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advancing patient safety since 2004

2014 | 2015 ANNUAL REPORT | 1

Manitoba Institute for Patient Safety

Strategic Plan 2014-2017

VISION

Excellence in patient safety

MISSION

To promote and enhance patient safety in Manitoba

VALUES Accountability: Patient safety is the primary concern of the Manitoba Institute for Patient Safety and

therefore all decisions must be evaluated in terms of their impact on patient safety.

Collaboration, Partnership and Fiscal Stewardship: The Manitoba Institute for Patient Safety

will enter into partnerships with other organizations to promote patient safety.

Integrity: The Manitoba Institute for Patient Safety will conduct its activities based on its values,

policies and by-laws, fostering a climate of respect, trust and transparency.

Engagement and Consultation: The Manitoba Institute for Patient Safety will ensure extensive

involvement with volunteers, members and the public in its activities.

Excellence: The Manitoba Institute for Patient Safety and the board will continually strive for

excellence.


Table of Contents

Message from the Board Chair ………………………………………………………………… 3

Message from the Executive Director ………………………………………………………… 4

Manitoba Institute for Patient Safety: Who We Are ………………………………………… 5

Executive Summary Highlights of the Fiscal Year Ending March 31, 2015 ………………. 8

Major Accomplishments 2014-2015 …………………………………………………………… 9

Initiatives that promote leading practices and initiatives in the healthcare

system to enhance patient safety……..……………………………………………….. 9

Initiatives that engage the public in advocating for themselves and

others for safe healthcare …………………………………………………………... 17

Reaching out to Communities: Connecting with Providers and Manitobans …………... 22

Future Directions ……………………………………………………………………………… 24

Members ………………………………………………………………………………………... 25

Financial Statements …………………………………………………………………………... 26

The Manitoba Institute for Patient Safety is a registered charity. Individuals and organizations that would like to donate to the

Manitoba Institute for Patient Safety may call 204-927-6477 for information and forms.

This annual report was released on June 3, 2015. For copies of this document, go to www.mips.ca or contact the Manitoba Institute

for Patient Safety at 204-927-6477.

http://www.mips.ca/


Message From The Board Chair

I am pleased to present the annual report of the Manitoba Institute for Patient

Safety (MIPS) for 2014-2015.

This is our first report as we begin our second decade serving as a nucleus to

stimulate, coordinate and support patient safety initiatives in Manitoba’s

complex and dynamic healthcare system.

We greeted our second decade with a fresh new strategic plan that will guide us

into 2017 in our mission to promote and enhance patient safety. Our vision is to encourage excellence

in patient safety. We will be guided by a commitment to collaboration, partnership, engagement and

consultation. We will conduct our work with integrity, accountability and fiscal stewardship.

It is fair to say that having three staff for the last decade we are quite practiced in stretching dollars and

resources as far as possible. We are very proud that our small organization has done so many big

projects that have been emulated across Canada and beyond over the years. We are confident that,

with our new strategic plan to guide us, we can continue to make new in roads and valued

contributions to patient safety in our province.

A significant part of our success can be attributed to engaging so many dedicated and talented partners

and collaborators from across the spectrum of our healthcare system and the general public. I feel the

same can be said about MIPS’ board members over the years. We are fortunate to have enjoyed a board

that is ever evolving thanks to a well-executed succession plan that balances experience and fresh

ideas. As we began our new decade we said goodbye with great appreciation to outgoing board

members, Louise Evaschesen, Dr. Rod Onotera, and Kim Poppel, and welcomed incoming board

members, Helga Bryant, Gary McPherson, and Judy Storjord.

Above all, with the release of this annual report, I would like to reiterate our continued thanks and

great appreciation to all those that have worked so hard on behalf of MIPS once again this year. We

welcome your continued input, ideas and partnership for patient safety.

Jan Currie

Chair, Board of Directors


Message From The Executive Director

It is difficult to believe that more than a decade has passed since the Manitoba

Institute for Patient Safety (MIPS) opened its doors in 2004. Time truly has flown

when every day is a busy one.

While the size of our office has not changed a decade later, the scope of our

activities has certainly increased dramatically. A visit to our mips.ca website will

show a host of activities and empowering resources for patients and healthcare

providers. The list of topics is diverse - patient and family centred care,

medication safety, patient rights, critical incidents and disclosure, infection control

and falls prevention, to name a few. There is also a research library and a toolkit

for the public that puts many of the most frequently asked for topics together in one place.

We are all very proud of the depth of the resources and partnerships that our board, patient advisory

committee and small staff of three have accomplished over the last decade.

This year was no exception as MIPS joined with the Manitoba Alliance of Health Regulatory Colleges to

launch an information sheet that promotes and raises awareness of Manitoba’s Apology Act. What I

find exceptionally uplifting is that our organization and the Alliance’s more than 20 regulated

healthcare professions were able to come together and unanimously agree on the importance of

apology and develop common language quite easily in a short time span. I don’t believe this would

have been possible a decade ago. It speaks volumes about how far we have come in Manitoba in the

last decade on embracing transparency, patients’ rights and patient safety.

A decade later, I continue to consider working at MIPS to be a great honour. I have had the

opportunity to work alongside some of the most brilliant and engaging people. It will be difficult to

top that in our second decade, but I feel that with the help of our member organizations and so many

more Manitobans dedicated to patient safety our “little institute with big ideas” is up for the challenge.

I look forward to another great year of new and exciting initiatives, to forging still more partnerships,

and to building creative ideas in support of patient safety in Manitoba.

