enhancing bedside manner with ipad

8/11/2019 Enhancing Bedside Manner With iPad

1/10

Enhancing bedside manner with iPad.

Not only has iPad increased efficiency from a provider perspective its increased engagement between the provider and patient. Dale Potter, Senior Vice President Strategy and Transformation, The Ottawa Hospital

Bedside care is a vital part of health care professionals relationships with their patients. But the staff at The Ottawa Hos pital foundthat modern technology sometimes made those interactions more difficult. Since the introduction of technology in this industry,Senior Vice President Dale Potter explains, physicians have been tethered to devices like PCs and forced to go see k information.Even a laptop wasnt truly mobile.
https://ssl.apple.com/ipad/business/profiles/video/video-ottawa-hospital.htmlhttps://ssl.apple.com/ipad/business/profiles/video/video-ottawa-hospital.htmlhttps://ssl.apple.com/ipad/business/profiles/video/video-ottawa-hospital.html#video-ottawa-hospitalhttps://ssl.apple.com/ipad/business/profiles/video/video-ottawa-hospital.html#video-ottawa-hospital


2/10

This inability to bring information to the bedside meant physicians had to constantly shuttle between patients and tethered PCs toget status updates, schedule surgeries, prescribe drugs, view X-rays, and perform other important tasks.

When Apple introduced iPad, physicians at The Ottawa Hospital knew theyd found a solution. With iPad, the hospitals doctors andnurses have bedside access to everything they need, and can remain in contact with patients and their families while viewinginformation that is critical to their care.

They can answer patients questions immediately and make decisions about whats going to be done, with the most currentinformation available, says Dr. Glen Geiger, Chief Medical Information Officer. Nothing beats being able to use an app to pull up anX- ray on the device.

Increased Patient Interaction

Physicians at The Ottawa Hospital have started using iPad in innovative new ways. They can use the built-in iPad camera tophotogr aph a patients wound during treatment, and store the image in the patients electronic medical record for future reference.

Using iPad, physicians can show patients the progress of their recovery right at the bedside, Dr. Geiger notes. I can say, Heres what your wound looked like three weeks ago. Im showing them what it looked like then and what it looks like today.

iPad fits physicians workflows in many ways, Potter says: The form factor of iPad is very attractive. The screen size is op timal.

Ther es almost instant access to information. Battery life exceeds the length of a shi ft. Its critically important for a physici an to beable to know that they can rely on that device, work for an entire shift, and provide the same level of care to all their patients.

Substantial Time Savings

The Ottawa Hospital has also developed an in-house app called the Clinical Mobile App. The app facilitates three major aspects ofphysicians daily workflows: accessing patients clinical information, viewing clinical im ages such as X-rays and CT scans, andordering clinical tests and prescriptions.

iPad and the Clinical Mobile App enable physicians to significantly reduce the time they spend reviewing patients cases befo remaking their rounds each morning. This would take several hours, Dr. Geiger says. We would just be sitting in the room goingover each case. The process was so time -consuming that some non- critical care patients often didnt get to see their physiciansthat day.

But iPad and the Clinical Mobile App have changed all that. Now we meet first thing in the morning, make sure we have a completerecord of all the patients, and immediately start to see them, says Dr. Geiger.

By eliminating lengthy meetings and the need to shuttle between patients and tethered PCs, Potter estimates the physicians saveapproximately two hours per day in their clinical care activities. Not only has iPad increased efficiency from a provider pe rspective its increased engagement between the provider and patient, he says.

Developing on the iOS platform is actually fairly quick. Were talking days and weeksas opposed to months and sometimes years. Valrie Gamache- OLeary, Chief Information Officer, The Ottawa Hospital

Quick Development Times

In addition to the Clinical Mo bile App, the hospital has developed three other custom apps: a pain study app to document a patientspain thresholds and determine proper treatment; a hand hygiene app to record and report on hand hygiene compliance; and apatient rounding app with a standard set of questions that nurses ask patients on a daily basis, so the answers are recorded in aconsistent way.

