Longwoods Radio

We describe our experience with a Nursing Usability Laboratory, where human factors design principles were applied to common nursing procedures. This paper will be of interest to any hospital seeking to enhance safety by applying human factors design principles.

Graham Scott is Chair of Canadian Institute for Health Information (CIHI) and Glenda Yeates is President and Chief Executive Officer, CIHI.

St. Peter's Residence at Chedoke in Hamilton, Ontario, a 210-bed long-term care facility, is building the capacity of front-line employees to become engaged in quality improvement. With training and tools, teams made up of front-line and other staff are becoming engaged in creating a quality improvement culture. This innovative initiative was recently featured in Promising Practices in Research Use, a series produced by the Canadian Health Services Research Foundation highlighting organizations that have invested their time, energy and resources to improve their ability to use research in the delivery of health services.

Saskatchewan's Chronic Disease Management Collaborative is a quality improvement model that brings together healthcare providers to learn about, test and share experiences with improvement ideas in diabetes and coronary artery disease care. This innovative initiative was recently featured in Promising Practices, a monthly series produced by the Canadian Health Services Research Foundation highlighting organizations that have invested their time, energy and resources to try to improve their ability to use research in the delivery of health services.

To ensure the safe care of patients repatriated to HDGH, we have implemented a process that identifies patient needs prior to their repatriation. The process provides us with critical information regarding a patient's condition well before repatriation so our staff can confirm that we can safely meet the patient's needs. The process is simple and easy for both the sending and receiving facilities to adopt.

Titles include The Obstetric Pathology of Poverty: Maternal Mortality in Kep Province, Cambodia; Maternal Chronic Ill Health Negatively Affects Child Survival in a Poor Rural Population of Pakistan; and The Relationship of Sexual and Gender-Based Violence to Sexual-Risk Behaviour among Refugee Women in Sub-Saharan Africa.To read these and other articles on Women's health in developing countries visit www.worldhealthandpopulation.com.

A partnership between health services researchers from Queen's University and the University of Ottawa, a community nursing agency and a home care authority in Ottawa led to major improvements in the quality of care for people with leg ulcers. The synthesis of both external and local evidence played a key role in the adoption of an evidence-based protocol and provided the critical context to support a significant reorganization of the existing service delivery model. This case demonstrates that, with a collaborative partnership approach, systematic and transparent research processes can be rapidly developed to support policy change.

It is included on Longwoods' Radio with their kind permission. EXTRA stands for Executive Training for Research Application, a program to promote the movement of research findings directly into the management of the health care system. One of the first participants, and one of the program's staunchest proponents, Dr. James Worthington, explains how EXTRA made a difference to him, and how his project had an impact at the Ottawa Hospital.

Building on its vision to be a leader in health innovation, Trillium Health Centre has undertaken a unique approach towards creating a supportive infrastructure to promote a culture of continuous quality improvement and to empower staff and physicians to deliver evidence-based care consistently, appropriately and safely. Although the hospital's approach to best practice may be unique in comparison to other hospitals, it is one that can be replicated and applied at other healthcare organizations.

The Grey Bruce Health Network began developing regional clinical pathways in 2002 (Meleskie and Wilson 2003). The Total Hip Replacement (THR) pathway was one of the first developed. A three-stage pathway, the THR pathway has an acute stage for the first five hospital days following surgery, a post-acute stage for convalescent care in hospital and a community-care stage for community physiotherapy after hospital discharge. Pilot results (119 patients) have shown an increase in information transfer, streamlining care and increasing efficiencies (capacity savings of over $92,000), increased usage of best practices, more consistent care across the continuum of care and decreased length of stay (by 1.55 days) at the regional hospital centre.