New Patient Safety Initiative
The Center for Leadership, Innovation and Research in EMS (CLIR), along with its sponsoring organizations – the EMS Chiefs of Canada, the National EMS Management Association and the North Central EMS Institute – today announced a new patient safety initiative. The EMS Voluntary Event Notification Tool (EVENT) provides an anonymous tool for EMS providers and others to report adverse events that occur in the EMS setting. CLIR is a non-regulatory, not-for-profit group that is promoting and advancing the practice and profession of EMS internationally. The National Association of State EMS Officials is a partner organization for EVENT and CLIR will begin seeking additional partner organizations this month.
The goal of every emergency medical provider (first responder, E.M.T., Paramedic, Flight Nurse, Physician and others) is to respond to patients in their time of need and to provide them with the most appropriate and highest quality care possible. This care is frequently critical to a patient’s health or survival and is often provided in settings that are challenging, chaotic and even hazardous. Decisions and actions by emergency medical providers are sometimes influenced by environmental factors but are always based upon the experience, training, protocols, medical direction, common medical practice and ultimately the provider’s best judgment. Regardless of training, experience and especially the intent of the provider, medical errors in the EMS setting occur and cause harm or even take the life of the very patients the system is intending to save.
Emergency Medical Services (EMS) are an important part of the healthcare system and have the responsibility to do no harm. It would be naive to think that errors in EMS either don’t exist or that nothing can be done to reduce or even eliminate them. One tool that moves systems in this direction is an “Event Reporting System.” An Event Reporting System allows providers to anonymously report safety events that have occurred, could have occurred or could potentially occur in order to capture the event so work can be done to improve the system of care.
Anonymous reporting models have been in place for industries such as aviation for decades. The model for EVENT was first developed and used by the state EMS office Pennsylvania. The purpose of the Pennsylvania system and that of EVENT is to collect and utilize valuable information from anonymous reports to help improve the consistency and quality of the care in the EMS arena. Information provided in these anonymous reports identify needed changes in the systems and processes without placing blame on the individual provider. The EVENT system is not designed to nor can it directly improve either the quality or consistency of care provided by EMS systems. EVENT is a channel for thoughtful, accurate and timely notification through anonymous submissions to the appropriate state, territory or provincial EMS governing body. Once the governing body receives the anonymous notification, they are encouraged to address systemic issues in order to improve the overall quality of care provided.
The EVENT system can be used to anonymously report any patient-safety related issue such as:
- “Sentinel Events” where unexpected or unintended occurrences result in serious physical injury, psychological trauma or death
- Unexpected or unintended occurrences that result in any physical injury or psychological injury of a patient, including adverse drug reactions
- “Near Misses” which are close calls that could have resulted in accident, injury or illness but did not either by chance or through timely intervention
- Equipment or device failures, malfunctions or provider errors of omission (not using when called for) or misuse (using it in the incorrect way); that cause or could cause harm to a patient.
- Lessons learned, safety ideas and/or concerns or any topic that has been vetted through local authority either without resolution or the reporting person feels that it cannot be brought up with local authority without the risk of repercussion
The EVENT system is only applicable to patient safety events that are related to care given by components of the pre-hospital or out-of-hospital EMS system including but not limited to: ambulance attendants, first responders, all levels of EMTs and paramedics, Critical Care Transport service personnel, quick response services, ambulance services, air ambulance services, dispatch centers and medical command facilities. EMS agencies that operate their own internal event reporting system are encouraged to also report their events anonymously through EVENT.
EVENT is one effort of many to improve the safety and quality of care provided by EMS.
Thank you for your interest in improving EMS. Please help spread the word about the availability of EVENT throughout the EMS community in the US and Canada.
Click image to access http://Event.clirems.org
Two Canadian medics killed in Afghanistan
Master Corporal Kristal Giesebrecht and Private Andrew Miller, both medics out of CFB Petawawa, were killed in Afghanistan on Saturday.
Photographed by:
DND handout, xx
KANDAHAR, Afghanistan — Two Canadian medics were killed Saturday morning, including the third Canadian woman to die in combat, when the armoured vehicle they were travelling in struck a homemade landmine in Afghanistan.
