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Longwoods eLetter August 19, 2008

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“. . .if your life is in someone's hands, that person is completely responsible for what happens to you, often for whether you live or die.” Cambridge Idioms Dictionary

OFF THE CUFF
Top 10 Reasons for Not Washing Hands
1. I'm a doctor. 2. Germs? What germs? I don't see any germs! 3. There was no sink or soap or paper towel in a two step radius. 4. No one was watching me. 5. I only washed a little old lady. 6. I used gloves, that's enough right? 7. I washed them 10 minutes ago. 8. My boss didn't wash his/her hands. 9. But I am sure I did, I always wash them. 10. I had my flu shot.

C. difficile primarily an issue in developed countries
From Wikipedia: On June 4, 2003, two outbreaks of a highly virulent strain of this bacterium were reported in Montreal, Quebec, and Calgary, Alberta, in Canada. Sources put the death count as low as 36 and as high as 89, with approximately 1,400 cases in 2003 and within the first few months of 2004. C. difficile infections continued to be a problem in the Quebec health care system in late 2004. As of March 2005, it had spread into the Toronto, Ontario area, hospitalizing 10 people. One died while the others were being discharged.

1. A similar outbreak took place at Stoke Mandeville Hospital in the United Kingdom between 2003 and 2005.
2. On October 1, 2006, C.diff was said to have killed at least 49 people at hospitals in Leicester, England over eight months.
3. On October 27, 2006, 9 deaths were attributed to the bacterium in Quebec, Canada.
4. On November 18, 2006, the bacterium was reported to have been responsible for 12 deaths in Quebec, Canada.
5. On February 27, 2007. a new outbreak was identified at Trillium Health Centre in Mississauga Ontario, where 14 people were diagnosed with the bacteria.
6. In October 2007, Maidstone and Tunbridge Wells NHS Trust was heavily criticized by the Healthcare Commission . . . estimated that about 90 patients "definitely or probably" died as a result of the infection. In November 2007, the 027 strain has spread into several hospitals in southern Finland, with ten deaths out of 115 infected patients reported on 2007-12-14.
7. Clostridium difficile was mentioned on 6,480 death certificates in 2006 in UK.
8. Reported mortality rates from Clostridium difficile disease in the United States increased from 5.7 per million population in 1999 to 23.7 per million in 2004. Increased rates may be due to emergence of a highly virulent strain of C. difficile.

Recent Reports

1. There have been at least 264 deaths at seven Ontario hospitals since 2006 from C. difficile, a drug-resistant bacteria that spreads in health-care institutions. The Ministry of Health confirmed Tuesday [June 24, 2008] that it was aware of outbreaks at 19 hospitals in the province, but said it could not provide an updated list of C. difficile deaths because it does not have that information. [Toronto Star. June 24, 2008].
2. Coroner Catherine Rudel-Tessier's report, made public Tuesday [September 25, 2007], said basic hygiene precautions were not in place at the hospital between May and November of last year, when 16 deaths that were the object of the report occurred. Canada.com.
3. It was determined that C. difficile caused 10 of the 26 deaths reviewed and was a contributing factor in another eight. Government of Ontario.
4. C. difficile has claimed about 2,000 lives in Quebec since 2003. CBC report.
5. In the past 12 months, 107 patients contracted the infection while in Joseph Brant. Thirty-eight of those patients died within 30 days of diagnosis but not all because of the infection. CBC report.
6. C. difficile deaths soar by 72 percent - UK (Reuters)
7. Based on data from Ohio, estimates suggest that currently there may be as many as 500,000 cases of C. difficile infection occurring annually in the United States, contributing to between 15,000 and 30,000 deaths. (CDC source (PDF)| June 2008)

Hand-washing compliance and RFID. (PDF) Do you have this in your organization?
To reduce the spread of infections, a new automated hand-sanitizing system uses RFID to monitor how well health-care workers wash their hands. . . . Hospital administrators can then run departmental statistics and other compliance reports to determine which caregivers have completed the washing cycles.

