Canadian Patient Safety Institute (CPSI)
Introduction
Canada has a quality health care system that delivers safe and effective
care to Canadians every day. Providing safe, quality health care to Canadians
is a priority for all governments. However, even with the best systems in
place, things sometimes go wrong. Improving the safety of patients is about
creating an environment that is open to disclosure and committed to change.
There is a need to alter the culture of silence and promote a culture of
sharing and learning such that safety can be improved.
There is significant activity in Canada related to patient safety. Because
of this, governments recognize the need to work collaboratively with other
sectors and each other, to share best practices, and recognize the role of
research, knowledge transfer and evaluation to ensure patient safety. The  CPSI
will facilitate collaboration between governments and stakeholders to enhance
patient safety initiatives.
Origins of the Canadian Patient Safety Institute
In September, 2001, the Royal College of Physicians and Surgeons of Canada
held a one-day forum on patient safety as part of its Annual Conference. Over
50 experts, health-care professionals, government officials and health-care
association members (domestic and international) participated in the
roundtable. Consensus was reached on the need to develop a coordinated strategy
for improving patient safety within Canada.
The National Steering Committee on Patient Safety, (NSCPS), chaired by Dr.
John Wade, was created as a result of this one-day conference. The committee
was supported by five working groups with responsibility to address the
following aspects of patient safety:
- System Issues
- Legal/Regulatory Issues
- Measurement/Evaluation
- Education/Professional Development
- Information/Communication
The working groups consulted with over 26 Canadian health care
organizations, 8 provincial/territorial ministries of health, Health Canada,
and other experts on aspects of patient safety, over a period of a year. In
September 2002, the NSCPS released the report
Building a Safer System: A National Integrated Strategy for Improving Patient
Safety in Canadian Health Care (PDF Version).
The report provided recommendations in the 5 theme areas listed above, along
with 19 specific recommendations, including the establishment of a Canadian
Patient Safety Institute (CPSI) to promote innovative ways of improving patient
safety, such as professional development programs, and research and analysis of
patient safety issues.
The 2003 First Ministers' Accord on Health Care Renewal stated that "the
implementation of a national strategy for improving patient safety is critical.
Health Ministers will take leadership in implementing the recommendations of
the National Steering Committee on Patient Safety." In response, the 2003
federal budget announced the provision of $10 million annually to support
patient safety initiatives, including the creation of the CPSI.
An Interim Patient Safety Committee was established to provide
organizational continuity from the original stakeholder-led process. The
committee, and its mandate, terminated upon the establishment of the CPSI.
Membership on the committee included senior representatives from:
- Association of Canadian Academic Healthcare Organizations
- Canadian Medical Protective Association
- Canadian Council on Health Services Accreditation
- Canadian Healthcare Association
- Canadian Medical Association
- Canadian Nurses Association
- Canadian Pharmacists Association
- College of Family Physicians of Canada
- Federation of Medical Licensing Authorities of Canada
- Royal College of Physicians and Surgeons of Canada
- Federal/Provincial/Territorial (F/P/T) governments (Health Canada, Alberta,
British Columbia, Saskatchewan, Manitoba, Ontario, Nova Scotia,
Newfoundland).
Guiding Principles of the CPSI
Key principles for the CPSI are that it:
- be independent from governments, stakeholders, and regulatory bodies;
- build on and complement initiatives that are underway, in collaboration
with existing actors, not duplicate their roles and activities;
- make patient and public involvement a central part of its activities;
- ensure the involvement of health care providers in its activities;
- aim to maintain credibility with stakeholders and the public, through an
emphasis on evidence-based decisions;
- be accountable for its activities to its members, funders, and to the
public;
- ensure ongoing evaluation and assessment of its activities and
effectiveness to ensure appropriateness and efficacy.
Mandate & Scope of the CPSI
The mandate of the CPSI is to provide a leadership role with respect to
patient safety issues in the context of improving health care quality, by
providing advice to governments, stakeholders and the public on effective
strategies.
To that end, the CPSI will:
- Foster the sharing of knowledge and information about optimal patient
safety practices and models;
- Influence change in culture and provide advice to support change in systems
to improve patient safety; and
- Collaborate with stakeholders in an ongoing dialogue to support patient
safety improvements.
Patient safety issues cut across the continuum of care, care settings, and
patient populations. The scope of the CPSI will be to examine issues of
priority importance for patient safety, and bring forward what it considers to
be the best practical information and strategies to support improvements in
patient safety. The Institute will include an analysis of perspectives from a
wide range of system stakeholders in its work.
In keeping with jurisdictional and legislated responsibilities, the role of
the CPSI will be advisory and facilitative rather than operational. The CPSI
does not have the authority to deliver health care, or to oversee, manage, or
prescribe practices for the delivery of health care. It does not have a role in
regulating health professions. And it will not perform a regulatory role
related to the approval of devices, technologies or inventions.