Master Cpl. Kristal Giesebrecht, 34, of Wallaceburg, Ont., who was married and on her second tour of Afghanistan, and Pte. Andrew Miller, 21, of Sudbury, Ont., had gone out with troops sent to defuse an improvised explosive device, which the military said the Taliban had planted in the doorway of a house.
Giesebrecht was from the 1 Canadian Field Hospital in Petawawa, Ont., and Miller was from 2 Canadian Field Ambulance, also in Petawawa.
They died 20 kilometres west of Kandahar City in Panjwaii District, a Taliban hotbed where most of Canada’s battle group is now arrayed.
Peter MacKay, minister of national defence, issued a statement on the deaths of the two soldiers.
“We grieve the loss of Master Cpl. Kristal Giesebrecht and Pte. Andrew Miller who died yesterday in Afghanistan. … This is a tragic loss for Canada and for the Canadian Forces.
He said the two gave their lives helping to create the secure conditions needed for reconstruction efforts and continued progress in Afghanistan.
They were the sixth and seventh medics to die in Afghanistan and the 11th and 12th Canadians to die here this year.
“My heartfelt sympathies are with the families and loved ones of these brave soldiers,” MacKay said.
Their deaths bring to 150 the total number of Canadian soldiers who have died in Afghanistan since 2002.
“We cannot say for certain that these medical personnel were targeted deliberately,” Brig.-Gen. Jon Vance, the Task Force Kandahar commander, said in an announcing the deaths.
In what was an apparent allusion to the presence in southern Afghanistan of large numbers of insurgents from Pakistan, he added: “It is certain that the threat to Afghans stemming from the influence of out-of-area fighters at this time of year is very serious.
“Our efforts to aid local Afghans and their government to function properly have begun to bear positive results, but those who do not live here, yet come here to fight, are immune to counter-insurgency influences.”
Another Canadian injured in the attack was in stable condition at the main medical hospital at Kandahar Airfield.
“It maybe seems to you that we are simply victims here — I assure you we are not,” Vance said in remarks directed at Canadians at home.
“We take casualties and we hurt, and such is the nature of war, but your soldiers, soldiers like Kristal Giesebrecht and Andrew Miller, stand as guardians between a terrible threat and the innocents who cannot protect themselves.”
The last Canadian woman to die in Afghanistan was Trooper Karine Blais of the 12e Regiment blinde du Canada of Valcartier, Que. She was killed in April 2009, in an IED attack in Shah Wali Khat District.
The first Canadian woman to ever die in combat was Capt. Nichola Goddard of the 1st Royal Canadian Horse Artillery of Shilo, Man. A forward observation officer, she was killed in Panjwaii in May 2006, when a rocket-propelled grenade was fired at her armoured vehicle by an insurgent.
Women, who comprise about 15 per cent of the Canadian Armed Forces, have been welcome in all military trades except submarines since 1989. However, relatively few female soldiers have served in combat roles.
Most of the women who have gone into harm’s way have been medics who go forward with infantry and combat engineers into dangerous places or logisticians who have been part of combat logistics patrols that resupply forward bases and outposts.
Giesebrecht was a whirlwind of activity when spotted recently in a clinic, rushing around good-naturedly at double or triple time as she made her rounds.
The medic was, Vance said, “a mentor and an inspiration” to the other combat medics, who form a tight, highly respected and trained community within the military.
“Kristal prided herself on her health and her fitness, although she always felt the solution to any problem could be found in a box of chocolates,” the general said.
Miller had made it known that he wanted to come to Afghanistan “so that he could put his skills to the test,” Vance said. An accomplished cook, he went by the nickname Caillou because of his resemblance to the infinitely curious cartoon character of that name, the general said.
© Copyright (c) Canwest News Service
Patient Safety in Emergency Medical Services
As well trained compassionate caregivers, emergency medical services (EMS) personnel often care for patients in challenging and dynamic environments. Providing healthcare services in unstable, high stress environments can lead to a real potential for risk of harm.
To better understand and begin to formally address the current patient safety issues in EMS, in 2008, the Canadian Patient Safety Institute partnered with the EMS Chiefs of Canada (EMSCC) and the Calgary EMS Foundation to fund research exploring patient safety in EMS.