Developing on the iOS platform is actually fairly quick, says Valrie Gamache - OLeary, Chief Information Officer. Compared toapplications in other environments, youre able to iterate through versions of software, get them into production, and test themvery, very quickly. Were talking days and weeks as opposed to months and sometimes years.

A Hospital Wide Solution


3/10

The Ottawa Hospital has thousands of iOS devices in circulation. Physicians, pharmacists, nurses, and executives rely on iPad, andmany other employees also use iPhone and iPod touch. A housekeeper can say, Im in this room, Im at this bed, and its rea dy for apatient, and that information can be immediately transmitted from their iPod touch or iPhone, Potter says.

Among the hospitals executives, iPad is a key part of the drive toward paper - free meetings. Everyone has an iPad, says Potter. Wecan intercommunicate with each other. We can share documents. There really is no reason for us to have paper in our meetings.

I believe iPad represents the future of patient - centered care at The Ottawa Hospital. Dr. Glen Geiger, Chief Medical Information Officer, The Ottawa Hospital

The Future of Patient Care

As Potter walks through the hospital, he finds physicians engaging wi th patients the way they used to many decades ago. As I observe the physicians doing their work, theyre at the bedside interacting with patients and fami ly members, he says. Theres anintimacy there that wasnt possible before iPad.

In fact, he adds, The riskiest thing I could do in my position as CIO at The Ottawa Hospital is try to take iPads away from my users!

iPad and apps help physicians at The Ottawa Hospital interact more effectively with patients and provide more immediate, focused

treatment. iPad and apps have changed the way we deliver care, Dr. Geiger says. Its the foundation for patients becoming moredirectly engaged with their own health care. I believe iPad represents the future of patient- centered care at The Ottawa Hospital. Patient Safety is a priority at The Ottawa Hospital. It is one of four quadrants that make up our Quality Framework:

1. Access

2. Appropriate (effective and efficient)

3. Safety

4. Satisfaction.

As a leader in patient safety, The Ottawa Hospital strives to create a Patient Safety Culture that features:

Acknowledgement of the high risk and error-prone nature of health care activities

A blame free environment where individuals are able to report errors and close calls without fear of reprimand or punishment

An expectation of collaboration to seek solutions and create action plans A willingness on the part of the organization to divert resources for addressing safety concerns

Centre for Pat ient SafetyThe Ottawa Hospital is home to The Centre for Patient Safety, a 'virtual' centre created in 2005 to gui de TOH to provide the safest patient care through nationallyrecognized research, education, and evaluation methods.

The Centre is a result of a strong collective commitment from clinicians and renowned researchers at our hospital and our research arm, the Ottawa Hospital ResearchInstitute to improve the safety of patient care at TOH.

Every year in Canada patients die or become seriously ill from infections acquired in hospitals. It is estimated that at least 30% of hospital acquired infectionsare preventable. Bacteria that cause infections are most frequently spread from one patient to another on the hands of health car e workers.

Scientific evidence shows that hand hygiene is the single most important way of controlling the spread of micro organisms which can cause infection.

In an effort to promote and improve hand hygiene, The Ottawa Hospital takes part in the Ministry of Health and Long Term Care's Just Clean Your Handsrogram. This evidence-based program builds on work done by the World Health Organization and the United Kingdom . It was specifically designed for

Ontario hospitals and was successfully pilot t ested in 10 Ontario hospitals, including The Ottawa Hospital.

The goals of the program are:

Improve Hand Hygiene practices among health care workers Obtain and sustain long term improvement in the hand hygiene practices among Ontario's health care wo rkers Build a culture of hand hygiene compliance where infection prevention and control is everyone's business.

For more information visit , Just Clean Your Hands .

Patient safety remains the most important priority for Th e Ottawa Hospital and we are working to create a culture of patient safety that involves everyone health-careadministration, health-care professionals, and, of course, patients and families.

