approx. 1 in 9 adult ED visits
More here: bit.ly/2Q7UGi8
#drugsafety #ptsafety #MedEd
Each year in British Columbia, ADEs account for:
👉240,000 emergency dept (ED) visits
👉480,000 days in hospital
👉approx. 1 in 9 adult ED visits
More here: bit.ly/2Q7UGi8
#drugsafety #ptsafety #MedEd
3/6: In Canada, adverse drug events 💊 cause or contribute to almost 2⃣million emergency department visits annually 😯 🆘
See publication list here: actionade.org/referenced-art…
#MedEd #ptsafety #prescribing
See publication list here: actionade.org/referenced-art…
#MedEd #ptsafety #prescribing
🧵 “How can I improve #PICC safety in my hospital?”
I’ve received many questions like this following the recent publication of our @BMJ_Qual_Saf paper showing how we did this in 50+ hospitals.
qualitysafety.bmj.com/content/early/…
Today, we released the formula (Thread)
I’ve received many questions like this following the recent publication of our @BMJ_Qual_Saf paper showing how we did this in 50+ hospitals.
qualitysafety.bmj.com/content/early/…
Today, we released the formula (Thread)
@BMJ_Qual_Saf First, head over to improvePICC.com and click on “Implementation” in the top menu - this will take you to the Roadmap for Quality Improvement.
@BMJ_Qual_Saf Then, pause for a moment.
You’re about to go on a journey - a #qualityimprovement journey.
Look for your markers, prepare yourself for change!
You’re about to go on a journey - a #qualityimprovement journey.
Look for your markers, prepare yourself for change!
THREAD: Dr. John Mandrola: “The more you see, the harder the medicine gets”
1/7 Some new views on legacy prescriptions: Beta-blockers, ASA & #statins by Dr. John Mandrola
(based on @drjohnm presentation hosted by @drug_evidence Oct 17, 2020: bit.ly/32fsPiA)
#MedED
1/7 Some new views on legacy prescriptions: Beta-blockers, ASA & #statins by Dr. John Mandrola
(based on @drjohnm presentation hosted by @drug_evidence Oct 17, 2020: bit.ly/32fsPiA)
#MedED
2/7 Example 1: Beta blockers in heart failure 💊♥️
Observational studies suggest beta-blockers for heart failure tx beyond 3 years are NOT associated with beneficial outcomes 😯
These findings challenge current recommendations: bit.ly/3acX9P7
#MedEd #deprescribing
Observational studies suggest beta-blockers for heart failure tx beyond 3 years are NOT associated with beneficial outcomes 😯
These findings challenge current recommendations: bit.ly/3acX9P7
#MedEd #deprescribing
3/7 Ex. 2: How about beta blockers to treat MIs, looking at research from pre-reperfusion & reperfusion eras?
Large meta-analysis of about 60 trials, with > than 100,000 pts found NO difference from using beta blockers in the reperfusion era: bit.ly/3dfvn6u
#MedEd
Large meta-analysis of about 60 trials, with > than 100,000 pts found NO difference from using beta blockers in the reperfusion era: bit.ly/3dfvn6u
#MedEd
THREAD: Tamiflu for #influenza prevention – the evidence
1/6 In 2019 21,000 BC citizens were prescribed Tamiflu (oseltamivir), many to prevent the flu. Flu prevention guidelines. AMMI Canada ammi.ca/?ID=171
Systematic review of Tamiflu safety: pubmed.ncbi.nlm.nih.gov/27246259/
1/6 In 2019 21,000 BC citizens were prescribed Tamiflu (oseltamivir), many to prevent the flu. Flu prevention guidelines. AMMI Canada ammi.ca/?ID=171
Systematic review of Tamiflu safety: pubmed.ncbi.nlm.nih.gov/27246259/
2/6 Tamiflu for prevention ↘️ symptomatic flu (by 3%, NNT=33) with uncertain effect on asymptomatic flu.
One likely explanation is that Tamiflu has a central symptom lowering effect but may not ↘️ viral transmission.
pubmed.ncbi.nlm.nih.gov/27246259
#influenza #flu #tamiflu
One likely explanation is that Tamiflu has a central symptom lowering effect but may not ↘️ viral transmission.
pubmed.ncbi.nlm.nih.gov/27246259
#influenza #flu #tamiflu
3/6 Tamiflu doesn't reduce risk of developing flu-like illness though it can make people feel better (i.e. fewer self-reported symptoms) & reduces fever.
