Safety Improvement Project

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The Measurement and Monitoring of Safety Framework via the Canadian Patient Safety Institute

“The Measurement and Monitoring of Safety Framework challenges our assumptions in terms of patient safety,” says Virginia Flintoft, Senior Project Manager, Canadian Patient Safety Institute. “The Framework helps to shift our thinking away from what has happened in the past, to a new lens and language that moves you from the absence of harm to the presence of safety.”

The Measuring and Monitoring of Safety Framework was used as the backdrop to structure and stimulate discussions and to establish a baseline of the culture of quality improvement in the FBC. Over an eight-month period, there were 285 participants in staff safety huddles, 75 participants in patient and family safety huddles and 49 new ideas generated and initiatives implemented.

“We looked for ways to engage patients in our safety huddles,” says Luisa Guerrera, Patient Care Manager, Family Birthing Centre. “Initially, we did not know how to effectively engage patients, but once we figured out the safety huddle framework, we were able to include ongoing participation of a Patient and Family Advisor. Since partnering with patients and families, the nature of our conversations has shifted to more of a solution-focused approach.”

Read more on Safety Improvement Project for the Measurement and Monitoring of Safety via the Canadian Patient Safety Institute.

Welfare Challenge

Post written by Dr. Iris Liu, Abbotsford-Mission Family Practice Residency Program Faculty Lead for Behavioural Medicine & Scholarship

Hi Everyone!

So June 13, 2019 was our welfare challenge for our residents.  The inspiration for this challenge came from my patients, who do indeed work hard to trying to manage their chronic illness, disability and social circumstances.  Social economic status has a major impact on health.  (Read here for a quick summary: https://www.apa.org/pi/ses/resources/publications/work-stress-health)

There is a mental and physical stress component to being on a tight budget.  So knowing this – I wanted to give my residents a taste of what it is like to be on welfare.  I will confess that as a physician, I get frustrated by the level of paperwork that piles on my desk for disability forms, tax forms, food forms etc.   However, I try to remind myself that my laziness to put my signature on a piece of paper, may mean that my patient might go without.  Hence the following challenge:

Welfare Food Challenge
How much money do you think your patient has on welfare for food?
1)     You have $20 to buy groceries for yourself
2)     It is to last for 1 week
3)     Please put your cell phone on airplane mode
4)     DO NOT use the calculator function of the phone
5)     You have 45 minutes to get the groceries and meet me at the house of James Coffee shop

The actual website from https://welfarefoodchallenge.org/ actually states $19.  (I decided on $20 for my sanity as an administrator.)

You may wonder about the instructions 3 – 5 – they aren’t on the website!  They are there because I wanted my residents to get a taste of what it is like.

Item # 3: My patients have confided to me that they often feel isolated  and that there is no one whom they can turn to for help.  I was hoping that by being on airplane mode – my residents will experience what it is like to be socially isolated.  After all, how often do I face a problem, and text a friend for help?  I also wanted them to NOT have internet access.  After all these are smart people and they will start looking up the deals at Superstore. What I wanted them to experience was the mental and physical exhaustion of having to look for the items which are on sale and fits their budget while being completely isolated.

Item #4 – no calculators.  Again I wanted them to feel the mental exhaustion of having to account for every penny in your head.  Because that’s what happens when you are on welfare. I also wanted to let them experience what it feels like to go up to the counter – go over the budget, and then feel the humiliation of asking the check-out person – “Sorry, I don’t want that item.”

Item #5 – this item was inspired from talking to my friends at Social Work.   I will confess that often times as a physician I get frustrated “Why is this patient late – they don’t have a job! What could possibly be holding them up!!!”  Well – over the years I have learnt that I really need to learn to walk in my patient’s shoes.  It isn’t easy to get around – buses run late or are inconsistent.  Childcare can be impossible to find.  And groceries are HEAVY.  I wanted them to feel how annoying / tiring it is to lug your groceries up a hill.

After the challenge, I then asked me residents to journal on the following and we had a chat about the challenge over some gelato.

