Brian Wong Profile picture
Oct 18, 2018 7 tweets 7 min read Read on X
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
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 Image
.@eddeestyle also introduces the role of cognitive biases (e.g., anchoring, framing, pre-mature closure, deference to authority etc.,) and how they affect diagnostic accuracy qualitysafety.bmj.com/content/22/Sup… #ICRE2018
"Just a Routine Operation" - video with @MartinBromiley discussing tragic death of his wife Elaine to illustrate important human factors principles & their impact on teamwork & #ptsafety

Often used to support #ptsafety training in #MedEd



#ICRE2018
Closing out with discussion on how to re-vamp M&M rounds to focus on both cognitive & systems issues (i.e., human factors)

OM3 model used in many organizations to improve both #ptsafety learning and outcomes @dr_lisa_lcalder @drjfrank

qualitysafety.bmj.com/content/early/…

#ICRE2018 #MedEd
Here is a really useful facilitator guide that can help you get started if you want to make M&M rounds more #ptsafety / systems focused:

emottawablog.com/wp-content/upl…

#ICRE2018 #MedEd

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More from @Brian_M_Wong

Sep 24, 2020
I often hear people say that we should apply what we know from #QI to the #COVID19 response -- the concerns around COVID testing and trying to increase our testing capacity serve as a good example where knowledge of systems can be helpful. A thread.
I often teach #QI with @kgshojania.

He uses this analogy of a Rube Goldberg machine to describe complex systems in healthcare.

Rube Goldberg machines are intentionally designed to perform a simple task in an indirect and overly complicated way

E.g., a pencil sharpener
A: Open window
B: Fly kite
C: Pull pulley
D: Lift cage door
E: Release Moths
F: Eat coat
G: Raise boot
H: Flip switch
I: Turn on iron
J: Burn shirt
K/L: Smoke out opossum
M: Jump out of tree
N: Land in basket
O/P: Lift cage
Q: Reveal woodpecker
R: Sharpen pencil
Read 9 tweets
Sep 23, 2020
I have set my clock to 10:30 AM to get @jkwan_md's amazingly informative updates on Ontario's #COVID19 situation.

Want to take this opportunity to thank her immensely, but also reflect on 4 #COVID19 curves that really worry me.
The first is the fact that we have no known Epi-link for 50% of our new cases -- @IrfanDhalla points this out repeatedly as a major barrier to properly #TestTraceIsolate Image
The 2nd is the fact that our testing turnaround time is getting longer -- for the first time since early April, we have more pending test results than reported test results (a whopping 48,000 tests pending) -- which means a delay to identifying cases and proper #TestTraceIsolate Image
Read 6 tweets
May 25, 2020
The inaugural @NEJMres360 resident #QI challenge was launched this year. Received 90 submissions.

Of these, 59 invited to prepare and post a poster -- can view them here: resident360.nejm.org/groups/qi-chal…

I'm thrilled that FOURTEEN posters are from @uoftmedicine cc @UofTMedDean @UofTPGME
Would like to highlight these amazing #QI posters from resident programs in medicine (@UofT_DoM), pediatrics (@SickKidsNews) and family medicine (@UofTFamilyMed)

cc @UofTPGME @SalSpadafora1 @UofTDoMChair @LennoxHuang @ronald_cohn @CQuIPS @tara_kiran @kgshojania
1) Let 'em breathe -- submitted by @Aditijain8243 @leechristiem et al from @ccmtoronto @SinaiHealth (critical care) -- increased rates of spontaneous breathing trials in the ICU from 53% to 71% resident360.nejm.org/posts/21339
Read 17 tweets
Mar 13, 2020
Today, as the Director of the Centre for Quality Improvement & Patient Safety (@CQuIPS) at the University of Toronto (@uoftmedicine) sent a message to all of our members -- a call to action to mobilize now to support health system efforts to respond to #COVID19
"Our focus at @CQuIPS will be to mobilize as many of our members, graduates and current students and direct them towards their local QI efforts to respond to the #COVID19 pandemic."
I urged each and every one of them to strongly consider whether any non-COVID related initiatives can be put on hold for now, and direct their time and energy to help our health system respond to the #COVID19 pandemic
Read 6 tweets
Feb 11, 2020
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
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 Image
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/…
Read 14 tweets
Dec 6, 2019
We are now accepting applications for EQUIP for 2020-21, our #QI certificate course at @CQuIPS that prepares faculty & senior trainees to lead QI in academic environments. Pls retweet & encourage others to apply. Deadline for applications is March 27, 2020 cpd.utoronto.ca/equip ImageImage
Read 4 tweets

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