Activities of the CPSI
In seeking to fulfill its purpose, the CPSI will collaborate with
territorial, provincial, federal governments and health system stakeholders to
achieve the following objectives:
- Provide advice to governments, stakeholders and the public on effective
strategies to improve patient safety;
- Perform a coordinating role across sectors and systems;
- Promote best practices related to patient safety; and
- Raise awareness of patient safety issues with patients and the general
public through public education and reporting.
Founding Board of Directors
The CPSI's Founding Board of Directors is comprised of nine members who have
expertise in the area of patient safety, including representatives from three
provincial governments. Nominated by the Interim Patient Safety Committee,
members have been drawn from key stakeholders and professions in the area of
health care, and from all regions of the country. The Founding Board will work
with relevant stakeholders to determine how this non-governmental organization
can develop necessary partnerships and strategies to ensure its effectiveness.
These partnerships will be national and will allow the Institute to build on
expertise from across the country.
The inaugural meeting of the Founding Board was held in Ottawa on February
6, 2004 at which time the following officers of the corporation were
selected:
- Chair: Dr. John Wade
- Vice-Chair: Dr. Denis Roy
- Secretary: Dr. Brian Postl
- Treasurer: Mr. James Nininger, Ph.D.
Non-governmental Directors
1. Ms. Wendy Nicklin
Ms. Wendy Nicklin is a Certified Health Care Executive with the Canadian
Council of Health Service Executives and a registered nurse with a Bachelor of
Nursing and Masters of Science (Applied). In 1998, she was appointed Operating
Officer and Vice President of Nursing at the Civic Campus of the Ottawa
Hospital, which was the result of the merger of the Ottawa Civic Hospital, the
Ottawa General Hospital and the Riverside Hospital. In 2002, she became Vice
President Nursing, Allied Health, Clinical Programs, Quality, Risk Management,
and Patient Safety at the Ottawa Hospital. She has several years experience as
a clinical nurse specialist and nursing coordinator in the Emergency Department
of the Ottawa Civic Hospital and the University of Ottawa Heart Institute.
Ms. Nicklin is a recipient of several awards, including the Canadian Nurses
Foundation Scholar and the Y Woman of Distinction Award - Health Services. She
has served on a number of boards, including the Institute of Clinical
Evaluative Studies (ICES) and thee Canadian Nurses Foundation, and is the Past
President of the Academy of Canadian Executive Nurses.
2. Ms. Bonnie Salsman
Bonnie Salsman has over 20 years of pharmacy experience, including clinical
pharmacy practice, drug distribution and hospital pharmacy management. She was
the Director of Pharmacy at Camp Hill Medical Centre from 1992-1995 and at the
Queen Elizabeth II Health Science Centre from 1995-2001. She has contributed
extensively to professional pharmacy journals, and has given presentations on
clinical pharmacy, management and medication safety topics to a wide variety of
audiences. Bonnie is a Past President of the Canadian Society of Hospital
Pharmacists (CSHP) a past Board Member of the Pharmacy Association of Nova
Scotia, and a past Board member of the Canadian Hospital Pharmacy Residency
Board. She is currently the Chairperson of the CSHP Board of Fellows.
Bonnie was the Chairperson of Health Canada's Resource Management Subgroup
on Pandemic Influenza Planning and served for five years as a member of the
Management Advisory Committee for Health Canada's Therapeutic Products
Directorate. She recently served as a representative on the Canadian Coalition
for Medication Incident Reporting and Prevention, and was a member of the
National Steering Committee on Patient Safety. She is currently a Pharmacy
management and medication safety consultant based on Halifax Nova Scotia.
3. Dr. John Wade
A graduate of the University of Manitoba and University of California in San
Francisco (UCSF), Dr. John Wade pursued studies in respiratory physiology,
neurophysiology and anaesthesia. In 1979, he was appointed Vice
President-Medical, Health Sciences Centre, Winnipeg. From 1982-1988, Dr. Wade
served as Dean of Medicine at the University of Manitoba. He then decided on a
career change and spent a year at the Institute for Health Policy Studies at
UCSF and as a Visiting Scholar at the Stanford School for Business.
Dr. Wade returned to Winnipeg to practice clinical anaesthesia and also
began a health consulting company. After serving as Executive Director of
Research and Planning for Manitoba Health, he was recruited by the Ministry of
Health in Ontario to serve as Advisor to the Deputy Minister on the Academic
Health Science Centres.
In 1995, Dr. Wade was appointed Deputy Minister of Health, province of
Manitoba. In April 1997, he was appointed as Advisor to the Manitoba Minister
of Health. He now runs John G. Wade Health Consulting Ltd. and chairs the
Resource Based Relative Value Schedule Commission of Ontario.
