World Antimicrobial Resistance Awareness Week (WAAW) Nov 18-24
The World AMR Awareness Week (WAAW) is a global campaign to raise awareness and understanding of AMR (Antimicrobial Resistance) and promote best practices among healthcare workers. The theme for the World AMR Awareness Week (WAAW) 2024 is “Educate. Advocate. Act now.”
There are two opportunities to win some great prizes during the week:
- In the Firstline app (either on your smart phone or any clinical desktop in NS Health) there is a hidden bug. Find this bug emoji somewhere in our guidelines section and you will be entered to win a prize from Firstline.
- Sign the pledge to be an Antimicrobial Ambassador and then provide your contact information HERE to be entered to win prizes from our own local Antimicrobial Ambassadors (AKA the NS Health Antimicrobial Stewardship Program)
A poster about five things to know about Antimicrobial Resistance (AMR) is available here.
Launching the Physician Engagement Framework
Nova Scotia’s health system is undergoing significant change, emphasizing the importance of engaging physicians in transformation efforts. Feedback from interviews, focus groups, surveys, and workshops with physicians and system leaders led to the development of a Physician Engagement Framework, endorsed by Nova Scotia Health, IWK Health, and the Department of Health and Wellness.
The Physician Engagement Framework provides a toolkit for health system leaders to use that incorporates ongoing efforts for more comprehensive and effective physician engagement by design, as well as strategic enablers to better address barriers to effective physician partnership and involvement. The framework also includes a list of recommendations to build understanding of transformation, maintain an open feedback loop with physicians, broaden and diversify physician perspectives in health system change and empower physicians to thrive in leadership roles.
More information can be found here.
Key initiatives already underway include:
- Fall Seminar Series on Medical Affairs
- An updated Physician Leadership Directory on the Physician Information Portal
- Onboarding videos for new physicians
- A leadership coaching podcast featuring physician leaders.
These efforts aim to refine engagement strategies and ensure effective implementation of health system changes. We look forward to providing further updates.
We thank everyone who contributed to this work and shared their insights and perspectives. You helped us identify things that are working well in addition to common challenges experienced by system leaders and physicians across the system.
Hydroxocobalamin (Cyanokit) Shortage
The Atlantic Canada Poison Centre has been informed of a supply shortage of Cyanokit® (hydroxocobalamin) 5G, injectable. The approximate return date is December 20, 2024. This antidote is indicated as a first-line treatment for cyanide poisoning.
In the context of this shortage, the Poison Centre issues the following recommendations:
- During the shortage, use hydroxocobalamin ONLY for the treatment of cyanide poisoning, and not for other indications (e.g. vasoplegia)
- Consider using expired vials of hydroxocobalamin
- If you have run out of hydroxocobalamin at your hospital and need it urgently, please contact the emergency department closest to your facility; Cyanokits are distributed throughout the province as part of the antidote program and may be readily available at a nearby facility. Additionally, please call the poison centre for advice at 902-470-8161.
- Sodium thiosulfate is an alternative treatment for cyanide poisoning. Certain sites may stock this product (e.g., sites with dialysis units). The Halifax Infirmary site stocks this product if it cannot be sourced locally. Please call 473-5200 to access this medication.
The Drug Shortage Report for CYANOKIT can be found here.
Health Beyond Hospital: Integrated Discharge Hub
In October, 50 participants from Nova Scotia Health, Emergency Health Services and other Government of Nova Scotia partners were engaged in a prototyping workshop for Health Beyond Hospital: Integrated Discharge Hub to build, try and test the model design.
The Health Beyond Hospital team has been presenting to various groups across Nova Scotia Health. We would be pleased to provide an overview of this project and updates to your team. Please reach out to Graeme.Kohler@nshealth.ca to schedule a time to hear more.
Next steps include testing the prototypes at sites across the province (e.g., cross-departmental escalation processes). We will continue engagement by expanding communications. Once the prototype testing phase is complete, pilot implementation will begin in the spring of 2025.
See full update for more details and background on Health Beyond Hospital.
EHS Operations Introduces Penthrox Pilot Program for Paramedics
As part of our commitment to improve clinical care, EHS Operations has introduced a pilot program using Penthrox (methoxyflurane), a non-opioid inhaled analgesic, as a new option for pain relief. Penthrox may be given in some situations by EHS to patients experiencing moderate to severe acute pain due to trauma. A patient who received Penthrox may be taken directly to the waiting room as per regular process, if they otherwise meet the Direct-to-Triage criteria.
Penthrox has been used effectively by paramedic services internationally and has been selected based on its proven track record and safety profile. For the first phase of the pilot, Penthrox is stocked on all Emergency Preparedness and Special Operations (EPSO) units across Nova Scotia. If successful, a second, larger pilot program in selected rural and urban settings will launch in 2025.
Questions? Please contact clinicaldevelopment@emci.ca.
OPOR News
Digital Health Week: OPOR and the Role of Technology
Digital Health Week (November 18 – 24) is a time to reflect on the transformative role digital health plays in advancing patient care, supporting healthcare providers, and enhancing system efficiency.
The One Person One Record Clinical Information System (OPOR-CIS) is one of the many initiatives driving digital health advancements across the province. It is an example of how technology can provide the right tools at the right time to enhance healthcare processes, experiences, and outcomes.
The OPOR-CIS will transform documentation from paper to digital, with information, orders, and patient care plans entered in real-time. Care teams will have easy access to the information, including workflows, they need to make the best possible clinical decisions, and ultimately spend more time with patients and less time searching for records.