There is not enough evidence to say it prevents death, hospitalizations, or flu complications
pubmed.ncbi.nlm.nih.gov/27246259/
There is not enough evidence to say it prevents death, hospitalizations, or flu complications
pubmed.ncbi.nlm.nih.gov/27246259/
THREAD: Are we using ACEIs & ARBs properly? A TI Tweetorial
1/6: British Columbia doctors give 4.5m scripts/year for ACE inhibitors (ACEIs) & angiotensin receptor blockers (ARBs) to control bp. Goal is to ↘️ mortality & morbidity, not simply to ↘️ bp.
#MedEd #hypertension
1/6: British Columbia doctors give 4.5m scripts/year for ACE inhibitors (ACEIs) & angiotensin receptor blockers (ARBs) to control bp. Goal is to ↘️ mortality & morbidity, not simply to ↘️ bp.
#MedEd #hypertension
2/6 BEST EVIDENCE on ARBs & ACEI for #hypertension
3⃣@CochraneHTN systematic reviews:
ACEs v ARBs for htn bit.ly/34vS0hu
BP lowering efficacy of ACEIs for htn bit.ly/30YNIOX
BP lowering efficacy of ACEIs for htn https://t.co/u8dN378QAe
#MedEd
3⃣@CochraneHTN systematic reviews:
ACEs v ARBs for htn bit.ly/34vS0hu
BP lowering efficacy of ACEIs for htn bit.ly/30YNIOX
BP lowering efficacy of ACEIs for htn https://t.co/u8dN378QAe
#MedEd
3/6 ACEIs over ARBS when considering HARMS 🤔
Both ACEIs & ARBs ↘️ blood pressure to similar extents.... BUT only ACEIs have evidence for a reduction in risk of morbidity & mortality. So they’d be your first choice 🥇
#MedEd #medsafety #ptsafety
Both ACEIs & ARBs ↘️ blood pressure to similar extents.... BUT only ACEIs have evidence for a reduction in risk of morbidity & mortality. So they’d be your first choice 🥇
#MedEd #medsafety #ptsafety
THREAD: Are we using ACEIs & ARBs properly? A TI Tweetorial
1/6: British Columbia doctors give 4.5m scripts/year for ACE inhibitors (ACEIs) & angiotensin receptor blockers (ARBs) to control bp. Goal is to ↘️ mortality & morbidity, not simply to ↘️ bp.
#MedEd #hypertension
1/6: British Columbia doctors give 4.5m scripts/year for ACE inhibitors (ACEIs) & angiotensin receptor blockers (ARBs) to control bp. Goal is to ↘️ mortality & morbidity, not simply to ↘️ bp.
#MedEd #hypertension
2/6 BEST EVIDENCE on ARBs & ACEI for #hypertension
3⃣@CochraneHTN systematic reviews:
ACEs v ARBs for htn bit.ly/34vS0hu
BP lowering efficacy of ACEIs for htn bit.ly/30YNIOX
BP lowering efficacy of ACEIs for htn https://t.co/NCl1dfCCAO
#MedEd
3⃣@CochraneHTN systematic reviews:
ACEs v ARBs for htn bit.ly/34vS0hu
BP lowering efficacy of ACEIs for htn bit.ly/30YNIOX
BP lowering efficacy of ACEIs for htn https://t.co/NCl1dfCCAO
#MedEd
3/6 ACEIs over ARBS when considering HARMS 🤔
Both ACEIs & ARBs ↘️ blood pressure to similar extents.... BUT only ACEIs have evidence for a reduction in risk of morbidity & mortality. So they’d be your first choice 🥇
#MedEd #medsafety #ptsafety
Both ACEIs & ARBs ↘️ blood pressure to similar extents.... BUT only ACEIs have evidence for a reduction in risk of morbidity & mortality. So they’d be your first choice 🥇
#MedEd #medsafety #ptsafety
THREAD: 5 Things You Need to Know About PPIs
For many years, we've dissected the research on Proton Pump Inhibitors (PPIs) 🤔
This thread captures our publications on PPIs that can help you in clinical practice: ti.ubc.ca/?s=ppis
#MedEd #medsafety #DrugEvidence #GERD
For many years, we've dissected the research on Proton Pump Inhibitors (PPIs) 🤔
This thread captures our publications on PPIs that can help you in clinical practice: ti.ubc.ca/?s=ppis
#MedEd #medsafety #DrugEvidence #GERD
2/6 PPI COSTS VARY CONSIDERABLY 💰
Even without differences in efficacy or safety between PPIs, costs can vary x 10. The cheapest in BC? Pantoprazole Mg 40mg or Rabeprazole 10mg. Most expensive: Dexlanzoprazole
More here: ti.ubc.ca/letter99