Through a competitive process, a research team from the University of Toronto was commissioned to develop the report, “Patient Safety in Emergency Medical Services: Advancing and Aligning the Culture of Patient Safety in EMS”.
Together with a pan-Canadian Advisory Group, experts and stakeholders from across Canada and internationally were engaged to contribute information and expertise throughout the research process. The findings highlight the important challenges and opportunities for improving patient safety in EMS and that collaboration across Canada is required to better define and understand patient safety incidents in EMS.
This paper is the first of its kind in the world and the researchers have already presented their findings internationally. It is our collective hope that this work forms a firm foundation for future improvement initiatives and investments in high quality research and education to improve patient safety in EMS.
Please read this important patient safety document and share with your colleagues.
Sécurité des patients dans les services médicaux d’urgence
En tant que professionnels de la santé bien formés et intervenants empathique, le personnel des services médicaux d’urgence (SMU) travaille le plus souvent dans le vif de l’action et dans des conditions particulièrement difficiles. Prodiguer des soins dans ces circonstances hautement stressantes et instables comporte un risque réel de préjudices.
Afin de bien cerner les enjeux actuels de la sécurité des patients en SMU et de porter ceux-ci sous la lorgnette de la science, l’Institut canadien pour la sécurité des patients s’est, en 2008, adjoint deux précieux partenaires, les Directeurs des services médicaux d’urgence du Canada (DSMUC) et la Calgary EMS Foundation, qui ont contribué avec lui à l’effort financier pour faire avancer la recherche sur la sécurité des patients en SMU.
Après la tenue d’un concours, une équipe de chercheurs de l’Université de Toronto s’est vue confier le mandat de rédiger un rapport, intitulé « La sécurité des patients dans les services médicaux d’urgence : Promouvoir et harmoniser une culture de sécurité des patients dans les services médicaux d’urgence (SMU) ».
Sous l’éclairage expert d’un groupe-conseil pancanadien, des experts et des intervenants des quatre coins du pays et du monde ont mis en commun leurs connaissances pour enrichir le processus de recherche. Les résultats ont mis en lumière les défis et les occasions à saisir pour améliorer la sécurité des patients en SMU et la nécessité d’une vaste collaboration nationale pour mieux circonscrire et comprendre les incidents qui surviennent dans le contexte des SMU et mettent en péril la sécurité des patients.
Ce rapport est une première mondiale en son genre, et les chercheurs ont déjà présenté leurs conclusions à la communauté internationale. Nous espérons tous que ce colossal travail jette les bases de louables initiatives d’amélioration et suscite l’intérêt d’investir dans la recherche et la formation de haute qualité afin d’améliorer la sécurité des patients en SMU.
Nous vous invitons à lire cet important document sur la sécurité des patients et de le faire circuler parmi vos collègues.
Haiti Emergency Response
On behalf of the EMS Chiefs of Canada (EMSCC), I would like to provide you with an update on our association’s response to the tragic earthquake in Haiti.
Our EMSCC Executive committee has met and reviewed the current situation in Haiti, and stand ready to provide resources upon approval from the federal government. We have been in constant communication with our colleagues at the CACP (Canadian Association Chiefs of Police), and the Canadian Association of Fire Chiefs (CAFC) .We have been encouraged by the federal government to work through our provincial emergency management agencies to coordinate any potential responses.
At this point, the UN has indicated that there is no need for additional capacity on the ground. The decision to not send the National HUSAR team at this time was based on many factors, primarily information gathered by the Canadian reconnaissance team in Haiti such as airport backlogs, the many transportation challenges, and the presence on the ground of more than 30 teams. Canada would consider deploying National HUSAR capabilities if requested.
The EMSCC is represented through a Joint Emergency Management Committee chaired by Deputy Chief Sue O’Sullivan of the Ottawa Police Service. EMSCC Board members Bruce Farr and Tom Sampson represent the EMSCC on this committee, and have received timely updates through this committee with respect to any requests of our interagency associations (CACP, CAFC, EMSCC).
We will endeavor to keep you informed of any updates with respect to our joint response to this emergency situation.
Additionally, should you wish to make a financial contribution to the relief efforts, below are links to several agencies for your information.