Research shows that hand hygiene i s the single most effective way to reduce the r isk of healthcare-associated infections. Hand hygie ne is a key issue for our hospital, andwe continually work to improve compliance. Of course it is something we all do but we want to continue to do better and ensure everyone cleans their hands at the righttimes and in the right way.
http://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/PatientSafety/HandHygiene?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/handhygienecompliance/handhygienecompliancehttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/PatientSafety/HandHygiene?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/handhygienecompliance/handhygienecompliancehttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/PatientSafety/HandHygiene?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/handhygienecompliance/handhygienecompliancehttp://oahpp.ca/services/jcyh/index.html/http://oahpp.ca/services/jcyh/index.html/http://oahpp.ca/services/jcyh/index.html/http://oahpp.ca/services/jcyh/index.html/http://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/PatientSafety/HandHygiene?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/handhygienecompliance/handhygienecompliance


4/10

Patients can help improve their own safety Hand hygiene involves everyone in the hospital, including patients. Hand cleaning is one of the best ways you and your health-care team can prevent the spread of manyinfections. Patients and their visitors should also practice good hand hygiene before and after entering patient rooms.More patient-specific information is available a t www.ontario.ca/patientsafety and www.oha.com/patientsafetytips an dwww.oha.com/cleanhandsprotectlives .Measuring compliance rates

Ontario hospitals are posting their hand hygiene compliance rates as percentages for time periods identified by the Ministry of Health and Long-Term Care, using thefollowing formula:

# of times hand hygiene performed x 1000# of observed hand hygiene indications

These percentages also reflect:

1. hand hygiene before initial patient/patient environment contact by combined health-care provider type (e.g., nurses, health professionals, physicians, housekeeping,support staff, etc.)

2. hand hygiene after patient/patient environment contact by combined health-care provider type (e.g., nurses, health professionals, physicians, housekeeping,support staff, etc.)

In simple terms, the rates include hand hygiene compliance both before and after contact with the patient.

Hand hygiene compliance rates at The Ottawa Hospital

Patient Safety

Patient Safety Indicator results at Health Quality Ontario

Effective December 2012, patient safety indicator results, as reported by Ontario hospitals, as well as other patient safety i nformation, are available on HealthQuality Ontarios (HQO) website. Publically reporting patient safety indicators aligns with HQOs mandate to monitor and report on Ontarios health caresystem to the public.

Public reporting also increases transparency and accountability, and supports quality improvement efforts. View provincial and individual hospital results ofnine patient safety indicators on the Health Quality Ontario website.

Other useful links

For more information on infection prevention and control, please visit Public Health Ontario Additional tools and resources through The Ontario Hospital Association

Patient Safety Indicator Public ReportingImproving patient safety is about creating an environment that is transparent and committed to change. This is the mandate of the government's PatientSafety Initiative.

The government announced public reporting of eight indicators on May 28, 2008 as part of a comprehensive plan to create an unprecedented level oftransparency in Ontarios hospitals. A Public Hospitals Act (PHA) regulatory amendment, effective July 28, 2008, requires hospitals to publicly report onpatient safety indicators related to hospital-acquired infections, actions undertaken to reduce such infections, and mortality. Under Regulation 965 of the PHA,hospitals are required to disclose the results of each i ndicator through their website.

As of 2010 Ontario hospitals publicly report on nine patient safety indicators. Standardized data elements, case definitions and reporting requirements havebeen developed for all i ndicators. The list of patient safety indicators and timeframes for reporting are given below.

Patient Safety Indicator Date of initial Public Reporting Reporting Frequency

Clostridium difficile Infection (CDI) rate Sept. 26, 2008 Monthly

Methicillin-resistant Staphylococcus aureus (MRSA) rate Dec. 30, 2008 Quarterly in January, April, July and October

Vancomycin-resistant Enterococci (VRE) rate Dec. 30, 2008 Quarterly in January, April, July and October