Laurie A. Thompson

Executive Director


Manitoba Institute for Patient Safety: Who We Are

The Manitoba Institute for Patient Safety (MIPS) is an independent, non-profit organization created in

2004 in response to the recommendations of the Manitoba Patient Safety Steering Committee. The

Manitoba Institute for Patient Safety is a registered charity. Core funding comes from the provincial

government to cover operational costs. The Manitoba Institute for Patient Safety partners with other

organizations on projects of mutual interest and benefit. MIPS is under the direction of a board of 12

directors. Five are appointed by the Minister of Health. Seven are elected by the members of the

Manitoba Institute for Patient Safety.

Mr. Adam Chrobak*, Chair1, Member6,7 Mr. Ronald Guse*, Board Vice-Chair, Member3,6

Mr. Rene Comte**, Member1 (to June ‘14) Ms. Suzanne Hrynyk**, Member2

Ms. Jan Currie**, Board Chair, Chair6, Ms. Kathy McPhail*, Chair2, Member,6 (from July ’14)

Ms. Brenda Dawyduk*, Chair7, Member3 Mr. Gary McPherson* Member1,5

Ms. Brie DeMone**, Chair3, Member4,7 Dr. Rod Onotera*, Member4 (to June ‘14)

Ms. Louise Evaschesen*, Chair2, Member,6(to June ‘14) Dr. Luis Oppenheimer*, Chair4, Member7

Ms. Connie Gretsinger**, Member1,7 Ms. Kim Poppel**, Chair5 (to June ‘14)

*Elected **Ministerial Appointment

Committees:

1-Finance, 2-Audit, 3-Membership, 4-Patient Safety Initiatives, 5-Patient Advisory, 6-Executive, 7-Board Development

Staff

Ms. Ginger Tetreault, Administrative Assistant

Ms. Laurie A. Thompson, Executive Director

Mrs. Dawn White, Consultant (to July ’14)

Ms. Denise Widmeyer, Leader - Patient Safety Initiatives (from Oct. ’14)

2014-2015 Board of Directors Front Row L-R: Ronald Guse, Jan Currie

Back Row L-R: Adam Chrobak, Judy Storjord,

Helga Bryant, Brie DeMone, Connie Gretsinger,

Gary McPherson, Brenda Dawyduk, Kathy McPhail

Missing: Dr. Luis Oppenheimer, Suzanne Hrynyk


BOARD of DIRECTORS (*Elected **Ministerial Appointment)

Adam Chrobak * Adam has been a board member since 2010. Adam is CEO/Registrar of the College of Medical

Laboratory Technologists of Manitoba. He has provincial and international experience in the health

sector. He has served on many professional committees.

Helga Bryant*

Helga initially served on the MIPS’ board from 2009-2012. She was re-elected to the board in June 2014.

She has more than 40 years of experience in nursing, nursing management, research and healthcare

administration. Helga is CEO of Northern Health Region.

Jan Currie ** Jan was appointed chair of the board in January 2013. Jan is retired from a 40 year career in the

healthcare system. She was vice-president and chief nursing officer at Winnipeg Regional Health

Authority. She has held administrative positions in various facilities in Winnipeg and Ontario. Jan

remains active in professional and community activities.

Brenda Dawyduk* Brenda was elected to the board in June 2013. She is a nurse practitioner in Northern Health Region

and has extensive experience working in northern communities in hospital and community settings.

Brenda teaches medicine, nursing, and nurse practitioner students.

Brie DeMone ** Brie has been a board member since 2012. She is executive director of Acute, Tertiary and Specialty

Care at Manitoba Health, Healthy Living and Seniors where she leads a team responsible for a variety of

portfolios including acute care policy, patient safety, community health assessments, Lean Six Sigma,

and acute care wait times. Brie co-chairs the Manitoba Quality and Patient Safety Council and the

Manitoba Acute and Specialty Health Care Services Council.

Ronald Guse * Ronald is vice-chair of MIPS and has been a board member since 2004. He is registrar for the College of

Pharmacists of Manitoba. He has been on several provincial and national committees and is also a

member of the Faculty Council at the College of Pharmacy, Faculty of Health Sciences, University of

Manitoba.

Connie Gretsinger ** Connie has been a board member since 2009. She is a retired registered nurse. She has experience in

long term care, home care, staff education and infection control. Connie is a past board member and

board chair of RHA Central.


Suzanne Hrynyk** Suzanne was appointed to the board in 2013. Until recently, she was director of care at Parkview Place

Personal Care Centre. Suzanne is a registered nurse. She was a school trustee in the Winnipeg School

Division and is on the Discipline Committee of the Law Society of Manitoba. Suzanne has been a

labour relations officer at the local, provincial and federal levels.

Kathy McPhail * Kathy has been a board member since 2009. Kathy is CEO for Southern Health/Santé Sud. Kathy has

served in a variety of leadership, management and coordinator/liaison roles. She also has served on the

board of the College of Registered Nurses of Manitoba as well as a number of other healthcare boards

and committees.

Gary McPherson* Gary was elected in 2014. He is retired following 35 years of service with the Royal Canadian

Mounted Police. Gary has held a variety of leadership and management roles. Since retirement, Gary

has remained active by teaching and has served on a number of boards and committees.

Luis Oppenheimer * Luis has been a board member since 2008. He is a professor of Surgery & Family Medicine, University

of Manitoba. He has over 30 years of experience in clinical, academic, and administrative positions in

the healthcare system. He has worked on various initiatives, including international experience as a

visiting professor and lecturer.

Judy Storjord** Judy was appointed to the board in 2014. Judy was born and raised in Swan River Valley and worked

in accounting and as a sales office manager in the western region office of Sherwin-Williams Paint, and

subsequently for the Winnipeg Free Press. She returned to Swan River to retire on the family farm.

Judy served on the Farm Products Board for 11 years.


