1. Global Patient Safety Alerts Sharing for Learning

2. Background  Reporting and Learning Consultation – Pan-Canadian – International  World Health Organization – Reporting and Learning Systems work stream  Ask, Listen, Talk

3. Process  Environmental Scan – What countries/jurisdictions? – What organizations? – Which patient safety incidents?  Retrieval and summation of each alert/advisory/recommendation found – 13 possible attributes assigned (title, summary, keywords, topic, etc) – Associated actions to reduce risk 5 categories – communication, scheduling and fatigue, training, environment and equipment, and rules/policies/procedures.

4. The International Classification for Patient Safety  A language developed by the World Health Organization for the global patient safety community  Joins the WHO Family of International Classifications  Harmonize language about patient safety  Preferred terms, definitions, key concepts 4

5. Preferred Terms Harmful Incident An incident that resulted in harm to the patient Replaces “adverse event” Patient Safety Incident Preventable and unnecessary harmful, no harm, and near-miss incidents 5

6. Preferred Terms No Harm Incident An incident that did reach the patient but did not result in harm Near-Miss An incident that did not reach the patient Replaces “close call” 6

7. Preferred Terms Harmful Incidents 7 No-Harm Incidents Near-Miss Incidents Patient Safety Incidents Reportable Circumstances No-Harm Incidents Patient Safety Incidents Reportable Circumstances

15. What we’ve heard since the launch  Email Quotes: – Thank you very much for this innovative platform of learning. Patient Safety Alerts is a wonderful opportunity to learn from others and share our experiences. – Yemen – Thank you such a great website - thanks for the remarkable idea and the successful outcome. Your work will benefit many around the world. Wishing you continued success! – Canada – CPSI has done a fantastic job of scoping this important project and taking up a core challenge that WHO posed to the world when it first pushed the issue of patient safety for all WHO member states back in 2001. We believe that this portal offers incredible potential for improving access to and knowledge of patient safety alerts and alert networks out there and we will work with CPSI to link Global Patient Safety Alerts to WHO's Patient Safety Global Reporting and Learning Community of Practice. Moreover, the virtual launch has been a fantastic experience. Ed Kelley Head, Strategic Programmes and Coordinator WHO Patient Safety

16. Improving Care Search Centre

17. What is the Improving Care Search Centre?  Google-like search centre  allow visitors to search for content related to patient safety and quality improvement

18. Search Superbugs Superbugs

19. Search Results - Superbugs NACS Getting Started Kits Getting Started Kit: A New Approach to Controlling Superbugs May, 2010 … http://www.saferhealthcarenow.ca/EN/Interventions/aro_mrsa/Documents/NACS Getting Started Kit.pdf NACS One-Pager Quick overview of the New Approaches to Controlling Superbugs Interventions… http://www.saferhealthcarenow.ca/EN/Interventions/aro_mrsa/Documents/NACS One-pager.pdf Superbugs

20. Improving Care Alliance  Group of organizations that generate and share their patient safety and quality improvement related content on the Improving Care Search Centre  Contributors to the Improving Care Search Centre

21. What happens when you Share Information BC Patient Safety & Quality Council SickKids NWT Health and Social Services PEI Department of Health and Wellness SK Ministry of Health Interior Health Accreditation Canada Health Quality Council of Alberta Shared Hand Hygiene Information by: Search Results: Hand Hygiene BC Patient Safety Quality Council - Ideas for Change Start at the Front Line! The Positive Deviance ApproachIdeas for Change Start at the Front Line! The Positive Deviance Approach SickKids - Information about C. difficile in childrenInformation about C. difficile in children North West Territories Health and Social Services - HAND HYGIENE: Using an Alcohol Based RubHAND HYGIENE: Using an Alcohol Based Rub PEI Department of Health and Wellness - Health Professional ResourcesHealth Professional Resources Sasketchewan Ministry of Health - How to properly wash your handsHow to properly wash your hands Interior Health - Hand Washing - Clean Hands Really Can Help your Bottom LineClean Hands Really Can Help your Bottom Line Accreditation Canada - Infection Prevention and ControlInfection Prevention and Control Health Quality Council of Alberta – 2009 Measuring and Monitoring for Success2009 Measuring and Monitoring for Success

22. What is in it for you?  What are the burning issues in patient safety?  See what other organizations are doing and how they are doing it and why they are successful.  What innovations in patient safety can be adapted locally?  Quick reference to dealing with patient safety incidents – Alerts & Research  Seek out professional development opportunities in patient safety including webinars, virtual programs and conferences.

23. SAFE CARE…… ACCEPTING NO LESS

24. Contact  Erin Pollock, Project Manager, CPSI – epollock@cpsi-icsp.ca epollock@cpsi-icsp.ca – 780-498-7267