Hospital-Standardized Mortality Ratio (HSMR) Dec. 30, 2008 Annually in December

Ventilator-Associated Pneumonia (VAP) rate April 30, 2009 Quarterly in January, April, July and October
http://www.ontario.ca/patientsafetyhttp://www.ontario.ca/patientsafetyhttp://www.ontario.ca/patientsafetyhttp://www.oha.com/patientsafetytipshttp://www.oha.com/patientsafetytipshttp://www.oha.com/patientsafetytipshttp://www.oha.com/cleanhandsprotectliveshttp://www.oha.com/cleanhandsprotectliveshttp://www.oha.com/cleanhandsprotectliveshttp://www.ottawahospital.on.ca/wps/wcm/connect/edaa1b004b25b25a918cd51faf30e8c1/hh-rates-e.pdf?MOD=AJPEREShttp://www.ottawahospital.on.ca/wps/wcm/connect/edaa1b004b25b25a918cd51faf30e8c1/hh-rates-e.pdf?MOD=AJPEREShttp://www.hqontario.ca/public-reporting/patient-safetyhttp://www.hqontario.ca/public-reporting/patient-safetyhttp://www.oahpp.ca/index.htmlhttp://www.oha.com/Pages/Default.aspxhttp://www.oha.com/Pages/Default.aspxhttp://www.oahpp.ca/index.htmlhttp://www.hqontario.ca/public-reporting/patient-safetyhttp://www.hqontario.ca/public-reporting/patient-safetyhttp://www.ottawahospital.on.ca/wps/wcm/connect/edaa1b004b25b25a918cd51faf30e8c1/hh-rates-e.pdf?MOD=AJPEREShttp://www.oha.com/cleanhandsprotectliveshttp://www.oha.com/patientsafetytipshttp://www.ontario.ca/patientsafety


5/10

Central Line-Associated Primary Blood Stream Infection (CLI) rate April 30, 2009 Quarterly in January, April, July and October

Surgical Site Infection (SSI) prevention rate in hip and knee jointreplacement surgeries April 30, 2009 Quarterly in January, April, July and October

Hand Hygiene Compliance April 30, 2009 Annually in April

Surgical Safety Checklist (SSC) compliance July 30, 2010 Bi-annually in January and July

Other Patient Safety InitiativesThe Ontario government has taken a number of steps to strengthen patient safety in health care institutions across the province.

CDI Outbreak Definition A Health Protection and Promotion Act regulatory amendment, effective September 1, 2008, makes Clostridium difficile Infection (CDI) a communicabledisease designated as reportable. As a result, public hospitals are required to report all cases and outbreaks of CDI to their Public Health Unit.

Hand Hygiene ImprovementEffective December 1, 2011, the Ministry of Health and Long-Term Care completed the transfer of the Just Clean Your Hands (JCYH) program to PublicHealth Ontario.

JCYH is an evidence-based, multifaceted program established in Ontario in 2008 to improve compliance with hand hygiene best practices in health caresettings to prevent healthcare associated infections and promote patient safety. In 2009, JCYH was adapted and rolled out for use in long-term care homes,and launched to retirement homes in 2011.

For more information about the JCYH program, please visit the P ublic Health Ontario website a t oahpp.ca/services/jcyh.

Regional Infection Control NetworksFourteen Regional Infection Control Networks (RICNs) have been created across the province to promote the best approaches to infection prevention andcontrol. This includes promoting consistent infection prevention and control policies and surveillance practices. Development of the networks has broughttogether infection prevention and control expertise from all health care settings, i ncluding hospitals, public health units, community care centres and long-termcare homes.

Infection Prevention and Control PractitionersThe government has provided funding for infection prevention and control practitioners (ICPs) in hospitals across the province. ICPs are typically health careprofessionals who have specialized training and expertise in infection prevention and control. The ICP works with all departments in an organization toprevent health care-associated infections through planning, implementing, evaluating and providing feedback on current practices. They also educate healthcare staff on infection prevention and control, conduct surveillance and provide expert consultation as needed.

An extensive education program for infection prevention and control professionals in acute care facilities has been developed by the government inpartnership with infection prevention and control experts and other stakeholders. The program provides current, evidence-based educational modules forfront-line health care professionals in acute care settings. The modules focus on hand hygiene, chain of transmission and routine practices.

