Research and Quality

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The Research Lead Office is committed to improving quality of patient care, health services efficiency and integration through efforts to build and support quality improvement initiatives and scholarly activities.  Facilitating a focus on quality, the Research Lead Office seeks opportunities where quality improvement and research may intersect.  

Where do Quality Improvement and Research meet?

  • The tested intervention involves deviation from established practices
  • There are clear, measurable aims and a timeline for achieving them
  • A rigorous design is possible without disrupting normal work unduly
  • Everything possible is done not to sacrifice data quality and completeness
  • Careful attention is paid to ethics
  • Publication is anticipated throughout the work

Quality Improvement in the Intensive Care Unit

The Research Lead Office is currently conducting a quality improvement/research program in collaboration with the Canadian ICU Collaborative ‘PAD your ICU’ in order to implement proper management of pain, agitation, and delirium (PAD) in the intensive care unit at the St. Catharines Site. This multidisciplinary quality improvement program incorporates a well-designed research methodology to 1) target nurses with focus groups and education sessions funded by the Ontario Nurses’ Association to understand barriers and to provide education surrounding PAD management; 2) monitor PAD related quality metrics; and 3) develop tools to improve PAD management. This program will run from June 2016 to December 2017, with funding from the Physicians’ Services Incorporated Foundation pending.

Interprofessional Education for Quality Improvement Program (I-EQUIP)

I-EQUIP is a unique applied experiential learning collaborative that seeks to foster a culture of continuous quality improvement in health care through academic and practice innovations. Since 2012, McMaster University, Brock University, and Niagara Health have partnered on initiatives that span the healthcare system in Niagara, ranging from acute care to long term care and rehabilitation. I-EQUIP provides participants with an opportunity to design and implement a quality improvement project in an interprofessional team, developing skills in leadership, and influencing change in the healthcare setting.

Medication Reconciliation Quality Improvement Program

Medication discrepancies, i.e., unexplained differences in medication regimens across different sites of healthcare, are very common and represent a major threat to patient safety. One solution to this problem is medication reconciliation. The Agency for Healthcare Research and Quality-funded Multi-Center Medication Reconciliation Quality Improvement Study (MARQUIS), conducted at five US hospitals, consolidated and rigorously evaluated best practices in a real-world setting. Results showed significant reductions in potential harmful medication discrepancies. The MARQUIS toolkit, now refined based on lessons learned from the prior study, provides a scalable and testable approach to markedly improve medication safety at numerous institutions. The long-term objective of this research is to widely disseminate, implement, and evaluate sustainable medication reconciliation interventions that improve patient safety during healthcare transitions. The MARQUIS toolkit is being implemented at 18 diverse hospitals including Niagara Health, using a mentored implementation model to rigorously evaluate the effects on unintentional medication discrepancies, and to evaluate the success of implementation using the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance) to inform future dissemination.
Team: Andrea Delrue, MD, Madelyn Law, PhD, Andrea Forgione, Susan Cubelic, Matthew Greenway, MD

 

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