Pre-analytical specimen labelling and processing errors in the ICU

Introduction: Specimen rejections have been associated with increased in-hospital stay and cost. The majority of errors occur in the pre-analytic phase. Specimen rejection can lead to high rate of recollection, delay in result availability, and high rate of test abandonment. These factors affect patient care and safety. Methods: This study conducted a retrospective review of Patient Safety Learning System (PSLS) reports for the intensive care unit (ICU) at The Ottawa Hospital General Campus (TOH) between 2010 and 2018, and a prospective review using interviews, surveys, and process mapping. Results: From 2098 PSLS reports, 52.6% were related to laboratory specimen collection and processing (pre-analytic phase). Specimen mislabelling with the wrong patient identifier accounted for 9.8% of pre-analytical error reports, while 16.4% of errors were due to non-sufficient quantity (NSQ) of specimen. 12.2 % of pre-analytical error reports involved cytology specimens. Conclusions: Pre-analytical errors are not only costly and resource draining, but may also place a burden on patients. Areas where errors were found include labels and requisitions stored in bedside cabinets, inconsistencies between specimen labels and requisitions, out-dated and difficult to access laboratory manuals, and non-sufficient quantity specimen collection. In the future we hope to start new initiatives to tackle these issues to improve patient safety and hospital efficiencies. This includes the development of a website for the laboratory manual, so that it is more easily accessible and user-friendly. With a new electronic medical record (EMR) system at TOH in 2019, we will explore the affects of pre-analytical processing of specimens.

To lecture or not to lecture, that is the question! Modern medical and nursing students' perceptions regarding lectures and lecture attendance at the University of Ottawa

Lecture has historically been a core method used for content delivery in healthcare profession education. However, lecture attendance has decreased within the recent generations of students. The current study focus was to assess the medical and nursing students’ perceptions regarding lecture attendance. To assist with this, second year medical (110/320) and nursing students (95/215) were requested to answer a 10-item survey. The results show that the top reasons why medical and nursing students attended lectures, respectively included: “lectures were mandatory” (81.8% and 68.8%), “socializing with peers” (68.2% and 30.1%), and “professor emphasized important points” (67.3% and 90.3%). While some reasons for students not attending lectures were that the lecture format was not effective (63.5% and 67.7%), students preferred to use recordings of the lectures (43.3% and 18.1%). Overall, 64.6% of medical students and 63.4% of nursing students agree that traditional lectures are an effective way of learning. Sixty two percent of medical students (62% n=68) of medical students stated that traditional lectures is their preferred method of learning compared to flipped classroom (27%), small group learning (30%), and online learning (31%). While (39%) of nursing students stated that traditional lectures is their preferred method of learning compared to flipped classroom (21.5% ), small group learning (3.2%), and online learning (7.4%). The results suggest that there is variability in students’ preferred learning style. While some prefer the face-to-face interaction with the professor, other students favour studying at their own pace. The majority of medical and nursing students think traditional lectures continue to play a major educational role.

Optimizing pre-clerkship medical education at the University of Ottawa

COVID-19 has brought forth unprecedented changes in the delivery of medical education. With concerns rising over a new variant and an upheaval in vaccine distribution, institutions have had to re-strategize and, in many cases, implement provisional shutdowns to contain the spread of SARS-CoV-2. For medical schools, providing an optimal balance between in-person training and virtual learning has been challenging. At the University of Ottawa Faculty of Medicine, key components of the undergraduate medical education, including in-class lectures, interactive practical sessions, and clinical placements, have been affected by the pandemic. In this paper, we highlight barriers to an optimal learning experience among pre-clerkship students at the University of Ottawa and propose ways in which this can be overcome.