Proper hand hygiene demonstrated by leaders has been shown to positively influence others’ compliance by up to 70%.
See: The Need for Better Hand Hygiene. (PDF) [from handhygiene.ca]

From the Public Health Agency of Canada
How do people get C. difficile? | What can be done to prevent its spread? | What are the symptoms of C. difficile infection? | Is C. difficile fatal? | How can C. difficile be treated? | Why are we hearing so much about C. difficile now? | What is the Public Health Agency of Canada doing about this situation? | What will the Agency do with this study? | What sort of things will the study examine? | What hospitals are participating in the study? | Have the recent issues with C. difficile prompted this new study? | What puts a person at risk of C. difficile? | What is the Public Health Agency of Canada going to do about the use of proton pump inhibitors?

• Canada's Hand Hygiene Campaign? Click on Campaign
• First Do No Harm. (PDF) Healthcare Quarterly: Hamilton Health Sciences’ Experience with a Medication Safety System
• The Canadian Pandemic Influenza Plan for the Health Sector (PDF)
• Reducing Childhood Diarrhea Morbidity: Does Behaviour Change by IK Osumanu
• On the other hand: Doctors might be better off washing their hands with yoghurt instead of relying on antiseptic soap-scrubbing; a discussion paper by a University College London researcher. [Put this in context: C. difficile is a decidedly developed nations issue.]

Canada’s Patient Safety Papers:
Published by Longwoods on behalf of the Canadian Patient Safety Institute. Open access. Edited by Dr. Ross Baker
Issue one: home page + content | Issue two: home page + content | Issue three: home page + content

Pandemic or Pandemonium with Dr. Donald Low
See the slide deck + voice-over here.

Send your news and innovations to news@longwoods.com. (Let your communications VP know.)

Ever wonder what happens to all those eLetters? Stay tuned here.
If you received this eLetter from a colleague, sign up for your own issue. Click here.

1. Breakfast with the Chiefs with Alan Hudson: September 16, 2008 | Toronto | Register here. (Attend all the breakfasts with one membership to the HealthcareBoard - subscribers who are leaders in healthcare policy, research, practice and management. Others please contact Susan Hale). Breakfast with the Chiefs is further enabled by educational grants from: Accenture, CGI, McKesson, HP Canada, Philips and the support of the Association of Canadian Academic Healthcare Organizations, Ontario Hospital Association, HPME (University of Toronto) and the Provincial Health Services Authority of BC.
2. The Health Care Governance Forum immediately follows the breakfast. Issues: CEO Pay for Performance; Physician Relationships; Community Engagement; Working in a LHIN Environment; Board and Committee Evaluation; Quality and Patient Safety. Register here (PDF).
3. Across LHIN borders. With Dr. Barry McLellan: placing our patients ahead of postal codes featuring: Terry Sullivan, Sarah Kramer and more (Think of the issues. Patients will assume access anywhere. Who is responsible, accountable and capable? Questions that need answers in strategic plans and programs.) Also enabled by our corporate and institutional collaborators. Details here . . . registration limited to the first 100.

SAVIEZ-VOUS QUE?
En moyenne, 120 enfants reçoivent des transplantations d’organes au Canada chaque année.

Healthcare Quarterly
The Role of Healthcare Work Environments in Shaping a Safety Culture
Graham S. Lowe

HealthcarePapers
Deepening the Impact of Initiatives to Promote Teamwork and Workplace Health: A Perspective from the NEKTA Study
Michael P. Leiter

Nursing Leadership
Effects of Director of Care Support on Job Stress and Job Satisfaction among Long-Term Care Nurse Supervisors
Katherine S. McGilton, Linda McGillis Hall, Veronique Boscart, Maryanne Brown

Healthcare Policy / Politiques de Santé
Work Mistreatment and Hospital Administrative Staff: Policy Implications for Healthier Workplaces
Karen P. Harlos and Lawrence J. Axelrod

