Qmentum ROPs: Tips and Tools for Implementation in Your Organization Teague Lamarche & Greg Kennedy Canadian Patient Safety Officer Course Ottawa, Ontario April 14, 2011 Teague Lamarche & Greg Kennedy Canadian Patient Safety Officer Course Ottawa, Ontario April 14, 2011

© Accreditation Canada/Agrément Canada 2 Overview  1) VTE prophylaxis  2) Safe surgery checklist  3) Falls prevention strategy  Rationale  Clarification on expectations  Examples from the field  Exercise: Challenges & Solutions

© Accreditation Canada/Agrément Canada 4 The ROP Handbook  New version released February 2011:  Provides full listing of ROPs, including reference sections

© Accreditation Canada/Agrément Canada 5 VTE Prophylaxis  ROP: The team identifies medical and surgical clients at risk of VTE (DVT and PE) and provides appropriate thromboprophylaxis.

© Accreditation Canada/Agrément Canada 6 Tests for Compliance 1)The organization has an organization-wide, written thromboprophylaxis policy or guideline. 2)The team identifies clients at risk for VTE (DVT and PE) and provides appropriate evidence- based, VTE prophylaxis.

© Accreditation Canada/Agrément Canada 7 Tests for Compliance cont. 3)The team establishes measures for appropriate thromboprophylaxis use, audits the implementation of appropriate thromboprophylaxis, and uses this information to make improvements to their services.

© Accreditation Canada/Agrément Canada 8 Tests for Compliance cont. 4)The team identifies major orthopedic surgery clients (hip and knee replacements, hip fracture surgery) who require post-discharge prophylaxis and has a mechanism in place to provide appropriate post-discharge prophylaxis to such clients. 5)The team provides information to health professionals and clients about the risks of VTE and its prevention.

© Accreditation Canada/Agrément Canada 9 Paediatric Exemption  Applies to patients ≥ 18 years of age  Paediatrics hospitals will not be expected to implement this ROP

© Accreditation Canada/Agrément Canada 10 SHN! Getting Started Kit  Lead by the team at Sunnybrook Health Sciences Centre, in collaboration with SHN! and ISMP- Canada

© Accreditation Canada/Agrément Canada 11 Safe Surgery Checklist The View From Aviation: “One wonders whether such checklists would have been introduced much earlier in medicine if surgeons shared the fate of their patients, as pilots share that of their passengers” Adrian Boelen, Retired Pilot Dorval, Quebec

© Accreditation Canada/Agrément Canada 12 Safe Surgery Checklist  ROP: The team uses a safe surgery checklist to confirm safety steps are completed before beginning a surgical procedure.

© Accreditation Canada/Agrément Canada 13 Two-fold Purpose of Checklist A. Communication tool B. Patient safety tool

© Accreditation Canada/Agrément Canada 14 Tests for Compliance 1) The team has agreed on a standard checklist to be used in the operating room.

© Accreditation Canada/Agrément Canada 15 Tests for Compliance cont. 2) The team uses the checklist ‘before’ every surgical procedure.  Content references the 3-stage checklist: i. Briefing ii. Time out iii. Debriefing

© Accreditation Canada/Agrément Canada 16 Tests for Compliance cont. 3)The team has an ongoing process of monitoring compliance with the checklist.

© Accreditation Canada/Agrément Canada 17 Tests for Compliance cont. 4)The team evaluates the use of the checklist and shares results with staff and service providers. 5)The team uses results of the evaluation to make improvements to implementing and expanding the use of the surgical checklist.

© Accreditation Canada/Agrément Canada 18 Falls Prevention Strategy - Compliance

© Accreditation Canada/Agrément Canada 19 Falls Prevention Strategy  ROP: The team implements and evaluates a fall prevention strategy to minimize the impact of client falls.

© Accreditation Canada/Agrément Canada 20 Tests for Compliance 1)The team has implemented a falls prevention strategy. 2)The strategy identifies the populations at risk for falls.

© Accreditation Canada/Agrément Canada 21 Tests for Compliance cont. 3)The strategy addresses the specific needs of the populations at risk for falls.

© Accreditation Canada/Agrément Canada 22 Tests for Compliance cont. 4)The team evaluates the falls prevention strategy on an ongoing basis to identify trends, causes, and degree of injury. 5)The team uses the evaluation information to make improvements to its falls prevention strategy.

© Accreditation Canada/Agrément Canada 23 Exercise ROPs: Challenges & Solutions

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