#MedEd #DrugCosts #GERD
Even without differences in efficacy or safety between PPIs, costs can vary x 10. The cheapest in BC? Pantoprazole Mg 40mg or Rabeprazole 10mg. Most expensive: Dexlanzoprazole
More here: ti.ubc.ca/letter99
#MedEd #DrugCosts #GERD
3/6 RESPONSE IS VARIABLE
1 in 2 pts w/ acid reflux get symptom relief with a PPI (NNT~2) w/in 4-8 wks
Responders notice symptom relief w/in 1-9 days. If no relief in ~2 wks consider 🛑 PPI. Non-acid reflux doesn’t benefit from PPI
More here: ti.ubc.ca/letter99
#MedEd
1 in 2 pts w/ acid reflux get symptom relief with a PPI (NNT~2) w/in 4-8 wks
Responders notice symptom relief w/in 1-9 days. If no relief in ~2 wks consider 🛑 PPI. Non-acid reflux doesn’t benefit from PPI
More here: ti.ubc.ca/letter99
#MedEd
THREAD: Ten Commandments for patient-centred treatment 🧾
1/11 A TI Tweetorial on the “Ten Commandments’ of the New Therapeutics
Revisiting timely words of medical wisdom from the BMJ
bjgp.org/content/65/639…
#MedEd #prescribing
1/11 A TI Tweetorial on the “Ten Commandments’ of the New Therapeutics
Revisiting timely words of medical wisdom from the BMJ
bjgp.org/content/65/639…
#MedEd #prescribing
2/11 1st Commandment:
Thou shalt have no aim except to HELP patients, according to the GOALS they wish to achieve 👩⚕️
bjgp.org/content/65/639…
Shared decision-making lessons from @LessIsMoreMed: lessismoremedicine.com/hands-on
#MedEd #TreatmentGoals
Thou shalt have no aim except to HELP patients, according to the GOALS they wish to achieve 👩⚕️
bjgp.org/content/65/639…
Shared decision-making lessons from @LessIsMoreMed: lessismoremedicine.com/hands-on
#MedEd #TreatmentGoals
3/11 2nd Commandment:
Thou shalt always seek knowledge of BENEFITS, HARMS, COSTS of treatment & share this knowledge at all times
bjgp.org/content/65/639…
Try these:
ti.ubc.ca/therapeutics-l…
@thenntgroup
medi-mouse.com
pac.bluecross.ca/pharmacycompass
#MedEd #ptsafety
Thou shalt always seek knowledge of BENEFITS, HARMS, COSTS of treatment & share this knowledge at all times
bjgp.org/content/65/639…
Try these:
ti.ubc.ca/therapeutics-l…
@thenntgroup
medi-mouse.com
pac.bluecross.ca/pharmacycompass
#MedEd #ptsafety
THREAD: Painful Evidence: Do Common treatments for pain work❓
1/10 How effective are pain drugs? 🤔
In BC 120,000 ppl take cyclobenzaprine; 160,000 take gabapentin or pregabalin. Many others take duloxetine, venlafaxine, or amitriptyline
#MedEd #TIEvidence #painmanagement
1/10 How effective are pain drugs? 🤔
In BC 120,000 ppl take cyclobenzaprine; 160,000 take gabapentin or pregabalin. Many others take duloxetine, venlafaxine, or amitriptyline
#MedEd #TIEvidence #painmanagement
2/10 SIDE EFFECTS:
Most 👨🧕on gabapentin/pregabalin/duloxetine/TCAs (e.g. amitriptyline) experience some adverse side effects like sleepiness, dizziness, nausea, dry mouth or constipation
Benefits/harms here: ti.ubc.ca/letter96
#MedEd #painmanagement
Most 👨🧕on gabapentin/pregabalin/duloxetine/TCAs (e.g. amitriptyline) experience some adverse side effects like sleepiness, dizziness, nausea, dry mouth or constipation
Benefits/harms here: ti.ubc.ca/letter96
#MedEd #painmanagement
3/10 COCHRANE pain meds EVIDENCE:
Evidence frm 8 @cochranecollab reviews should ↘️ expectations abt likelihood+size of pain relief frm gabapentin, pregabalin, duloxetine, venlafaxine, amitriptyline, nortriptyline, imipramine, desipramine
ti.ubc.ca/letter96
#painmanagement
Evidence frm 8 @cochranecollab reviews should ↘️ expectations abt likelihood+size of pain relief frm gabapentin, pregabalin, duloxetine, venlafaxine, amitriptyline, nortriptyline, imipramine, desipramine
ti.ubc.ca/letter96
#painmanagement
Are you an academic clinician or trainee with a career focus in #QI?