Executive Summary Highlights of the Fiscal Year Ending March 31, 2015

The year 2014 marked MIPS’ 10th anniversary. The board issued a new vision, mission and values to

guide their work to March 2017. On May 26, 2014, the Manitoba Institute for Patient Safety held its

tenth Annual General Meeting (AGM) at the St. Boniface Hospital Research Centre and released its

annual report for fiscal year 2013-2014. Mr. Gary McPherson and Ms. Helga Bryant were elected to the

board. Dr. Luis Oppenheimer was re-elected. MIPS’ milestone 10th anniversary was marked by

“Growing the Legacy”, a two-hour education event following the AGM.

On October 27, 2014, MIPS issued the Apology Act Information Sheet jointly with the Manitoba

Alliance for Regulated Health Colleges. The information sheet explains the protection that the Apology

Act provides and the importance of an apology for patients and families.

During Canadian Patient Safety Week, MIPS partnered with the Long Term and Continuing Care

Association of Manitoba, Manitoba Society of Pharmacists, College of Pharmacists of Manitoba, and

Winnipeg Regional Health Authority to host education sessions on medication safety for seniors at

four locations throughout Winnipeg. The sessions were based on the MIPS’ resource Learn to be Safe –

Medication Safety. A Guide for Pharmacists.

MIPS continued to partner with organizations, community groups and community leaders to present

and exhibit the S.A.F.E. (Self-Advocacy For Everyone) Toolkit, which promotes messages on patient

safety and patient engagement.

In June 2014 and October 2014, in cooperation with Regional Health Authorities of Manitoba and

Manitoba Health, MIPS sponsored educational events on the governance role in patient safety and

quality. Participants were board members of Manitoba regional health authorities and Diagnostic

Services of Manitoba.


Major Accomplishments in 2014-2015

Over the past fiscal year, the board continued to work on governance priorities as established through

the new strategic plan, effective April 1, 2014. Fiscal year 2014-2015 is the first year of operations

guided by MIPS’ 2014-2017 strategic plan. Major accomplishments related to MIPS’ operational plan

for 2014-2015 follow.

Highlights of Our Work This Year to Further MIPS’ Strategic Objective # 1:

To promote leading practices and initiatives in the healthcare system to enhance patient

safety

On May 26, 2014, the Manitoba Institute for Patient Safety held its tenth Annual General Meeting

(AGM) at the St. Boniface Hospital Research Centre. At the tenth anniversary AGM, MIPS awarded a

Lifetime Achievement Award to Dr. John G. Wade. As professor and chair of the Department of

Anesthesia at the University of Manitoba, Dr. Wade was an innovative pioneer in assisting anesthetists

to practice safely. His department was also instrumental in developing the Canadian Anesthesia

Guidelines to Practice, which dramatically improved patient outcomes from anesthesia.

Dr. Wade chaired the Royal College of Physicians and Surgeons Health and Public Policy Committee

and spearheaded the internationally recognized CanMEDS initiative. CanMEDs outlines what

physicians in Canada require to effectively meet the needs of people they serve.

He has been vice-president of medical services at Health Sciences Centre in Winnipeg, dean of

medicine at the University of Manitoba, and served as Deputy Minister of Health in Manitoba from

1995 to 1997.

Beginning in 2001, Dr. Wade chaired the National Steering Committee on Patient Safety, and presented

the committee’s final report “Building a Safer System – A National Integrated Strategy for Canadian Health

Care”. This ground breaking report outlines key areas to be addressed to build safety healthcare

systems, including system issues, legal and regulatory issues, measurement and evaluation, education

and professional development, and information and communication.

In December, 2003, Dr. Wade was appointed as a member and chair of the founding board of the

Canadian Patient Safety Institute, leaving a rich legacy of national influence.

Dr. Wade also chaired a government appointed committee in Manitoba that recommended that the

Manitoba Institute for Patient Safety be established, resulting in our incorporation in May 2004.

In 2005, MIPS established the Dr. John Wade Research Award to recognize local excellence in patient

safety.

Dr. Wade is a Professor Emeritus of Anesthesia at the University of Manitoba; Dean Emeritus of the

University of Manitoba College of Medicine; past chair of the board of the Winnipeg Regional Health


Authority; and assistant executive director of the Manitoba Medical Services Foundation. Dr. Wade

serves on several boards.

Dr. Wade is also the recipient of numerous awards and recognitions, including most recently:

the Distinguished Service Award, and the Health Administration Award from Doctors Manitoba

that recognizes devotion to the highest ideals of the medical profession and in the promotion of

the art and science of medicine

the Judge J. M. George Memorial Award from the Regional Health Authorities of Manitoba to

recognize outstanding services in the healthcare field in Manitoba including volunteerism

the creation of the John G. Wade Visiting Professorship in Patient Safety and Simulation-based

medical education at the Royal College of Physicians and Surgeons of Canada, in recognition of

his contributions in patient safety and medical education in Canada

To mark the tenth anniversary, the board also sought nominations for a Patient Safety Champion

Award. This award celebrated an individual working in the healthcare system who shows a passion

and commitment for improving patient safety. Jan Currie, board chair, was honoured to present the

MIPS’ Patient Safety Champion Award to Susan Lessard-Friesen, deputy registrar, College of

Pharmacists of Manitoba.

Susan was described as a “quintessential promoter and activist for improving patient safety and

quality, and reducing harm to patients through her work”. She is identified as “THE action person”

that makes patient safety part of everything done at her workplace. She is a past recipient of the Dr.

John Wade Research Award. She is innovative and is committed to interprofessional education as a

key to improving patient safety. An example is her work to create the Interprofessional Continuing

Professional Development Network in Manitoba. She has partnered with MIPS on a number of key

initiatives, including:

It’s Safe to Ask medication card

Patient Safety is in YOUR Hand initiative

Learn to be Safe – Medication Safety. A Guide for Pharmacists

Learn to be Safe – A Simulation Learning Experience (committee chair)

In 2013, Susan was awarded the College of Pharmacists of Manitoba Patient Safety Award for her

contribution to protection of the public.

