Best Practice Spotlight Organization: Quality improvement as a culture

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Best Practice Spotlight Organization: Quality improvement as a culture

Toronto, January 4, 2019

By Amber Daugherty

Miranda Priestman
Miranda Priestman

As a Best Practice Spotlight Organization (BPSO) designated hospital, nurses across St. Michael’s are empowered to work on initiatives that enhance patient experience and safety.

Awarded to the hospital in 2012 by the Registered Nurses’ Association of Ontario, the designation supports nurses to work on implementing, evaluating and sustaining best practice guidelines (BPGs) which cover everything from pain management to care transitions to fall prevention and end-of-life care. As a result, more than 30 per cent of nurses at the hospital are BPG nurse champions, trained in quality improvement.

Miranda Priestman, registered nurse, is part of that 30 per cent, using her quality training to help make safety improvements in the trauma neurosurgery unit where she works. Between December 2016 and September 2017, there were 38 incidents of workplace violence in the unit, which she experienced first-hand. Determined to help reduce that number, she worked with her manager and nurse educator to explore new training that could be implemented for the team.

“The goal was to provide education on awareness, de-escalation tactics and last-resort strategies to prevent, manage and respond to violence,” she said. “I wanted to help create an environment where everyone feels respected and safe.”

As a BPG nurse champion, Priestman helped roll out staff training aligned with the Workplace Health, Safety and Well-Being of the Nurse best practice guideline that focused on a train-the-trainer model; seven staff members enrolled in the course and were trained to teach the content to their colleagues. Since launching, 127 staff members have received the education and more than 90 per cent have reported feeling safer, more effective and more confident.

“Research shows us that when you have more satisfied, empowered employees, it will support, safer, higher quality care for patients,” said Murray Krock, director, nursing practice and education. “Miranda is one of the nurses who has been able to make positive changes in their units that are having an impact both on their quality of work life as well as improving patient safety and experience.”

In addition to being given dedicated time to work on quality improvement initiatives, BPG nurse champions are also supported through a mentorship program and monthly forums where they can network and share ideas. Their initiatives are shared broadly every year during Nursing Week at a special poster gallery where other staff can learn about the results from ongoing initiatives and their impact.

“Quality is something that happens every day across the hospital,” said Sonya Canzian, vice-president, clinical programs and chief nursing and health disciplines executive. “It’s how we keep our patients safe and make sure they’re happy with their care. The BPSO designation is really special to us because it helps empower frontline staff to become quality champions so that at every level we’re looking at how we can improve.”

About St. Michael's Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 29 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

About Unity Health Toronto

Unity Health Toronto, comprised of Providence Healthcare, St. Joseph’s Health Centre and St. Michael’s Hospital, works to advance the health of everyone in our urban communities and beyond. Our health network serves patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education. For more information, visit

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