Are you interested in implementing QI initiatives in an academic teaching hospital/clinic settings?
Apply for EQUIP - QI certificate program offered by @CQuIPS
(Deadline Mar 27, ‘20)
cpd.utoronto.ca/equip
Are you interested in implementing QI initiatives in an academic teaching hospital/clinic settings?
Apply for EQUIP - QI certificate program offered by @CQuIPS
(Deadline Mar 27, ‘20)
cpd.utoronto.ca/equip
Program format:
1) Two 3-day in-person sessions in Toronto, Canada
2) Longitudinal #QI project
3) Webinars for participants to receive feedback on their projects
4) Personalized coaching from expert program faculty
1) Two 3-day in-person sessions in Toronto, Canada
2) Longitudinal #QI project
3) Webinars for participants to receive feedback on their projects
4) Personalized coaching from expert program faculty
Learn from the best — here are just a few of the expert @CQuIPS faculty you will interact with if you enroll in EQUIP
cpd.utoronto.ca/equip/faculty/…
cpd.utoronto.ca/equip/faculty/…
NEW in #JAMIA:
Large assessment of 1,400 patient/family reports examining patient/family experiences and safety concerns related to visit notes.
Most common concerns:
✔️Description of symptoms
✔️Medications
✔️Health problems
academic.oup.com/jamia/advance-… #ptsafety #opennotes
Large assessment of 1,400 patient/family reports examining patient/family experiences and safety concerns related to visit notes.
Most common concerns:
✔️Description of symptoms
✔️Medications
✔️Health problems
academic.oup.com/jamia/advance-… #ptsafety #opennotes
@fcbourgeois @RasuShrestha @BIDMChealth @cmd418 @AtriumHealth @BostonChildrens @jhalamka @TheIHI @AMIAinformatics Paraphrase:
"About 1/4 of 😷/👨👩👦👦 using an online reporting system identified potential documentation inaccuracies in visit notes, of which more than half were considered 'important' by 😷/👨👩👦👦 AND 👩⚕️🏥."
👏 to @fcbourgeois and team.
#ptsafety #opennotes
"About 1/4 of 😷/👨👩👦👦 using an online reporting system identified potential documentation inaccuracies in visit notes, of which more than half were considered 'important' by 😷/👨👩👦👦 AND 👩⚕️🏥."
👏 to @fcbourgeois and team.
#ptsafety #opennotes
@fcbourgeois @RasuShrestha @BIDMChealth @cmd418 @AtriumHealth @BostonChildrens @jhalamka @TheIHI @AMIAinformatics Why is this important?
"... highlights the possibility... clinicians & patients/families may further enhance the ability to effectively capture potential safety issues."
&
As #HealthIT transparency grows, orgs need ways to capture & respond to patient feedback about EHR errors.
"... highlights the possibility... clinicians & patients/families may further enhance the ability to effectively capture potential safety issues."
&
As #HealthIT transparency grows, orgs need ways to capture & respond to patient feedback about EHR errors.
Ok #QIeducators — let’s see if we can crowdsource to see what #QI #ptsafety being taught in medical schools across Canada — thanks @sdmckay2002 @SchulichMedDent for getting us started...
Cc @NishanSharma29 @DrToddLee @DrEmilyMcD @ACSmaggus @eddeestyle @HemeHillis @RogerWong10 @MKChan_RCPSC @cameacem
We also have been teaching #QI #ptsafety across the four years of medical school at @uoftmedicine — last year we had the privilege of work with @gregswings to partner with patients and families to teach #ptsafety to our students
It has been such a huge honour to co-direct @CQuIPS certificate course w/ 3 incredible women in med (@trey_coffey_TO, @DrAleneToulany & Olivia Ostrow) & graduate 6 cohorts of #QI clinicians & leaders. Special thanks to Eric Monteiro, Jerome Leis, Lisha, Tanya and Mohita as well!