MIPS’ milestone tenth anniversary was marked by “Growing The Legacy”, a two-hour public

education event that followed our AGM to recognize MIPS’ ten years of service to Manitobans in the

field of patient safety. Approximately 125 people attended in person at the St. Boniface Hospital

Research Centre and others joined across Manitoba at 12 MBTelehealth sites. The event featured three

well-known and respected leaders in their fields: The Honourable Justice Murray Sinclair, CBC Radio’s

Terry MacLeod, and Hugh MacLeod, the CEO of the Canadian Patient Safety Institute.


The Honourable Justice Murray Sinclair started the event with a profound presentation about his

experiences conducting the Pediatric Cardiac Surgery Inquest, studying the deaths of twelve children

in the pediatric cardiac surgery program of Winnipeg’s Health Sciences Centre in the 1990’s. CBC

Radio’s Terry MacLeod shared his personal healthcare experiences and the poignant experience of his

close personal friend. Completing the afternoon’s speakers was Hugh MacLeod, the Canadian Patient

Safety Institute’s CEO. Hugh shared his personal story as well as his knowledge of trends that are

shaping patient safety initiatives nationally and internationally. Following the presentations, the

audience participated with questions and comments.

A DVD of the 2 hour event is available from MIPS and can be viewed at www.sbrc.ca

The Dr. John Wade Research Award was established to recognize the valued contribution of Dr. Wade

to the creation of our organization and to recognize local excellence in patient safety. In consultation

with Dr. Wade, the board changed and expanded the award to include projects that advance the

practice, awareness and knowledge of patient safety with a broad audience. This is in keeping with

MIPS’ desire to raise awareness about patient safety with not only healthcare providers but the public

as well. Because of these changes, the call for submissions for the Dr. John Wade Patient Safety

Initiatives Grant was issued in July 2014. Grants totaled $15,000 and were awarded to:

Home Assistance Neepawa & District (HAND) & Viscount Cultural Centre for the Arts

Rrain Prior, Director of Programming, Viscount Cultural Centre for the Arts

Genie Barnaby, Senior Resource Coordinator, Home Assistance Neepawa & District

Project Goal - increase public awareness about patient safety issues through live theatre

Vita & District Resource Office

Carol Dolynchuk, Resource Coordinator, Services for Seniors

Project Goal - build awareness regarding safe use of walkers and wheelchairs and the

importance of equipment maintenance, proper disposal of medications and falls prevention

Age and Opportunity: Entry Program for Older Adult Immigrants

Maureen Keelan, Manager, Entry Program for Older Adult Immigrants

Project Goal - develop 11 lesson plans on safety topics such as hand hygiene, medication

safety, flu shots, patient rights and responsibilities

The project leads will present their projects at the AGM in June 2015.

In cooperation with Regional Health Authorities of Manitoba, Manitoba Health, and the Canadian

Patient Safety Institute, MIPS sponsored two education events for governors. In June 2014, a webinar

was held as a follow-up to the 2013-2014 workshop. Four regional health authorities, Diagnostic

Services of Manitoba, Manitoba Health, Regional Health Authorities of Manitoba, and MIPS had

representation. Key concepts included: the governance role, skills and knowledge for effective

governance for quality and patient safety, components of a leading practice quality plan, and an

http://www.mbips.ca/contact-us.html

http://www.sbrc.ca/


introduction to the importance of meaningful information and measurement to inform governance

decisions for quality and patient safety.

A workshop held October 22, 2014 as part of the Regional Health Authorities of Manitoba board

governance and education session built upon the previous events. There were 77 participants, the

majority of whom (83%) were regional health authority and Diagnostic Services of Manitoba board

members. Facilitators Joan Dawe, Laurie Hicks and Ruth-Anne Conyngham focused on:

developing and maintaining relationships

analyzing the questions “Is our care getting better? How do we know?”, including review of

how organizations were incorporating essential elements of an effective quality and patient

safety plan

applying learning from the education sessions to a recent case study

Of the participants who responded to the evaluation, 92% indicated that:

the agenda met their expectations

the learning session increased their knowledge of governance in quality and patient safety

MIPS will work with Regional Health Authorities of Manitoba and Manitoba Health to determine how

best to sustain the momentum for learning about leading practices to address governance roles and

responsibilities.

In November 2014, the Manitoba Institute for Patient Safety sponsored the Winnipeg Regional

Health Authority Required Organizational Practices Forum at Sam Cohen Auditorium, St. Boniface

Hospital Research Centre. It was broadcast on MBTelehealth across Manitoba regional health

authorities. This year’s event focused on “patient flow” (movement of patients, information or

equipment as part of a patient’s journey) which is a required organizational practice of Accreditation

Canada, the organization that accredits regional health authorities. Approximately 140 people

participated. The executive director of MIPS moderated a panel of Manitoba healthcare leaders on

patient flow experiences, challenges and potential solutions. More than 80% of those completing

surveys rated the overall forum as very good to excellent.

The Manitoba Institute for Patient Safety endorsed Canadian Patient Safety Week (CPSW) 2014 in

Manitoba from October 27 – October 31, 2014. The theme this year was hand hygiene. All regional

health authorities in Manitoba as well as other organizations participated in the week. They hosted

events and presentations, nominated patient safety champions, distributed MIPS’ resources, exhibited

throughout their communities, attended the Canadian Patient Safety Institute Virtual Forum and

hosted lunch and learn sessions. MIPS updated our CPSW Planning Guide to assist organizations in

planning their events. We partnered with the Canadian Patient Safety Institute to advertise on hand

hygiene in Brandon, Winkler/Morden, The Pas, Selkirk and Winnipeg through bus ads and billboards.