Learn more here.
OPOR Spotlight Series: Subject Matter Experts
The One Person One Record Clinical Information System (OPOR-CIS) represents the most significant, transformative change to healthcare delivery ever experienced in our province.
One of the many important aspects in the development of the OPOR-CIS is that while following the Cerner Canadian Reference Model as a guide, the new system is being designed by Nova Scotians, for Nova Scotians.
Subject Matter Experts (SMEs) participate in Design Workshops during which they lend their expertise to making design decisions for the new OPOR-CIS. There is a mix of clinical and non-clinical healthcare workers who have given their time to ensure the system meets the needs of physicians, providers, employees, and patients across the province.
We are excited to continue our series of interviews featuring some of the hundreds of SMEs from different care areas and work streams.
Meet Dr. Abraham (Rami) Rudnick, Nova Scotia Operational Stress Injury Clinic, Central Zone. Read a Q&A with Dr. Rudnick here.
OPOR Updates: The Latest OPOR-CIS Development & Timeline News
Here are latest updates on the development of the One Person One Record Clinical Information System (OPOR-CIS):
- CIS Design: The design phase of the OPOR-CIS is wrapping up (93 per cent data collection) and the final pieces of the design are being finalized.
- CIS Build: The CIS is 73 per cent built. Foundational elements of OPOR are in place, and our focus is now on tailoring the system to meet provincial needs.
- CIS Impact Spotlight: Did you know that more than 50 per cent of patient data will be housed in the CIS! The CIS will be one of the largest contributors of health data for the province, providing real time data to clinicians, source documentation, Computerized Provider Order Entry, Closed Loop Medication Management and more.
- Next steps: We have come a long way! OPOR is now in the “validate phase” of the CIS build, which is part of the change management “desire” phase.
When managing a large system change, it is critical to build excitement and share information on how the new system will change the way people work. The OPOR team is excited to demonstrate the change impact for future CIS users and dig deep into validation and testing of the system. Learn more and get the latest OPOR information in this month’s OPOR Monthly Update.
IWK RSV Prevention Program
Please see the RSV prevention package available here. For physicians outside Halifax who have patients that meet the criteria for RSV prophylaxis please use the enclosed request form and fax to the IWK Prevention clinic (902-470-7768).
For those within HRM, please use the enclosed referral form and fax to the RSV Prevention Clinic at the IWK Health (902-470-7768). If there are any issues with opening the attached, please email back with your fax number and a copy will be faxed to you.
If you have any questions or concerns, please call Karen Chestney, Provincial RSV Prevention Monitoring Nurse, at (902) 470-8329.
IV Manual and Smart Pump Update effective November 19, 2024
The IV Drug Therapy Manual website and smart pump libraries were updated on November 19, 2024. Please refer to this memo for details.
New Guidebook on Green Healthcare
The Canadian Coalition for Green Healthcare has recently released a guidebook designed to integrate green practices into existing strategic plans. Dr. Nabha Shetty, from the CZ Department of Medicine, is among the coauthors of this resource.
These guidelines offer practical strategies that align with the growing interest of healthcare professionals, including many NSH physicians, who are committed to advancing planetary health and incorporating sustainable practices into their medical work.
Find the guidebook here.
Nova Scotia Health Frailty and Elder Care Network Welcomes Dignity of Risk Program
The Frailty and Elder Care Network is excited to highlight our new Dignity of Risk Program, the first of its kind in Canada. The Program’s goal is to help older adults living with frailty and dementia maintain autonomy and uphold wishes to live with some risk.
The desire to “keep people safe” can unintentionally limit older adults’ choices in how they live and remove autonomy too early or unnecessarily. This can potentially lead to longer hospital stays, which can increase risk of harm, including increased frailty, deconditioning, and exposure to other illnesses. The ‘dignity of risk’ approach to care acknowledges that living with frailty or dementia comes with risks in daily life.
The Dignity of Risk team is supporting people to think differently when caring for older adults living with dementia, frailty or other age-related illness. The Program aims to educate healthcare teams, patients, caregivers, families and other essential care partners about balancing a person’s right to take reasonable risks that align with their preferences, dignity and values with support and strategies to manage risks that arise with frailty and dementia. Watch for our new Dignity of Risk resource coming soon. Contact the Dignity of Risk team at dignityofrisk@nshealth.ca.
New research project to enhance case management services for older adults with complex care needs
Continuing Care is excited to welcome Dr. Kelly O’Neil, one of 20 post-doctoral fellows across Canada conducting embedded research to improve health systems and patient outcomes.
For the next two years, Kelly will contribute to a renewed case management model through the practical application of her research findings. By gaining insights into supporting older adults with complex health and social care needs through collaboration with staff, PFAs and clients, Kelly’s research findings will inform staff competency training and the development of case management models, equity-informed practices and enhanced service.
This work is jointly funded through the Canadian Institute for Health Research Health System Impact Program and Nova Scotia Health. Continuing Care and the Nova Scotia Centre on Aging at Mount Saint Vincent University are partnering to support Kelly’s important research. Learn more.
Leading the Way: Episode 64 - Interview with Dr. Melissa Lem
In this episode, Dr. Melissa Lem discusses her leadership journey at the local, national and international level, sharing insights from her work in health, environmental advocacy, and engaging with the media. Listen here.
CSPL podcasts are now available on Apple podcasts.
The full newsletter is here.