Lots of talk at #ICRE2018 about incivility in the learning environment. @HopkinsMedicine implemented a multifaceted intervention to address the problem of the "Untouchables" —individuals who engaged with impunity in transgressive or disruptive behaviour journals.lww.com/academicmedici…
Intervention incudes: 1) Publicly discuss Untouchables problem across @HopkinsMedicine system 2) Coordinate & formalize mechanisms to identify, assess, remedy disruptive
behavior 3) Training in leadership behaviors to encourage voice 4) Build capacity for difficult conversations
Key piece = Safe at Hopkins -- graded remediation process
- communication that emphasizes impact of behavior on culture of safety
- referral for coaching / skill-building
But if behavior does not improve, findings can be cited as support for removal from position of power
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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.
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
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
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
Would like to highlight these amazing #QI posters from resident programs in medicine (@UofT_DoM), pediatrics (@SickKidsNews) and family medicine (@UofTFamilyMed)
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
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
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