We also advertised on monitors in the Manitoba Clinic, Winnipeg Clinic, Aikens Street Community


Health Centre, clinics/facilities in Prairie Mountain Health Authority and Southern Health Authority as

well as other non-healthcare locations.

During CPSW, MIPS’ also launched the Apology Act Information Sheet with Manitoba Alliance of

Regulated Health Colleges at the start of Canadian Patient Safety Week and MIPS co-hosted

presentations on medication safety at four independent living with services residences in Winnipeg.

MIPS jointly sponsored a contest with the Winnipeg Regional Health Authority titled “Hand

Hygiene Patient Safety Week – Share your Success Story”. The winners were:

Jennifer Welwood, Continuing Education Instructor, 2B Inpatient /Short Stay unit, St. Boniface

General Hospital “2B or not 2B Hand Hygiene Practice”

Cheryl Bennett, Continuing Education Instructor, 7A West & 7A South, St. Boniface General

Hospital “Hands Up Campaign – Get Caught in the Act!”

Kathy Miller, “Did I Wash My Hands?” Campaign, CH5, Children’s Hospital

Jan Currie, MIPS’ board chair, presented the awards with their president and CEO Dr. Michel Tètreault

and WRHA director of education and projects Kim Warner.

Following discussions with the Canadian Patient Safety Institute and members of the provincial

Quality and Patient Safety Council, the Manitoba Institute for Patient Safety agreed to administer the

Manitoba Patient Safety Education Program (PSEP Canada). The purpose of the program is to certify

trainers in regional health authorities and provincial health organizations to train regional staff about

patient safety. Trainers help build capacity for integrating patient safety practices in healthcare. This

program was initiated in Manitoba in 2012 through a provincial advisory committee in cooperation

with the Canadian Patient Safety Institute. Starting in June 2015, MIPS will be responsible for planning

future training events, guided by a provincial advisory committee, chaired by MIPS.

The Manitoba Institute for Patient Safety is working with Frontier College and the Manitoba

College of Pharmacists to conduct a pilot project with the public that will focus on increasing

participants’ knowledge of patient safety. “Be Well: Literacy, Nutrition & Your Health” has been

designed to support individuals as they learn about a wide range of health-related topics. Included in

the project will be continuing professional development for pharmacists on health literacy.


Highlights of MIPS’ executive director’s participation in patient safety committees and initiatives

this year included:

the Privacy and Security Advisory Committee of Manitoba eHealth

Accreditation Canada’s Quality Conference 2015 Planning Committee

the National Consortium on Patient Safety, Canadian Patient Safety Institute

the Pan-Canadian Health Quality Collaborative

Western Quality and Patient Safety Organizations

the Canadian Patient Safety Institute/Accreditation Canada National Patient Safety Roundtable

Co-chair, Interprofessional Working Group on Patient Safety and Quality, University of

Manitoba

Guest Speaker, Healthcare Insurance Reciprocal of Canada’s celebration of their 25 years in

Manitoba

Kathy McPhail, board member, represents MIPS on the Provincial Health Innovation Network.

The Manitoba Institute for Patient Safety reviewed, attended, or had provided input into the

following national and provincial initiatives and consultations:

CanMEDS 2015 framework for medical education in Canada

Canadian Patient Safety Institute’s National Consortium on Patient Safety (report two)

Canadian Patient Safety Institute’s summits, roundtables and reports on:

o Infection Prevention and Control

o Medication Reconciliation

o Safety in Home Care

o Patient Safety Education

o Consortium Strategic Communication Plan

o Never Events Committee

The Canadian Institute for Health Information and Canadian Patient Safety Institute joint

meeting on performance measurement

Provincial Patient Safety Strategy consultations

In response to discussions about apology with healthcare providers at patient safety forums in Brandon

in 2012, MIPS developed the Apology Act Information Sheet with the Manitoba Alliance of Health

Regulatory Colleges. The information sheet includes the intent, meaning, and impact of Manitoba’s

Apology Act.

The information sheet was launched October 27, 2014 during Canadian Patient Safety Week at the

Canadian Museum for Human Rights. The joint initiative demonstrated unanimous agreement on the

importance of creating more awareness of Manitoba’s Apology Legislation, and promoting apology as

the right and humane thing to do when the actions of caregivers bring unintended harm to patients and

families. In addition to the MIPS’ executive director speaking at the event were MIPS’ director Mr.


Adam Chrobak, chair of the Manitoba Alliance of Regulated Health Colleges, and Ms. Margaret

MacDonald, interim chair of the Manitoba Institute for Patient Safety Patient Advisory Committee. A

video highlighting patient stories of apology was aired.

The Apology Act Information Sheet contains information including:

why an apology is important for patients and families

why an apology can be healing for the health practitioner involved

suggestions on how to apologize

what is covered by Manitoba’s Apology Act

a reminder that an apology is not an admission of guilt in the eyes of Manitoba’s provincial

courts

The information sheet complements MIPS’ guide for patients and families on critical incidents and

disclosure as well as a related fact sheet for health professionals. There was significant media coverage

of the event and the issue of apology, including:

The National Post

CBC national radio “The Current”

CTV noon, 6pm, late night and next day morning show

CBC TV (English and French)

Radio Canada

Winnipeg Free Press

City TV

CJOB

Dauphin Manitoba CKDM Radio

The information sheet is being posted on websites of the Manitoba Alliance for Regulated Health

Colleges.

Since May 2012, the Manitoba Institute for Patient Safety executive director has co-chaired the

Interprofessional Patient Safety and Quality Working Group at the University of Manitoba with Dr.