Welfare Food Challenge – Journal time
Possible prompts for writing

– How did you feel overall?
– How was your stress level?
– What if you had a cold that day and was told by your GP to just take some Tylenol? (Do you know the cost of Tylenol?)
– How would you feel if you have been struggling with your weight and your GP tells you to “eat health”?
– What if you needed other stuff that week – e.g. toothpaste, toothbrush, toilet paper?
– What if it was your child’s birthday and you wanted to get her something?

I’m hoping that this Welfare Challenge will inspire us to be more patient and understanding.  This is just a small taste of what it is like.  Certainly for me, it has put my spending habits into scrutiny when I think about what I spend on food and entertainment.

As one of my mentors have said to me “Your patient lives with the chronic illness every day. You deal with it for ten minutes. So guess who is the expert in the room?”

4th Annual: R1 vs. R2 Volleyball Tourney 2019

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2018-2019 Crew

Oh it’s going down! Our 4th Annual R1 vs. R2 Volleyball Tourney is right around the corner! The objective this year is to shut down Dr. Metcalf’s serve because when that ball hits your arm it feels like you’re returning a cinder block. He dominated last year and silenced the R2s quickly in the first game. This year, I’m not sure. The R1s are a tight and strategic group known for employing their sense of humour and silliness to distract their opponents. I’ve been on the other side of the net and it’s hard to focus when you’re giggling! However, the R2s may have a little extra fire in their belly as they need to pull this off to tie the current standings.

The R1 vs. R2 Volleyball Tourney Standings
2016: R2s
2017: R1s
2018: R1s
2019: TBA

First place winners will take home a bottle of the best darn root beer this side of Saskatchewan and the second place team has to compose a limerick based on their field notes and have it submitted to me by Friday, July 5th. Last year, Dr. Bruce Griffioen penned the winning entry! Need help writing a limerick? Watch this 2 minute video!

Join us for this exciting afternoon and evening!

Date: Thursday, June 27, 2019
Time: 1300-1600
Location: Sand Courts, Mission Brew Pub, Mission, B.C.

See you soon!

Jacqueline

A Walk to Truth and Reconciliation

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Scene captured from Dr. Montana Halliday’s 2019 Scholar Research Project A Walk to Truth and Reconciliation.

UBC Family Practice Residents have embarked on a series of incredible projects this year. Dr. John Pawlovich recently shared with the faculty Dr. Montana Halliday’s award winning work A Walk to Truth and Reconciliation:

This community-informed experiential project sought to expand understandings on
whether or not a community-informed experiential learning process could increase levels of understandings in grades 6-7 students about Indigenous realities. The project was anchored in a partnership with Central Interior Native Health and received assistance from the Health Arts Research Centre, the Lheidli T’enneh Nation, the Prince George Native Friendship Centre and the Prince George Courthouse. The intervention centered on undertaking “A Walk to Truth and Reconciliation,” an immersive, educational event aimed at introducing grades 6-7 students to the present-day impacts of colonization on Indigenous individuals and communities. The project anticipated participants would be better engaged through experiential learning, as opposed to didactic learning, about Indigenous colonization, health and justice. Scholarly outcomes of this project will include working with community organizations and undertaking critical self-reflection in order to produce a qualitative reflection about the intervention.

View the wonderful video showcasing her project here.

Congratulations Montana from all of us! Thank you John for sharing!

#UBC #UBCDFP #MontanaHalliday #AWalkToTruthAndReconciliation #UBCLloydCollinsResearchAward #BuildingStrengthThroughCommunity #PrinceGeorgeFamilyPracticeResidencyProgram

Mistreatment in Birth

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“Vedam et al. [32] found that in British Columbia, women from vulnerable populations (i.e. recent immigrants or refugees, women with a history of incarceration and/or substance use, homelessness or poverty), women with pregnancy complications, those who have birth at hospital (versus home) and women who experienced pressure to have interventions were more likely to score very low on the MOR index, a scale that measures respectful maternity care [32]. Our intersectional analysis underscores that the negative impacts of race and social vulnerability are intertwined and cumulative, that those who are already at risk for the worst outcomes, also experience higher levels of mistreatment. Given that the burden of disparities borne by these populations has shown little improvement in recent decades, understanding the presence of mistreatment in childbirth may aid our efforts to comprehend underlying causes, and inform our efforts to eliminate them.”