City of Toronto TTC stations until Friday January 22nd:
http://www.toronto.ca/haitirelief/pdf/ttc_release_donations.pdf
Canadian Red Cross:
http://www.redcross.ca/article.asp?id=33900&tid=001
Global Medic:
http://www.globalmedic.ca/
World Vision:
https://www.worldvision.ca/Pages/Home.aspx
Sincerely,
Bruce Farr, President
Emergency Medical Services Chiefs of Canada (EMSCC)
Paramedics who tried to save Czapnik identified
Last Updated: Friday, January 15, 2010 | 2:00 PM ET
CBC News
Paramedics, left to right, Craig McInnes, Virginia Warner, Patricia St. Denis and Amanda Walkowiak rushed to help Const. Eric Czapnik as he was being stabbed to death on Dec. 29. (Ottawa Paramedic Service)
The Ottawa Paramedic Service has released the names of the four paramedics who intervened in the fatal stabbing of an Ottawa police officer, saying they showed “courage and professionalism” in what was a “dangerous and traumatic incident.”
Craig McInnes, 41; Patricia St. Denis, 24; Amanda Walkowiak, 26; and Virginia Warner, 29, rushed to help 51-year-old Const. Eric Czapnik on Dec. 29, the service confirmed Wednesday.
They had been inside the emergency department of the Ottawa Hospital’s Civic Campus when they spotted a man attacking Czapnik. Three of the paramedics reportedly disarmed and subdued the attacker while the fourth tried unsuccessfully to save Czapnik’s life.
Kevin Gregson, 43, a suspended RCMP officer from Saskatchewan, has been charged with first-degree murder in the incident.
Anthony Di Monte, chief of the Ottawa Paramedic Service, said McInnes, St. Denis, Walkowiak and Warner represent the “very best of our profession.”
“I am proud of their courage and professionalism during such a dangerous and traumatic incident,” he said in a statement.
However, he said the four cannot comment on the incident until the related court case is over to “ensure the integrity” of the court proceedings. He added that they are legally and ethically bound to respect and protect patient confidentiality.
Glucose Changes in Ontario Acute Stroke Protocol
Recent proposed changes to the Ontario Paramedic acute stroke protocol to reduce the inclusion criteria of blood sugar levels from 4.0mmol/L to 3.0mmol/L raised concern that there would be an increase in workload for Paramedic services. Data showed that this was not the case.
Click here to see the details.
FDA to Review Some External Biphasic Defibrillators’ Energy Levels
FDA notified healthcare professionals that it is investigating energy levels in external biphasic defibrillators with shocks of less than or equal to 200 Joules (J). FDA received reports of 14 events since 2006 in which a 200 J biphasic defibrillator was ineffective in providing defibrillation/cardioversion therapy to a patient, whereas a subsequent shock from a different 360 J biphasic defibrillator resulted in immediate defibrillation/cardioversion. The majority of events occurred during attempts at cardioversion of atrial fibrillation, but there was at least one instance with defibrillation of a ventricular arrhythmia as well. Analysis of the 14 cases does not suggest the need for any change to current clinical practice, and as FDA continues its evaluation of this situation, providers are encouraged to follow the American Heart Association’s guidelines/algorithms for treatment of cardiac arrhythmias, and to follow manufacturers’ instructions for using defibrillators.
Click here to read the original story.
EMSCC Share A Cup
Emergency Medical Services Chiefs of Chiefs of Canada (EMSCC) issues a challenge to all Emergency Medical Services across Canada to support the Canadian Forces in “Share a Cup with a Brave Canuck! Challenge.
When: Wednesday, October 28, 2009
Time: 1:00 p.m. EST
Location: Toronto EMS Headquarters, 4330 Dufferin St., in the ground floor atrium. Members of Toronto EMS will be present as well as Officers and Members of the Canadian Forces.
EMS Chiefs of Canada President and Chief of Toronto Emergency Medical Services, Bruce Farr is distributing a challenge to all Emergency Service employees across Canada to support our women and men of the Canadian Forces with a “THANK YOU!” and a small treat in time for the Holiday Season. Please note that this challenge is not only just EMS staff but Emergency Services personnel from Across the Country.