Michael Moffat. The purpose was to strengthen the culture of interprofessional (IP) education and

practice as a necessary platform to improve patient safety, and to introduce students to patient safety

and quality concepts. The initiative is under the leadership of Dr. Ruby Grymonpre and led by the

deans of each academic unit. The Patient Safety and Quality Working Group is comprised of

representatives from six faculties at the University of Manitoba, the Winnipeg Regional Health

Authority, and the Manitoba Institute for Patient Safety.

The working group developed and implemented an interprofessional learning opportunity on patient

safety and quality for approximately 250 students in six faculties that took place March 19, 2015. Pre-

learning for facilitators included an introduction to interprofessional practice, and a facilitator

orientation meeting. Twenty-four faculty facilitators each led a three hour small group student session.


Regional health authority patient safety staff assisted facilitators and participated in discussions on

safety incidents, disclosure and apology.

The learning opportunity used the MIPS’ resource Learn to be Safe – A Simulation Learning Experience as a

base for a case study. The working group also based their work on leading quality and patient safety

frameworks and principles and the Canadian Patient Safety Institute’s Safety Competencies

Framework.

A pre-learning package was developed to introduce students to:

concepts of quality, patient safety and interprofessional collaboration

leading practice tools on fall risk assessment and falls prevention

roles and responsibilities across disciplines

disclosure of patient incidents and apology

A detailed facilitator guide was compiled by the office of interprofessional education including:

interprofessional facilitation (roles, attributes)

learning objectives for the interprofessional learning opportunity

the case story of GG

facilitator tips and techniques

facilitator detailed case of GG

understanding roles and responsibilities by discipline

frequently asked questions about patient safety incidents, legal and organizational

requirements, and disclosure

scripts for disclosure role play

references

Evaluation results will be available in fiscal year 2015-2016.

In 2014-2015, the Manitoba Institute for Patient Safety endorsed:

National Venous Thromboembolism Audit Day, October 1 – 15, 2014

Canadian Medication Reconciliation Quality Audit, February 1 – 28, 2015

Manitoba Pharmacist Awareness Month, March 2015

http://www.patientsafetyinstitute.ca/English/toolsResources/safetyCompetencies/Pages/default.aspx

http://www.patientsafetyinstitute.ca/English/toolsResources/safetyCompetencies/Pages/default.aspx


Highlights of Our Work This Year to further MIPS’ Strategic Objective # 2:

To engage the public in advocating for themselves and others for safe healthcare

This fiscal year, MIPS’ messages about patient engagement and self-advocacy were publicly

communicated in a variety of formats and venues throughout Manitoba. The Manitoba Institute for

Patient Safety continues to network with community groups and organizations who work with

patients, families and the public. We advocate the use of our resource materials and tools to increase

involvement in self-advocacy.

MIPS’ Learn to be Safe Patient Safe Videos continued to reach Manitobans and Canadians by being

shown on-screen at:

Manitoba Clinic

Winnipeg Clinic

Klinic Community Health Centre

Aikens Street Community Health Centre

clinics/facilities in Prairie Mountain Health Authority

clinic in Southern Health – Santé Sud

“Doctors Care”, the publically broadcast Doctors Manitoba video series

a non-healthcare location

It is estimated that there were over 19 million views of the videos and other MIPS’ messages over

the fiscal year. The videos are also available to view or download on MIPS’ two websites.

MIPS conducted a campaign to promote infection prevention and control which adapted

Canadian Patient Safety Institute advertising. Posters were displayed at 11 sites at MTS Centre,

yielding approximately 400,000 views annually.

In Fall 2014, MIPS conducted a campaign to promote Canadian Patient Safety Week using the same

advertising on infection prevention and control used earlier in the year. This included:

an exterior bus ad campaign in Winnipeg and Brandon that reached a potential 88,000 people

per day for four weeks

billboards at five locations in Winnipeg, and in Brandon, The Pas, Morden/Winkler area and

Selkirk that reached a potential of over 103,000 people per day for four weeks

digital media at Manitoba Clinic, Winnipeg Clinic, Aikens Street Community Health Centre ,

clinics/facilities in Prairie Mountain Health Authority, a clinic in Southern Health – Santé

Sud, and a non-healthcare location.

http://www.mips.ca/pf-advocating-for-yourself---others.html


MIPS issued, or was part of, a number of media releases:

MIPS tenth anniversary education event

Interlake-Eastern Regional Health Authority Canadian Patient Safety Week

Manitoba Health Local Health Involvement Groups

Dr. Wade Lifetime Achievement Award

Manitoba Health joining the Global Alerts system of the Canadian Patient Safety Institute

Launch of the Apology Act Information Sheet

Education Sessions on Medication Safety for Seniors

MIPS was featured or had articles published in:

The Winnipeg Free Press (June 2014 and February 2015)

The College of Medical Laboratory Technologists Newsletter (February 2015)

The Canadian Patient Safety Institute online newsletter (10th anniversary)

The Canadian Patient Safety Institute ‘s Crosswalk (governance)

Healthcare Insurance Reciprocal of Canada online newsletter

Manitoba Coalition on Alcohol and Pregnancy News publication (patient advocate form)

The Wave – print and online edition - a publication of the Winnipeg Regional Health Authority

and the Winnipeg Free Press (patient safety tips and medication safety presentations for

seniors)

Prairie Mountain Health Report to Communities Newsletter (apology)

The “Examples of Health Literacy in Practice” document, prepared in partnership by the Public

Health Agency of Canada and the Canadian Public Health Association

http://www.cpha.ca/uploads/progs/literacy/examples_f.pdf

Senior Scope, Lifestyle 55 and Dauphin Herald (with Manitoba Society of Pharmacists for

Pharmacist Awareness Month)

We AdVANCE - A Documentary Film on Patient Safety, directed by Dr. Alexandre G. Tavares

of Prairie Mountain Health, Chris Brown, and Elsa Velthuysen. The documentary was awarded

a Rising Star Award at the Canada International Film Festival in 2015

The Manitoba Institute for Patient Safety’s website www.safetoask.ca is being redeveloped to be

consistent with the newly updated mips.ca and to streamline the content. The new website will be

directed to the public and healthcare providers and will support MIPS’ strategic objective of engaging

the public in self-advocacy.