Electronic Healthcare
IT Solutions for Patient Safety - Best Practices for Successful Implementation in Healthcare
Peggy Leatt, Chris Shea, Melanie Studer and Virginia Wang

World Health and Population
Health Sector Reform And Decentralization In Tanzania: The Case Of The Expanded Programme On Immunization At District Level
Innocent A. J. Semali, Don De Savigny, and Marcel Tanner

What is the research telling us about the quality of work-life for nurses and its implications for their retention and recruitment?
Linda O'Brien-Pallas and Tom Closson

Breakfast with the Chiefs, Great Minds in Dialogue (Tuesday, December 11, 2007): Linda O'Brien-Pallas (Professor, University of Toronto, CHSRF/CIHR National Chair, Nursing Health Human Resources). Tom Closson (Healthcare management consultant & Past President and Chief Executive Officer of University Health Network).

Listen Here. Running time: 60:45 minutes

Organizations interested in contributing to Longwoods Radio read this . . .
This is great opportunity to effectively transfer knowledge using storytelling, compelling lectures or gripping interviews – using simple digital recordings that we distribute on the web. Formatted for iPod listeners too. For criteria and specifications please contact Lina Lopez at LLopez@longwoods.com. All subject to editorial review and acceptance of course.

2008/2009 Calendar of Breakfast with the Chiefs

Tuesday, September 16, 2008 - Toronto - Limited Seating
Dr. Alan Hudson, Lead of Access to Services/Wait Times for the Health Results Team, Ministry of Health and Long-Term Care.
Topic: Improving Access - the Governance Challenges
Location: Imperial Room at The Fairmount Royal York, 100 Front Street West, Toronto
Sponsors:  ACAHO, Accenture, CGI, HP Canada, HPME - University of Toronto, McKesson Canada, Ontario Hospital Association, Philips Healthcare
Register here

Wednesday, October 22, 2008 – Toronto
Matt Anderson, CEO - Toronto Central LHIN
Topic: A View from a LHIN.
Location: Toronto
Sponsors: ACAHO, Accenture, CGI, Healthtech, HP Canada, HPME, University of Toronto, McKesson Canada, Ontario Hospital Association, Philips Healthcare
Register here

Tuesday, November 18, 2008 – Toronto
Vivek Goel
Vivek Goel is President and CEO of the Agency for Health Protection and Promotion
Topic: Renewing Public Health in Ontario: The Role of the Ontario Agency for Health Protection and Promotion.
Location: Toronto

Thursday, December 4, 2008 - Toronto
Murray T. Martin, President and CEO, Hamilton Health Sciences, Hamilton, ON
Cliff Nordal, President and CEO, London Health Sciences Centre & St. Joseph’s Health Care, London, ON
Topic: Let's settle the private/public hospital debate: A Conversation reflecting on a tour of Australia and New Zealand.
Location: Toronto
Sponsors: ACAHO, Accenture, Ontario Hospital Association

Tuesday, March 3, 2009 - Toronto
Michael Guerriere, Managing Partner, Courtyard Group
Topic: 2009 Review of IM/IT in Healthcare: The Unvarnished Version
Location: Toronto
Sponsors: ACAHO, Accenture, Courtyard Group, Ontario Hospital Association

Other confirmed Chiefs for 2008/2009 series of Breakfast with the Chiefs (dates TBD)
Dr. Michael Guerriere, Managing Partner, Courtyard Group Inc.; Ida Goodreau, President and CEO for Vancouver Coastal Health (VCH).

For more information on upcoming speakers or to view past presentations click here.

Breakfast with the Chiefs video: Matthew Anderson - then Vice-President, Chief Information Officer, UHN and Toronto Community Care Access Centre.
IT Collaboration Report (PDF).
Sponsors: Accenture, ACAHO, Dell Canada, Lanier Healthcare, Philips Medical Systems, Roche, and TELUS

The small print: Subscribers do have more options. If you are a personal journal subscriber and represent public healthcare management, practice, education, research or policy you can attend any and all of the breakfasts.  If you are a member of a commercial / service organization you have other options. Please contact Susan Hale or Matthew Hart for more information. Not yet a member, but would like to join Breakfast with the Chiefs? Contact Lina Lopez for more information.