4. Dr. James Nininger
Dr. Jim Nininger is the Past President and Chief Executive Officer of the
Conference Board of Canada (1978- 2001). He serves on the board of directors of
the Power Corporation of Canada, the Canadian Pacific Railway Company, the
Ottawa Hospital, the Rehabilitation Centre of the Ottawa Hospital, the
Community Foundations of Canada and Leadership Ottawa.
Dr. Nininger received a Doctorate in Industrial Relations from the
University of Michigan, a Masters of Business Administration from the
University of Western Ontario, and a Bachelor of Commerce from the University
of Ottawa.
Dr. Nininger is a Visiting Fellow at the Canadian Centre for Management
Development, the leadership development institute of the federal government. He
is currently working on a research project that explores both the individual
and organizational aspect of the loss of executives due to the aging of the
workforce.
Prior to joining the Conference Board, Dr. Nininger was on the faculty of
the School of Business at Queen's University. In addition to teaching, he was
actively involved in research and consulting.
5. Dr. Brian Postl
Dr. Brian Postl is a graduate of the University of Manitoba where he pursued
studies in community medicine and pediatrics. He has practised these
specialties in rural and northern areas of Manitoba and the Northwest
Territories. Since 1999, he has been the President and Chief Executive Officer
of the Winnipeg Regional Health Authority. Dr. Postl has also been actively
involved in the academic community as a consulting physician, professor and
Head of the Department of Community Health Sciences, University of Manitoba.
Dr. Postl has served on a number of boards and committees, including the
Canadian Society for Circumpolar Health, the Canadian Pediatric Society (Indian
and Inuit Health Committee), the Canadian Institute of Child Health, the
Canadian Institute for Health Information (CIHI), the Society of Medical
Administrators and the Western CEO's Committee.
Dr. Postl has published widely and has conducted research with a focus on
the health of residents in rural and isolated northern native communities and
circumpolar health.
6. Dr. Denis Roy
A graduate of the University of Ottawa, Dr. Denis Roy pursued studies in
nephrology, renal physiology and renal transplantation at the Royal Victoria
Hospital, McGill University and Stanford University. He practised these
specialties at McGill University until 1990 when he became Chief of Nephrology
and Medical Director at the Outaouais Regional Hospital Centre. He became
medical director at the Royal Victoria Hospital and subsequently at McGill
University Health Centre before becoming Chief Executive Officer of the Centre
hospitalier de l'Université de Montréal (CHUM). The CHUM is the result of the
merger of the three largest and oldest teaching hospitals and research
institutes affiliated with the University of Montreal, Notre-Dame, Saint-Luc
and Hxtel-Dieu de Montréal.
Dr. Roy has served on a number of boards and committees for the Quebec
Ministry of Health and Social Services as well as the McGill University Health
Centre. He was also a member of the National Steering Committee on Patient
Safety (Oct 2001-Sept 2002).
Provincial/Territorial Directors
7. Dr. Patricia Petryshen
Dr. Patricia Petryshen has been appointed Assistant Deputy Minister,
Performance Management and Improvement Division, British Columbia Ministry of
Health Services effective January 1, 2004. In this role, she will be
responsible for establishing the responsibilities of the Ministry of Health
Services and Health Authorities in performance management, developing and
negotiating performance expectations, and advancing system improvement.
Dr. Petryshen has been Executive Vice-President of Programs, Hospital
Relations, and Chief Nursing Officer at St. Michael's Hospital, Toronto for the
past eight years. She has held senior leadership positions in large teaching
and community hospitals in Ontario, and has held a faculty position at the
University of Saskatchewan and appointments at three other universities.
Dr. Petryshen holds a Doctorate in Epidemiology from the University of
Western Ontario and Masters in Nursing from the University of British Columbia.
Dr. Petryshen has chaired provincial and national committees, boards, and
professional associations and is a recognized leader and acknowledged expert in
the field of health care and performance measurement.
9. Mr. George Tilley
From 1979 to 1995, Mr. George Tilley served in various senior health care
leadership positions in St. John's, Newfoundland and in 1995 became Senior
Vice-President of the newly created Health Care Corporation of St. John's until
resigning in 1999 to become Chief Executive Officer of the Workplace, Health
and Safety Compensation Commission. In the fall of 2000, Mr. Tilley returned to
the Health Care Corporation of St. John's to assume his current position as
President and Chief Executive Officer of this major referral centre for
Newfoundland and Labrador. Mr. Tilley has extensive experience on various
national and provincial agencies including the Association of Canadian Academic
Health Care Organizations (ACAHO) and the Atlantic Regional Training Centre for
Health Services Research.
Mr. Tilley has a Bachelor of Commerce Degree and a Masters of Business
Administration and is a Certified Health Executive with the Canadian College of Health Services Executives.
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