We are increasing our presence on social media through Twitter @MIPS_PatientSafety.

http://www.cpha.ca/uploads/progs/literacy/examples_f.pdf

http://www.safetoask.ca/


In 2014-2015, MIPS worked with the Winnipeg School Division health education consultant and a

classroom teacher to plan a pilot of the introduction of MIPS’ medication safety and self-advocacy

messages into a grade 11 lesson on medication use and misuse. This was a continuation of work

initiated in 2013-2014 that saw MIPS review the existing curriculum in grades nine to 12 on self-

advocacy and engagement in healthcare. This was supported by the Ministers of Health and

Education.

MIPS’ aim is to raise awareness with teachers in the secondary school system on the importance of self-

advocacy skills. We want to offer tools, resources or literature that can be used by teachers to illustrate

the concepts and have students and teachers use the resources. MIPS considers these to be “life skills”.

We:

developed “insertion points” for MIPS messages into existing curriculum and a relevant

objective statement for the lesson plan

developed background materials for the teacher on patient safety

adapted MIPS’ resources for classroom use

identified/created medication safety stories for the teacher’s use

developed classroom activities

developed tools for the teacher and students to evaluate the pilot

The pilot is scheduled for April 2015. Discussions continue with the Manitoba Education and

Advanced Learning to offer self-advocacy related websites to update the curriculum document and to

plan for next steps.

The Manitoba Institute for Patient Safety is partnering with the Manitoba Association of Senior

Centres on two initiatives. The first is “Police Academy for Older Adults”. Medication safety was

added as a topic in the academy, a province-wide program that focuses on skills and safety principles

for older adults. Pharmacist presenters use the MIPS’ resource Learn to be Safe – Medication Safety. A

Guide for Pharmacists as a basis for their presentation and MIPS provides handouts such as the It’s Safe

to Ask Medication Card.

The second initiative is in the developmental stage. “Coffee and Conversations” will be a flexible

model of community outreach on self-advocacy that focuses on small informal groups rather than large

group presentations. MIPS will pilot this approach with a few community seniors groups in May 2015.

This year, MIPS partnered with the Winnipeg Regional Health Authority, Long Term and Continuing

Care Association of Manitoba, Manitoba Society of Pharmacists, and the College of Pharmacists of

Manitoba on ways to raise awareness of seniors living independently in the community about

medication safety. In August 2014, an education session was held at Riverwood Square with a

pharmacist from Tache Pharmacy presenting. This served as a template for planning additional

sessions during Canadian Patient Safety Week. Pharmacist-led education sessions on medication


safety were held in Winnipeg at Sturgeon Creek II, Riverwood Square, Portsmouth Retirement Living,

and River Ridge I. Approximately 100 people attended. A news release was issued and interviews

were held with Global Morning Show, Breakfast TV, and CTV Morning. Thank you to the Winnipeg

Regional Health Authority for your contribution to planning and moderating and to our participating

pharmacists and residences.

2014-2015 Patient Advisory Committee

Back Row L-R: Judy Storjord, Lorna Doolan, Randean Kopytko, Susan Van Koughnet

Margaret MacDonald, Gary McPherson and Denise Widmeyer

Front Row, L-R: Carrie Moran and Sonja Lundstrom

Missing: Deborah Schulz, Anne-Marie Brown, Meegan Carson

The MIPS Patient Advisory Committee was active this year. The committee participated in meetings

requesting their feedback on:

primary healthcare models

patient/stakeholder engagement in research

exploration of the Patient Advisory Committee and options for volunteerism at MIPS

Committee members accepted invitations to speak on patient engagement and self-advocacy at a

number of places and events. Examples include:

Donwood Manor Personal Care Home, Winnipeg

Transcona Seniors Group Dinner Discussion, Winnipeg

Manitoba Metis Federation, Head Office, Winnipeg

Manitoba Metis Federation, Southwest Regional Office, Brandon

Rossburn Community Resource Council, Rossburn

Seniors Helping Hands of Alstone, Reston

The Family Caregiver Conference, Herzing College, Winnipeg


Committee members also conducted exhibits on behalf of MIPS at the following public events:

Manitoba Caregivers’ Recognition Day, Winnipeg

Manitoba Pharmacy Technician/Assistant Conference, Winnipeg

The Long Term and Continuing Care Association of Manitoba, 11th Annual Provincial

Conference and Exhibition, Winnipeg

Seniors and Elders Day, Winnipeg

Prairie Mountain Health Annual General Meeting, Winnipeg

Mad Hatters Health Fair 2014 – Good Neighbours Active Living Centre, Winnipeg

6th Canadian Quality Congress, Winnipeg

WRHA Manitoba Pharmacy Technician Conference, Winnipeg

Winnipeg Public Diabetes Forum/National Conference, Winnipeg

Rady Centre Wellness Expo, Winnipeg

Manitoba Farm Women’s Conference, Brandon

Rupert’s Land Caregiver Services – A Conference for Caregivers and Older Adults, Winnipeg

The Manitoba Institute for Patient Safety continues to assist and direct the public to the appropriate

organizations and resources when contacted about various patient safety-related issues. People

inquiring are mainly interested in providing suggestions to improve quality of care or they want to

know who to contact to discuss their concerns with quality of care and patient safety.