To see the photo archives click here. To see our video archives click here.

With its theme, Inspiring Ideas and Innovation, HealthAchieve2008 is Canada’s largest health care show, attracting thousands of hospital leaders and health care professionals from across the country. This year, HealthAchieve will be held November 3, 4 & 5 at the Metro Toronto Convention Centre. Featuring keynote addresses from the Rt. Honourable Adrienne Clarkson, Uwe Reinhardt and Dr. Mehmet Oz, HealthAchieve2008 promises to be a truly inspiring event! For further information, visit www.healthachieve.com.

August 25-29, 2008: Vancouver, BC. 26th International System Safety Conference. The ISSC 2008 conference will provide evidence-informed, practical knowledge about how best to integrate new knowledge and practical applications of recent thinking about methods to achieve enhanced safety. The conference features opinion leaders from the fields of high reliability, resilience engineering and human factors including Richard Cook, a physician, educator, and researcher at the University of Chicago. The conference usually draws people from risk critical industries, such as aviation, the petro-chemical and nuclear power industries, and the military; and has increasingly been introducing themes of specific interest to health care. For details click here.

September 17-20, 2008: Toronto, ON. 5th International Nurse Practitioner/Advanced Practice Nursing Network Conference Leadership in Advanced Nursing Practice: Maximizing Health, Celebrating Collaboration and Promoting Innovation. Presented jointly by the Canadian Association of Advanced Practice Nurses (CAAPN) and the Canadian Nurses Association (CNA). This conference will inspire advanced practice nurses around the globe to learn new ways to handle challenges, and will provide an exciting opportunity to network with clinicians, administrators, policy-makers, educators, researchers, students, and interdisciplinary colleagues. Topics include Nurse Practitioner Roles in Anesthesiology and Models of APN role evaluation. International Speakers include Ann Hamric, Dorothy Brooten and Stephen Lewis. For details click here.

September 20, 2008: Toronto, ON. Network with industry leaders, while supporting a great cause at The Imagination Ball. Saint Elizabeth Health Care’s phenomenal fundraising Gala featuring: President and CEO Shirlee Sharkey, Honorary Chair Shirley Douglas, CTV’s own Ken Shaw, Presenting Sponsor TELUS, and many more…You’ll be in good company at the Imagination Ball! Saturday, September 20, 2008 at Toronto’s The Carlu. For tickets click here.

September 26-27, 2008: Toronto, ON. Health Human Resources Migration International Policy Symposium. Co-sponsored by the University of Toronto, The Connaught Committee and the Ontario Ministry of Health and Long-Term Care. Featuring Keynote Speaker Dr. Demetrios Papademetriou, President, The Migration Policy Institute, Washington, DC. For further details and registration information click here.

October 17, 2008: Toronto, ON. 8th Annual Kunin-Lunenfeld Applied Research Unit (KLARU) Conference “Connecting Research and Clinical Care: Improving Patient Safety in Long-Term Care Settings”. Attendees will be updated on recent advances of safety improvements as well as practical applications for long-term care providers to take back to their organizations to implement best practices. For more information, click here.

November 27-29, 2008: Toronto, ON. Family Medicine Forum. Canada’s largest family medicine conference. Co-hosted by the College of Family Physicians of Canada (CFPC), the Ontario College of Family Physicians (OCFP) and the CFPC’s Sections of Teachers and Researchers. For conference program and registration click here.

February 19-22, 2009: Victoria, BC. Revolutionizing Healthcare with Informatics: From Research to Practice. Information technology affects nearly every aspect of healthcare today. Health information systems are seen by many as the critical element in improving and modernizing healthcare in Canada and internationally. In order to achieve this potential there will need to be a stronger bridge between research and practice in order to solve complex healthcare problems using technology and to develop best practices based on proven results. Deadline for submission of abstracts is June 30, 2008. For details click here.

