Patient Safety - CHEO Research Institute

Patient safety has been identified internationally as a health care priority. Adverse events (AEs), broadly defined as unintended harm to the patient that is related to health care and/or services provided to the patient rather than the patient’s underlying medical condition, represent a significant threat to patient safety and public health. To date, patient safety research has focused on admitted patients. However, most Canadians, and especially children, are more likely to visit an Emergency Department (ED) than to be admitted to hospital. Little research has been conducted on pediatric patient safety in the ED. We have no evidence about how common AEs are among children seen and treated in EDs in children’s hospitals. Such knowledge is an essential first step to understand how to improve the safety of pediatric EDs and ultimately children’s health outcomes.

The ED Research team at CHEO is conducting research to better understand patient safety in the Emergency Department. Specifically we want to learn about the frequency, severity and preventability of adverse events occurring among children in the ED. This information will help us to improve the safety of ED care for all Canadian children.

Research Projects

A stochastic optimization approach for staff scheduling decisions at inpatient units
26/10/2022

In this paper, we propose an optimization scheme in order to schedule the operations of the orthopedic surgery division at Habib Bourguiba University Hospital. This type of planning could be performed for a general problem of scheduling “n” operations in “m” operating rooms and “b” recovery beds with the conditions that: m ⩽ b, longer operation takes longer recovery time and no wait as much as possible between the operating room and the recovery room.
I-PASS enhances effectiveness and accuracy of hand-off for pediatric general surgery patients
10/03/2022

Implementing I-PASS on a pediatric surgery service with modifications catered to surgical patients, improved the effectiveness and accuracy of written and verbal patient hand-offs and increased provider satisfaction and preparedness.
Medications to manage end-of-life symptoms in the immediate postpartum period
18/08/2021

There is a need for standardization of the medical management of infants born with life-limiting conditions whose parents choose to pursue palliative care.
What’s the harm in asking? A systematic review and meta-analysis on the risks of asking about suicide-related behaviors and self-harm with quality appraisal
25/07/2020

Unfortunately, misperceptions of harm remain which can compromise clinical care, research, and public health surveillance efforts. Our objective was to evaluate the empirical evidence on whether and how asking about suicide related behaviors (SRB), such as suicidal ideation and suicide attempts, and non-suicidal self-injury (NSSI) results in harmful outcomes.
Combined influence of practice guidelines and prospective audit and feedback stewardship on antimicrobial treatment of community-acquired pneumonia and empyema in children: 2012 to 2016
30/06/2020

Use of AAP should also be strongly considered in patients with effusions (even if no pathogen is identified), as clinical outcome appears similar to patients treated with broad-spectrum antimicrobials.
SuperNurse? Troubling the Hero Discourse in COVID Times
13/06/2020

Childlike, our society and its leaders have chosen SuperNurse as the favourite toy of the day. She serves as a temporary distraction for fears and anxieties that have become more acute within the context of COVID-19’s powerful lesson: our health is deeply connected to that of others, animals and the earth. The already overflowing waste bin remains poised in the background.
Adverse events in the paediatric emergency department: a prospective cohort study
29/04/2020

Conclusion One in 40 children suffered adverse events related to ED care. A high proportion of events were preventable. Management and diagnostic issues warrant further study.
Obstetrical safety indicators for preventing hospital harms in low risk births
02/04/2020

This question is: According to the available literature, what are the obstetrical safety indicators related to processes of care for low risk births that aim to reduce preventable hospital harms?
Predictors of postoperative respiratory complications in children undergoing adenotonsillectomy
15/01/2020

Prediction modeling concurrently evaluating comorbidities and polysomnography metrics identified cardiac disease, airway anomaly, and young age as independent predictors of PRAEs. These findings suggest that medical comorbidity and age are more important factors in predicting PRAEs than PSG metrics in a medically complex population.
A regional massive hemorrhage protocol developed through a modified Delphi technique
03/09/2019

This MHP template will provide the basis for the design of an MHP toolkit, including specific recommendations for pediatric and obstetrical patients, and for hospitals with limited availability of blood components or means to achieve definitive hemorrhage control. We believe that harmonization of MHPs in our region will simplify training, increase uptake of evidence-based interventions, enhance communication, improve patient comfort and safety, and, ultimately, improve patient outcomes.
Minimizing Transfusion in Sagittal Craniosynostosis Surgery: The Children’s Hospital of Minnesota Protocol
02/05/2019

Our protocol of preoperative EPO and iron with perioperative TXA increased the preoperative hemoglobin and was associated with a low transfusion rate without negatively impacting postoperative course.
Analyses of Adverse Drug Reactions-Nationwide Active Surveillance Network: Canadian Pharmacogenomics Network for Drug Safety Database
04/03/2019

Adverse drug reactions (ADRs) are a major problem in modern medicine, representing up to the fourth‐highest cause of mortality.
Defining and identifying concepts of medication literacy: an international perspective
18/09/2018

Future studies should focus on how this definition can be operationalized to support the role that pharmacists and other healthcare providers.
A qualitative exploration of which resident skills parents in pediatric emergency departments can assess
26/04/2016

This study demystifies how parents can become involved in the assessment of residents’ NTS. The findings will inform the development of assessment strategies and could be used to develop assessment instruments that enable parents to become actively involved in the assessment of residents in pediatric EDs.