I will be stepping down and passing the torch to @AdinaWeinerman (Medical Director or #QI and #ptsafety at @Sunnybrook) who will co-direct the @CQuIPS certificate course with Olivia Ostrow
Our awesome @CQuIPS certificate course leadership team — Olivia Ostrow, Eric Monteiro and @DrAleneToulany
The #ICRE2018 debate on the #BawaGarba case tightly links issues of #MedEd and #ptsafety — in the first 10 mins, have already heard about just culture, safe supervision, learning from mistakes, diagnostic uncertainty, systems failures & 2nd victim
Here are some more #MedEd #ptsafety topics being discussed at #ICRE2018 plenary:
Speaking up
Teamwork vs teaming
Handoffs
Fatigue and its impact on clinical performance
Psychological safety
Speaking up
Teamwork vs teaming
Handoffs
Fatigue and its impact on clinical performance
Psychological safety
Empirical data on patient safety incidents that involve residents:
Lack of supervision (~50%) and handoff problems (~20%) among the most common contributors to serious safety problems
Landmark article from 2007:
jamanetwork.com/journals/jamai…
#ICRE2018
Lack of supervision (~50%) and handoff problems (~20%) among the most common contributors to serious safety problems
Landmark article from 2007:
jamanetwork.com/journals/jamai…
#ICRE2018
Now up -- @eddeestyle leading a discussion on how to introduce discussions on human factors in residency education at #ASPIRE #ICRE2018 #ptsafety
For some, the term human factors may not be familiar. Here's a common definition:
"Human factors is the study of the interrelationship between humans, the tools and equipment they use in the workplace, and the environment in which they work."
who.int/patientsafety/…
#ICRE2018
"Human factors is the study of the interrelationship between humans, the tools and equipment they use in the workplace, and the environment in which they work."
who.int/patientsafety/…
#ICRE2018
Here's a real world example for how human factors influence behaviour and performance.
The urinal fly.
This simple intervention reduced spillage by 80% and cleaning costs by 8%.
washingtonpost.com/news/wonk/wp/2…
#ICRE2018 @eddeestyle
The urinal fly.
This simple intervention reduced spillage by 80% and cleaning costs by 8%.
washingtonpost.com/news/wonk/wp/2…
#ICRE2018 @eddeestyle
We start with discussion of #ptsafety culture and how to introduce discussions in #MedEd. Stacy Ackroyd uses this powerful video from @MedStarHealth to trigger reflection and discussion on ones organizational safety culture #ICRE2018 #ASPIRE
One of the major challenges facing #ptsafety is a culture of disrespect. Revisiting 2012 paper by Lucien Leape in @AcadMedJournal -- highly relevant for #ICRE2018 and its focus on the learning environment this year journals.lww.com/academicmedici…
Dear #hospitals:
Your discharge planning sets #patients up for failure. How? Let me explain (again, & again, & again). #PtExp #PtSafety #PtEng #EHR #interoperability #PatientAdvocacy #medtwitter #GMDD #hcldr
Photo Credit: Rob Potter (Unsplash)
Your discharge planning sets #patients up for failure. How? Let me explain (again, & again, & again). #PtExp #PtSafety #PtEng #EHR #interoperability #PatientAdvocacy #medtwitter #GMDD #hcldr
Photo Credit: Rob Potter (Unsplash)
1)Follow up appts, essential to a patient’s health & recovery, are listed as part of the discharge summary. These appts are recommended to be scheduled within 7-10 days. To be best prepared, patients need their records. #healthcare #PtExp #PtSafety #PtEng #EHR #GMDD #medtwitter
2)All records from a patient's hospital admission should be AUTOMATICALLY sent to every listed follow-up physician. Hospitals, you know which drs patients need to see; it’s listed in the discharge plans. This step needs to be embedded in the workflow #PtExp #EHR #interoperability
Burnout: a work-related constellation of signs/symptoms, often without prior psychiatric history. Marked by existential crisis, emotional exhaustion, and depersonalization. That’s academic. I described what it looks & feels like at @MassGeneralNews @acgme @TheIHI [THREAD]
Early in intern year, I was caring for Mr. V, an elderly HD patient. 1mo earlier, he was living independently & working at HR block. Now, he was admitted with delirium. I couldn't figure out why. I couldn't fix it. Weeks went by. He floundered on the service, sicker by the day.
After 14 inpatient days, we finally diagnosed Mr. V. Months before, PCP prescribed Morphine CR- normally cleared by the kidneys, but his didn't work. It made him sleepy enough that he missed HD once, the start of a downward spiral. Perhaps an error was made that day by his PCP...