For our complete list of conferences and events go here.

Ontario Hospital Association conferences www.OHA.com/conferences

Registered Nurses Association of Ontario conferences click here.

[We don't go looking for these conferences. Send details to conferences@longwoods.com]

Canadian Council for Donation and Transplantation to merge with Canadian Blood Services, with mandate of blood services + organ and tissue donation and transplantation. Funded by a combined investment of $35 million over the next five years by the federal, provincial and territorial ministries of health.

[Don’t forget, we don’t make these up. Please send your promotions, appointments, retirements and other transitions to publisher@longwoods.com.] 

Review all recently reported Transitions here.

Scholarships
August 15, 2008. The HIMSS Foundation announces the opening of its college scholarship application period. Twelve scholarships, worth a total of $44,000 are designed for undergraduate and graduate student members of HIMSS who are studying health information technology and management systems Applicants can apply through Oct. 30, 2008. Information on all of the HIMSS Foundation Scholarships and the online application form are available here.

For Healthcare companies and recruiters: This year HealthAchieve provides all +8500 attendees the HealthAchieve2008 Pocket Notebook. Will include new, unpublished insights from Canada’s top minds + information critical to every healthcare organization in Canada. As only our editors can edit. + Career opportunities from coast to coast. Recruiters can participate and reach all the attendees plus the 250,000 online visitors. For more information click here (PDF) or contact Susan Hale.

Program Manager, Clinical Neurosciences - University Hospital, LHSC, London, ON
Nurse Clinician, Aboriginal Health - BC Women’s Hospital & Health Centre (BCW), Vancouver BC
Registered Nurses - Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON
Director, Quality & Risk, VON Canada, Western Region
Exciting Career Opportunities with the Ministry of Health and Long-Term Care, Toronto, ON
Senior Policy Adviser - Ministry of Health and Long-Term Care, Toronto, ON
Infinite Possibilities - Bloorview Kids Rehab,Toronto, ON
Administrative Director, Surgical and Oncology Program - St. Joseph’s Health Centre, Toronto, ON
Senior Specialist, Health System Scorecard - Ministry of Health and Long-Term Care, Toronto, ON
Policy Analyst - Ministry of Health and Long-Term Care, Toronto, ON
Senior Policy Adviser - Ministry of Health and Long-Term Care, Toronto, ON
Medical Director - Burnaby Hospital & Delta Hospital, Vancouver, BC
GlaxoSmithKline Chair in Health Policy - Queen’s University, Kingston, ON
Director of Nursing - The Toronto Rehabilitation Institute, Toronto, ON
Executive Director, Acute Programs - Burnaby Hospital, Burnaby, BC
Manager, Health Services, Neonatal IC & Pediatrics - Royal Columbian Hospital, New Westminster, BC
Director, Community Engagement and Communications - Toronto Central LHIN
Director, Program Development - Toronto Central LHIN
Financial Analyst - Toronto Central LHIN
Web Content Entry - Longwoods Publishing, Toronto, ON
Marketing Manager, Healthcare - RIM, Waterloo, ON
Doctors Without Borders - Medical and Non-Medical Volunteers
Student Nurse Burseries - Northwest Territories Health and Social Services
Nursing & Leadership Opportunities with the Provincial Health Services Authority of BC
Career Opportunities at Courtyard Group
Career Opportunities at Strata Health
Career Opportunities at London Health Sciences
Career Opportunities in the Northwest Territories
Career Opportunities at Hamilton Health Sciences
Career Opportunities at Capital Health Edmonton
Career Opportunities at Vancouver Coastal Health
Career Opportunities at Vancouver Island Health Authority
Career Opportunities at Fraser Health
Nursing Leadership Careers (PDF)

Visit our portal of more than 60 participating healthcare recruitment centres
[Send your career opportunities to Susan Hale at shale@longwoods.com]

If you have ever wanted to re-visit an archived Longwoods eLetter go here. To unsubscribe from this newsletter click here.

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