Reaching out to Communities: Connecting with Providers and Manitobans

Board, committee members and staff of the Manitoba Institute for Patient Safety were involved in

numerous public events, MBTelehealth/teleconference meetings and conferences in 2014-2015.

Community leaders continue to use the S.A.F.E. Toolkit to conduct presentations with the public. MIPS’

staff are reaching out to community organizations to identify and approach new markets that can

potentially benefit from presentations promoting self-advocacy, and to build partnerships that promote

greater awareness and use of MIPS’ resources.

Exhibits were displayed at 20 events including those listed in the previous section attended by MIPS

Patient Advisory Committee members. Staff also attended, for example:

College of Registered Nurses of Manitoba AGM, Winnipeg

Interlake-Eastern RHA AGM, Arbourg

Southern Health/Santé Sud, Annual Public Meeting, Niverville

Paramedic Association of Manitoba, Emergency Medical Services Conference, Winnipeg

2015 Quality Forum, BC Patient Safety & Quality Council, Vancouver, B.C.

We sponsored events, including:

Manitoba Farm Women’s Conference, Brandon

Winnipeg Regional Health Authority Required Organizational Practices Forum, Winnipeg

Canadian Patient Safety Week

Winnipeg Regional Health Authority, Patient Safety and Quality Week

Regional Health Authorities of Manitoba, Governance Education, Winnipeg

In total, we made 27 presentations to organizations including those done by MIPS Patient Advisory

Committee (listed previously). Additional examples of invitations accepted by staff and directors

included:

Assiniboine Community College, Portage la Prairie

Robertson College, Winnipeg

College of Licensed Practical Nurses, Winnipeg

Red River College, Winnipeg

University of Manitoba, Faculty of Health Sciences, College of Medicine, Winnipeg

This fiscal year, the Manitoba Institute for Patient Safety continued to provide resources and tools free-

of-charge to healthcare providers, organizations and the public. In addition to the materials that

members of the public download from our websites, MIPS directly distributed over 52,000 printed

resources, including:

36,486 It’s Safe to Ask medication cards

8,766 It’s Safe to Ask brochures

1,686 Patient Advocate Forms

2,450 A Guide to a Critical Incident and Disclosure brochures

3,437 The Facts About Critical Incidents and Their Disclosure brochures

3,904 Safe Use of Medications


We continue to receive requests from organizations in and outside of Manitoba to use or adapt our

English and French materials. We are also being added to various organizational websites as a

resource for patient safety and patient and family engagement. Thank you to all of our community

partners who promote MIPS’ patient safety messages and use MIPS’ resources in presentations,

exhibits, and practice.


Future Directions

MIPS’ 2014-2017 strategic plan will continue to guide our organization in its second decade of

contribution to patient safety.

In the 2015-2016 fiscal year the Manitoba Institute for Patient Safety will:

continue to be involved in engaging the public in self-advocacy through community

presentations, exhibits, and by exploring additional opportunities for partnerships

work with organizations to promote Canadian Patient Safety Week, being held October 26 –

October 30, 2015

continue to support board governance education for patient safety and quality

host two public forums in our We Listen, We Learn series in Winnipeg, designed to encourage

the public to share their opinions and perspective on patient safety topics

continue to promote the incorporation of self-advocacy concepts and resources into secondary

education

be involved in ongoing work on a pan-Canadian patient safety strategy

lead the planning for a Patient Safety Education Program Training event in 2016

focus on opportunities to work with seniors on medication safety

produce a series of articles on patient safety for publication by partner organizations

develop a volunteer program


Members of the Manitoba Institute for Patient Safety as of March 31, 2015

Addictions Foundation of Manitoba

Assiniboine Community College

CancerCare Manitoba

College of Audiologists and Speech-Language Pathologists of Manitoba

College of Licensed Practical Nurses of Manitoba

College of Medical Laboratory Technologists of Manitoba

College of Pharmacists of Manitoba *

College of Physicians and Surgeons of Manitoba *

College of Registered Nurses of Manitoba *

College of Registered Psychiatric Nurses of Manitoba

Concordia Hospital

Diagnostic Services of Manitoba Inc.

Grace Hospital

J.A. Hildes Northern Medical Unit, University of Manitoba

Long Term & Continuing Care Association of Manitoba

Manitoba Association for Medical Laboratory Science

Manitoba Chiropractors’ Association

Manitoba College of Family Physicians Inc.

Manitoba Dental Association

Manitoba Health, Healthy Living and Seniors *

Misericordia Health Centre

Nurse Practitioner Association of Manitoba

Nursing Department, Red River College

Paramedic Association of Manitoba Inc.

Regional Health Authorities of Manitoba *

Seven Oaks General Hospital

St. Boniface Hospital *

The Arthritis Society, Manitoba/Nunavut Division

University College of the North, Faculty of Health

U of M, Faculty of Health Sciences, College of Medicine

U of M, Faculty of Health Sciences, College of Nursing

U of M, Faculty of Health Sciences, College of Pharmacy

U of M, Faculty of Health Sciences, College of Rehabilitation Sciences

Victoria General Hospital

Winnipeg Regional Health Authority *

*denotes Premier Member

The board of directors encourages organizations wishing to work with the Manitoba Institute for

Patient Safety to apply for membership. Application forms are available at Make Connections.

http://mips.ca/make-connections.html

102-175 Carlton Street, Winnipeg, MB R3C 3H9

P: 204.927.6477 | F: 204.779.6477

E: [email protected]

www.mips.ca | www.safetoask.caadvancing patient safety since 2004

2014|2015 {RepoRt AnnuAl · 2014 | 2015 ANNUAL REPORT | 7 Suzanne Hrynyk** Suzanne was appointed to...

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