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Wednesday, June 21, 2017

Engaging Patients in Patient Safety – a Canadian Guide

In the past decade, evidence has shown that when healthcare providers work closely with patients and their families in program and service design and delivery, the healthcare system becomes safer and patients have better experiences and health outcomes.

Beginning in 2016, the Canadian Patient Safety Institute brought together patients, government and organizations responsible for improving patient safety and quality at the national or provincial level on an Action Team to help develop the guide “Engaging Patients in Patient Safety”.

This extensive resource, based on evidence and leading practices, helps patients and families, patient partners, providers and leaders work together more effectively to improve patient safety.

Working collaboratively, we can more proactively identify risks, better support those involved in an incident and help prevent similar incidents from occurring in the future. Together we can shape safe, high-quality care delivery, co-design safer care systems and continuously improve to keep patients safe.

To access this resource, click here:

Wednesday, June 14, 2017

Geriatric Lecture Series

The Geriatric Lecture Series, sponsored by the Iowa Geriatric Education Center and the University of Iowa Roy J. and Lucille A. Carver College of Medicine, is presented online as a series of monthly lectures. Each lecture can be viewed for one month and is accessible exclusively during the month it is scheduled.

The series is devoted to topics in clinical geriatrics designed to teach important principles in the management of older adults.

Because of grant funding by the Bureau of Health Workforce of the U.S. Department of Health and Human Services, Health Resources and Services Administration, registration to view the Geriatric Lecture Series is being offered at no cost to all to participants for this year only.

Click here to register for and view the Geriatric Lecture Series:

Wednesday, June 07, 2017

Treatment in a Geriatric Day Hospital improve individualized outcome measures using Goal Attainment Scaling

Evidence regarding outcomes in the Geriatric Day Hospital (GDH) model of care has been largely inconclusive, possibly due to measurement issues. A prospective cohort study which took place in Halifax, Nova Scotia, aimed to determine whether treatment in a GDH could improve individualized outcome measures using goal attainment scaling (GAS) and whether improvements were maintained 6-months post-discharge.
The study demonstrated short- and long-term effectiveness of GDH in helping patients achieve individualized outcome measures using GAS.
To access this study, click here:

Wednesday, May 31, 2017

Are healthcare aides underutilized in long-term care? New study examines continuing care facilities in Canada

With increasingly high demands, rising costs and scarcity of healthcare resources (including workforce shortages) in the last 10 years, appropriate workforce utilization has become an important discussion amongst healthcare practitioners and policy makers in Canada.1
The ever-evolving role of healthcare aides (HCAs) has expanded to meet these shortages. Healthcare aides, also known as personal care home attendants, support workers, nursing aides and nursing assistants and help to provide physical and emotional support for patients under the supervision of nurses or other healthcare professionals.2 In Canada, healthcare aides provide up to 80% of direct care in nursing homes. There is no set educational standard for healthcare aides to enter practice in Canada, as competencies vary by province.3 Beyond healthcare aides’ competency profile, there are several factors that are important to consider when trying to decide how to best utilize healthcare aides in continuing care facilities.  For example, it has been shown that involving healthcare aides in more skilled work, such as assisting with medications, can enhance feelings of personal and professional accomplishment. This, in turn, can lead to greater job satisfaction and retention among employees and improve residents’ quality of life.4,5,6
However, very little research has examined standardized training, education and scope of practice for healthcare aides. In this Canadian study, Arain, Deutschlander, and Charland (2017) look at the differences in healthcare aide training and utilization in continuing care facilities.1 Results of the study showed variation in how healthcare aides are employed in supportive living and long-term care facilities. Healthcare aides in supportive living were more likely to be involved in medication management and medication assistance training was mandatory for most healthcare aides in these facilities. These results suggest that healthcare aides in supportive living facilities are better utilized according to their training and competencies.
Expanding the role of healthcare aides in long-term care facilities may be a cost-effective solution to workforce shortages and a more efficient way to utilize resources in continuing care in Canada. 
To read the full study, click on the following link:
1 M. A., Deutschlander, S., & Charland, P. (2017). Are healthcare aides underused in long-term care? A cross-sectional study on continuing care facilities in Canada. BMJ open, 7(5), e015521.
2 Hewko, S. J., Cooper, S. L., Huynh, H., Spiwek, T. L., Carleton, H. L., Reid, S., & Cummings, G. G. (2015). Invisible no more: a scoping review of the health care aide workforce literature. BMC nursing, 14(1), 38.
3 Berta, W., Laporte, A., Deber, R., Baumann, A., & Gamble, B. (2013). The evolving role of health care aides in the long-term care and home and community care sectors in Canada. Human resources for health, 11(1), 25.
4 Estabrooks, C. A., Squires, J. E., Hayduk, L., Morgan, D., Cummings, G. G., Ginsburg, L., ... & Norton, P. G. (2015). The influence of organizational context on best practice use by care aides in residential long-term care settings. Journal of the American Medical Directors Association, 16(6), 537-e1.
5 Chou, S. C., Boldy, D. P., & LEE, Y. H. (2002). Measuring job satisfaction in residential aged care. International Journal for Quality in Health Care, 14(1), 49-54.
6 Pekkarinen, L., Sinervo, T., Perälä, M. L., & Elovainio, M. (2004). Work stressors and the quality of life in long-term care units. The Gerontologist, 44(5), 633-643.