The employees of all emergency services will be asked to support the challenge by purchasing a $10.00 Tim Horton’s gift card to send to a member of the Canadian Forces serving in Afghanistan. This successful program was supported solely by Toronto EMS employees in 2008. This year we invite ALL EMS services across the country to participate. Last year alone, Toronto EMS staff contributed 1,800 cards and people who heard of our cause contributed 2,200 cards to total 4000 cards last year….. we endeavor to triple that number this year!
Our challenge ends on Wednesday December 16th 2009 and we are planning to present the collected Tim Horton’s gift cards to the Canadian Forces staff here at EMS Headquarters in Toronto on Thursday December 17th 2009 in order for them to arrive in Afghanistan prior to the December 25th.
Anyone wishing to answer our challenge (we are hoping to be able to send over 2,800 Tim Cards to Afghanistan) and support the challenge can send their Tim Cards to:
“SHARE A CUP”
C/O Toronto EMS
4330 Dufferin St.
Toronto, Ontario
M3H 5R9
The EMS Chiefs of Canada recognize the sacrifice that our Canadian Forces personnel make each day to support the many peacekeeping missions around the world. These certificates are a small token of our appreciation to each and every one of these Canadian soldiers.
Emergency Medical Service Chiefs of Canada (EMSCC) was incorporated in 2002 as a national forum for information gathering, policy development, and coordinated action by the leadership of Canada’s EMS systems. The Board of Directors consists of twenty (20) EMS Chiefs and Directors representing each province and one territory. Its’ membership was drawn from all types of EMS systems across the country, with voting membership open to those who actually operate EMS systems, large and small, and associate membership available to those who operate in EMS systems in a supervisory or managerial capacity, but who are not the senior officers of their respective services. The EMSCC envisions Canadian EMS as a mobile health care service, existing at the centre of the community, and reaching into many aspects of community life and community services.
Media contacts: Kelly Nash, Executive Director, EMS Chiefs of Canada (403) 538-6142 kelly.nash@albertahealthservices.ca Bruce Farr, President EMS Chiefs of Canada (416) 397-9240 bfarr@toronto.ca
Human Swine Influenza in Alberta
Date: April 29, 2009
To: All Staff
From: Senior Executive, Alberta Health Services
Dr. Gerry Predy, Sr. Medical Officer of Health, Alberta Health Services
RE: Human Swine Influenza in Alberta
Alberta Health and Wellness has confirmed cases of Human Swine Flu in Alberta. Nationally, a total of 13 cases have been recorded as of April 28. All of these cases are classified as mild. Currently, Alberta Health Services has increased surveillance levels and is working closely with Alberta Health and Wellness to monitor Human Swine Influenza activity in our province.
Across the province, AHS has taken the appropriate steps to implement our response plans for this situation. Locally, Emergency Operation Centres or EOCs have been activated as part of our standard practice for events such as this. These centres will assist with the streamlining of clinical directives and responses as needed.
As a healthcare worker, taking precautions to ensure the health and safety of yourself and others is part of our work environment. As always, to protect yourself from infectious disease at work, please follow routine infection prevention and control practices. Please remember to:
• wash your hands frequently
• cover your cough; and,
• stay home and inform your supervisor if you are ill. (If you have recently traveled abroad and are well, please report to work as usual).
Staff are reminded to follow the established protocols for dealing with people with cough and respiratory infections. If dealing with patients suspected of having Serious Respiratory Illness, or when performing aerosol generating procedures, N95 masks are recommended. If you have specific questions, please check with your local Infection Prevention and Control Program or local Medical Officer of Health.
Your health is a priority for Alberta Health Services. We will continue to monitor this situation and advise staff of any updates. For up-to-date information, please visit your local intranet site or www.albertahealthservices.ca.
Please share this with fellow staff members who do not have access to e-mails. Print and post on staff bulletin boards and in staff rooms.
Pandemic Alert Raised to Level 5
Interim Guidance for Emergency Medical Services (EMS) Systems and 9-1-1 Public Safety Answering Points (PSAPs) for Management of Patients with Confirmed or Suspected Swine-Origin Influenza A (H1N1) Infection
For more information: http://www.cdc.gov/swineflu/guidance_ems.htm