Department of Psychiatry Research Day: Conference Proceedings

UOJM is pleased to have collaborated with the Department of Psychiatry Research Day committee to put together this special issue. The University of Ottawa Department of Psychiatry virtually hosted its annual Research Day on November 17, 2021. This year’s theme was Climate Change and Mental Health. The online event welcomed 168 registered individuals. The abstracts found in these conference proceedings highlight the quality and diversity of ongoing research within the Department of Psychiatry. We’d like to thank all members of the planning committees, the UOJM team, and all students involved for their hard work in contributing to and finalizing this special issue.

Conference Proceedings: Faculty of Medicine Research Day

Actes de la conférence: Journée de la recherche de la Faculté de médecine / Conference Proceedings: Faculty of Medicine Research Day

Inégalités systémiques et de santé soulignant l’impact disproportionné de la pandémie de COVID-19 sur les peuples autochtones

Les mesures de santé publique restrictives visant à réduire la propagation d'infection par le COVID-19 ont amené les Canadiens à affronter les perturbations socio-économiques résultant de la pandémie. Cependant, les inégalités systémiques et de santé chez les peuples autochtones les prédisposent à être touchés de manière disproportionnée par la pandémie. Ce groupe minoritaire est confronté à des risques accrus d'infection, de morbidité et de mortalité liés au COVID-19, une détérioration de la santé mentale, une crise économique, ainsi qu'une multitude d'autres problèmes.

The Hidden Costs of COVID-19 and School Closure on Children

An initial public health measure enacted in response to the COVID-19 pandemic was the closure of schools.[1] This action was motivated by previous observations regarding school closure and prevention of pandemic flu transmission.[2,3] In response to periodic school closure, many schools in Ontario have adopted a hybrid model of schooling with both in-person and remote learning. However, due to the emerging SARS-CoV-2 variants, considerable concern has been raised regarding in-person learning.[4,5] This is an important discussion to have as additional variants and waves are likely to arise, and school closure poses a substantial burden to the well-being of children —especially those from marginalized populations.

Physician Assessment of Social Determinants of Health: A Necessary Component in Improving Care of Patients

The importance of building a therapeutic relationship between a physician and a patient is taught early on in a medical student's training, specifically through the practice of obtaining a patient history. This process consists of gathering information in four main categories: the history of the present illness, personal social history, past medical history, and family history. Each piece of information obtained within these categories is vital in ensuring a patient receives appropriate and effective care. Specifically, a social history consists of asking about a patient's relationship status, support system, home environment, interests, exercise, nutritional habits, substance use, and sexual history. To complete a successful and full social history, one should try to address the social determinants of health. As per the Government of Canada’s website, social determinants of health “refer to a specific group of social and economic factors within the broader determinants of health. These relate to an individual’s place in society such as income, education or employment” [1]. Consequently, a critical component of a complete social history interview should be investigating a patients socioeconomic status. Low socioeconomic status (LSES) has been found to play a role in incidence and susceptibility to a variety of health conditions. As such, I believe that screening for and asking questions pertaining to the socioeconomic status of a patient should be considered a vital and essential component of every patient assessment.

Disrupting the paradigm of oncology care in Canada: the triumphs, challenges and future implications of telemedicine

Medicine has long been one of the lingering aspects of society yet to be fully disrupted by technological advances. Unlike media, banking and commerce which have adapted to the growing demand for convenience and accessibility from the public, the practice of medicine in many ways remains much unchanged from decades prior. The 2019 novel coronavirus (COVID-19) demanded an immediate shift in the way Canadian healthcare was delivered to reduce the risk of viral transmission from in person patient encounters. Cancer poses a large and ever-increasing impact on the Canadian population and healthcare resources. Brenner et al. (2020) estimated nearly half of the Canadian population will develop cancer in their lifetime in addition to the recent increasing yearly number of new diagnoses and deaths as the population grows and ages [1]. Cancer patients were initially an ideal population for telemedicine encounters during the pandemic. These patients often have additional comorbidities association with COVID-19 mortality and a diagnosis of cancer may further increase this risk [2]. As healthcare enters a second year within the new paradigm of virtual medicine, it is important to consider the impact and future of telemedicine on Canada’s ever-growing oncology patients.