Wednesday, May 24, 2017

SOS! A Mobile App to Improve Early Detection of Deterioration & Unnecessary Emergency Hospitalization in the Elderly

In 2013-2014, nearly 33% of frail elderly admitted to hospital from long-term care were admitted unnecessarily. According to the Canadian Institute for Health Information, approximately 1/3 of transfers from long-term care to hospital were for preventable conditions, costing almost $11 million dollars (2014). Many personal support workers, nurses and even general practitioners lack the specialty knowledge and experience needed to effectively manage the very complex care of the frail elderly. As a result, this vulnerable population is often unnecessarily admitted to hospitals.

To address some of these issues, Baycrest has launched an online learning tool for a Sensory Observation System (SOS) to increase accessibility, retention and application of geriatric specialty knowledge for healthcare providers caring for the frail elderly at risk of acute deterioration. 2


The Sensory Observation System (SOS) is a mobile app that was created to replace pocket cards that are used by staff to monitor a patient's condition.

“SOS was originally a set of pocket cards we created to assist frontline staff to recognize, prioritize and report meaningful information about changes in client condition,” says Jennifer Reguindin, an
interprofessional educator from Baycrest's Centre for Learning, Research and Innovation.“This tool is one part of a larger educational curriculum we developed to enhance resident care and support the Ministry of Health and Long-Term Care’s goal to reduce emergency transfers from long-term care homes to hospitals.” 3

To download the app, click here: 


Sources of potentially avoidable emergency department visits (2014). Canadian Institute for Health Information (CIHI). Retrieved May 23, 2017 from 

SOS! A gamified app to improve early detection of acute deterioration associated with unnecessary emergency hospitalization in the frail elderly (n.d.).Baycrest. Retrieved May 24, 2017 from

Mobile app aims to expand Baycrest's educational reach. (January 29, 2014). Baycrest Matters 10 (2). Retrieved May 24, 2017 from 

Wednesday, May 17, 2017 – Understanding and working through grief and loss

“I am at the epicentre of this earthquake.”  This is how Bonnie describes her grief when Ray, her husband of 41 years, died in 2013. She is one of 12 men and women from different cultural perspectives who share their very personal stories of grief, loss and healing after the death of a spouse, partner, child, parent or sibling. is a free online resource to help people work through their grief from the comfort of their own home, at their own pace. It was developed by family members who’ve “been there,” and grief experts to complement existing community resources and help address the lack of grief services particularly in rural and remote areas. It is also an education tool for health providers.


This online tool consists of 9 sections that people can navigate through easily to find the information they need. It covers a variety of topics including: 
  • Recognizing how grief affects you before and after death
  • Facing emotions such as sadness, loneliness, anger, fear and guilt
  • Managing situations that trigger grief
  • Managing family dynamics
  • Dealing with unhelpful comments and unwanted advice
  • Recognizing if you are stuck in grief; and re-engaging with life after a death was produced by the Canadian Virtual Hospice in collaboration with a team of families, grief experts and partners. Dr. Robert Neimeyer, renowned international grief expert was a member of the development team. Funding was provided by the Canadian Partnership Against Cancer. For more information, contact 

Wednesday, May 10, 2017

New Canadian Guideline and App for Opioid Therapy & for Chronic Non-Cancer Pain

Approximately 15 to 19% of Canadians live with chronic, non-cancer pain, which is defined as pain that lasts for more than 3 months and that interferes with daily activities.

In a new clinical practice guideline released this week, doctors are being advised to reduce their prescribing of opioid medication to patients with chronic non-cancer pain.Canadians are the second highest users per capita of opioids in the world and the rates of opioid prescriptions and opioid-related hospital visits and deaths have steadily increased in recent years.


Some recommendations include:

  • Non-drug and non-opioid pharmacotherapy should be considered first and optimized for patients with chronic non-cancer pain 
  • A trial of opioids for patients who have not responded to non-opioid treatment if patient does not have a current or past substance abuse problem or other psychiatric disorder
  • For patients starting opioids, a dose of less than 50 mg morphine equivalents a day is recommended and it is strongly recommended that the total daily dose is under 90 mg a day (this is a change from the previous 2010 guideline which suggested that the max dose be 200 mg/day)
  • A trial period of opioids to the lowest effective dose, potentially to none, for patients who are currently on 90 mg morphine equivalents a day or more, recognizing there are some patients who may need this tapering paused or abandoned 
Led by the renowned Michael G. DeGroote National Pain Centre at McMaster University and funded by Heath Canada and CIHI, this guideline has been developed by an international team of clinicians, researchers and patients. The full guideline is available at:

In addition to the guideline, an app has also been created to help doctors and patients work together to find a solution to manage their pain. The app is available at:

Note: This guideline does not include recommendations on opioid use for acute pain, patients with cancer-related pain, those in palliative care, or those currently undergoing treatment for opioid use disorder or opioid addiction


Forum for Science, Industry and Business. (n.d.). Retrieved May 08, 2017, from