More on The Giving Voice to Mothers study: Inequity and mistreatment during pregnancy and childbirth in the United States by Drs. Vedam, Stoll, Taiwo, Rubashkin, Cheyney, Strauss, McLemore, Cadena, Nethery, Rushton, Schummers, Declercq, and the GVtM-US Steering Council via Reproductive Health.

4types.jpegThank you to UBC Professor Saraswathi Vedam and Birth Place Lab for bringing this topic to the forefront and igniting an extremely important conversation about how women are treated during their pregnancy. The Birth Place Lab, in the Division of Midwifery at the University of British Columbia, facilitates multi-disciplinary and community-based participatory research on high quality maternity health care across birth settings. Learn more at www.birthplacelab.org/mistreatment.

#UBC #BirthPlaceLab #ListenToTheVoiceOfMothers #StopTheMistreatmentOfWomen

 

Pub & Papers 2019: Scholar & Preceptor Appreciation Evening

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FM Physicians (left to right): Drs. Liang, Metcalf, Chen, Shokar (finally got him to laugh), Westgeest, Dueckman, Singh, Dickinson, Wilson, Husband, & Liu. Over my shoulder is our amazing Site Coordinator Ann Douglas!

Congratulations to all of our Residents who participated in our Pub & Papers 2019: Scholar & Preceptor Appreciation Evening! We were incredibly impressed with the quality of their presentations and the delivery of their content. Our Residents topics ranged from investigating gender bias to the language skills of BC’s family physicians. They also shared their findings with the intent to make a difference in the field of Family Medicine. We are so stoked to have a committed and dedicated team of healthcare professionals that are positioned to create great changes in how we think, design, and deliver care!

There was a tie for Best Presentation Award! Congratulations to Dr. Dueckman for his performance and research in “Barriers to Receiving Medical Care Experienced by Transgender Patients: A Musical Enquiry” and Dr. Westgeest for his work and analysis in  “Pre-operative Exercise and Abdominal Surgery”. Congratulations to Dr. Michelle Hanbidge for winning the Peter Grantham Resident Teaching Award and Dr. Jennafer Wilson for her CFPC Indigenous Award nomination.

We would also like to acknowledge our Site Medical Education Award winners Drs. Nader Elmayergi, Manjit Gosal, Jeff Kornelsen, Iris Liu, Thanh Luu, and Presley Moodley. The 2019 Coach’s Award goes to Drs. Nader Elmayergi, Iris Liu, Jeff Kornelsen, and Shavinder Gill. Dr. Nader Elmayergi also won the Residency Site Teaching Award for 2019. The man cleaned up this year :)! We greatly appreciate the support of our preceptors and their drive to innovate and improve our Residents’ learning experience.

We thank our fantastic administrative team Dr. Holden Chow (Site Director), Ann Douglas (Site Coordinator), and Susan Hart (Site Assistant) for designing and executing such a fun and engaging event. A big shout out to our Behavioural Medicine & Scholar Lead Dr. Iris Liu for her contributions and effort invested.

Thank you to our community members from ARHCC’s administration and foundation team, Abbotsford Division of Family Practice, as well as our UFV colleagues who took the time to join us and participate in the evening’s festivities!

We look forward to next year!

Jacqueline

*This event was sponsored by the warm and generous hearts of ourimage001.png

Participants Needed!

UntitledDuring the Pub & Papers 2019: Scholar & Preceptor Appreciation event, we had the opportunity to connect with our University of Fraser Valley colleagues. UFV student, Joleen Prystupa, is currently conducting a study from September to October investigating the role of physical activity on anxiety in cancer survivors. There’s a great deal of research looking deeper into depression, fear, anxiety, and post-traumatic stress disorder in cancer survivors. It’s wonderful to learn that we have a study on the topic occurring right in our backyard! To learn more about Joleen’s work and to participate, please contact her at Joleen.prystupa@student.ufv.ca