Despite decreases in school bullying, cyberbullying rose steadily, particularly among girls. Increased attention to sociodemographic differences in bullying could promote help-seeking and positive online behavior.
evaluate the impact of the curriculum changes. Conclusion: A collaborative, modular, longitudinal QIPS curriculum for UT FRCP emergency medicine residents that met CanMEDS requirements was created using multiple educational methods. The first resident cohort that completed the curriculum demonstrated an absolute increase in QI knowledge and its applicability (as measured by the QIKAT-R) by 19.6%. Two PDSA cycles were completed to improve the curriculum with the change ideas generated from resident feedback. Ongoing challenges include limited staff availability to teach and supervise resident QI projects. Future directions include incentivising staff participation and providing mentorship for residents with a career interest in QI beyond what is offered by the curriculum. Keywords: quality improvement and patient safety, residency training, CanMEDS Introduction: The administration of "to-go" medications in the Kelowna General Hospital Emergency Department was identified as an issue. Frequently, multiple administrations of "to-go" medication prepacks were administered to individual patients on a frequent basis. In addition, the variability in "to-go" medication was substantial between providers. Recognizing the patient issues (addiction, dependency and diversion) and system issues (costs, risk) a team-based quality improvement initiative was instituted, utilizing a variety of quality improvement techniques. The aim was to reduce the number of "to-go" medications by half, within a year. Methods: The project began January 2015, and is ongoing. Multiple stakeholders were engaged within the emergency department; these included leaders of the physician, nursing and pharmacy teams, including an executive sponsor. Using change theory, and traditional Plan-Do-Study-Act (PDSA) cycles, an iterative methodology was proposed. The outcome measure proposed was number of "to-go" medications administered; secondary measures included number of opioid "to-go" and benzodiazepine "to-go"prescriptions. Balancing measures were the number of narcotic prescriptions written. Physician prescribing practice and nursing practice were reviewed at meetings and huddles. Individualized reports were provided to physicians for self-review. Data was collated at baseline then reviewed quarterly at meetings and huddles. Run charts were utilized along with raw data and individualized reports. Results: At baseline (January 2015), the number of "to-go" medications was 708. Over the next year, this value reduced to 459, showing a 35% reduction in "to-go". Two years later (June 2017), this had reduced to 142, resulting in an overall reduction of 80% "to-go" medications. Secondary measures are currently under analysis. Further, no increase in prescribing of narcotics was seen during this time period. Conclusion: The administration of "to-go" medications from the emergency department has significant individual and societal impact. Frequently, these medications are diverted; meaning, sold for profit on the black market. Further, opioid prescribing is under i...
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