Nationally recognized for its leadership in infection control, The Ottawa Hospital's Infection Prevention and Control Program is an essential component of quality patient

care. The program's evidence-based guidance and recommendations help reduce the risk of infection for patients, staff and visitors.

The program helps ensure the protection of patients, health care workers, staff and visitors from preventable nosocomial disease through surveillance, education,consultation, outbreak investigation, research and the development of policies and procedures.

Nosoco mial or Hospi ta l-Acqui red Infec t ionA nosocomial infection is one that was not present or incubating prior to the patient being admitted to the hospital, but occurred within 48 hours after admittance to thehospital. It is often referred to as hospital -acquired'.

TOH monitors infection rates very closely. Despite our best efforts, nosocomial rates for MRSA, VRE and C difficile are on the rise in hospitals across Canada , as well asin the United States and Europe . Increases are being seen for a number of reasons including:

Todays hospitalized patients are sicker than ever before; The number of patients with weakened immune systems is increasing;

New devices and procedures with inherent risks are in use; Antibiotic use is resulting in the development of resistant bacteria; Increased travel allows global spread of bacteria and other pathogens.
http://www.oahpp.ca/services/jcyhhttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/PatientSafety/InfectionPreventionControl?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreportinghttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/PatientSafety/InfectionPreventionControl?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreportinghttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/PatientSafety/InfectionPreventionControl?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreportinghttp://www.oahpp.ca/services/jcyh


6/10

To combat this global rise in infection rates, TOH has implemented several measures to address infection rates, including:

Hand hygiene program with increase access to alcohol gel; Screening patients on admission for silent carriage of resistant organisms;

Use of single rooms, gowns, and gloves to control transmission; Renovations to patient care areas; Increased housekeeping resources; Education and awareness campaigns for patients and health care providers.

Learn more abou t :

Antibiotic-Associated Diarrhea Avian Flu C difficile MRSA

The Ottawa Hospital publicly reports on several patient safety indicators and immediately reports Clostridium Difficile (C. difficile) outbreaks to their local public health unitsso that Medical Officers of Health have the information they need to monitor and respond to emergent outbreaks.

Units currently experiencing a greater than normal rate of patients affected, can be viewed on the Monitoring Clusters and Outbreaks page.

Patient safety indicators to be reported publicly are: Central line infections Clostridium difficile (C. difficile) Hand hygiene compliance Hospital Standardized Mortality Ratio (HSMR) Methicillin-resistant Staphylococcus aureus (MRSA) Surgical Safety Checklist Surgical site infections (SSI) Vancomycin-resistant Enterococci (VRE) Ventilator-associated pneumonia (VAP)

Monitoring

As a result of extremely high occupancy rates, The Ottawa Hospital can experience an increased number of cases of MRSA , an dClostridium difficile (C. difficile) in its in-

patient units. Our health-care teams work hard to reduce their occurrence and when cases are detected, special measures are put in place to reduce their spread.

These include:

Isolating patients who have diarrhea in private rooms when possible. Using a bleach solution to clean the environment.

Auditing to ensure equipment and hands are cleaned between patients. Reminders to staff, patients and visitors that frequent hand washing, or use of alcohol-based hand rubs, is the best way to stop the infection. Preventing unnecessary traffic and congestion in the unit experiencing the outbreak.

OutbreaksThe Ontario government strongly encourages all hospitals to report outbreaks and outbreak-associated cases of MRSA, VRE and C. difficile to their local public health unitwhen the definition of an outbreak is met in their facility. For details of this definition, please visit the Ministry website a t www.health.gov.on.ca .

Clusters

The Ottawa Hospital is committed to providing patients and their visitors with the information they need to play a greater role in their care and the care of their loved ones.As a result, the hospital goes a step beyond Ministry requirements, and reports on units that are experiencing a greater than normal number of cases but have not reachedoutbreak levels.

In-patient units currently on alert:

Civic Campus General Campus

VRE --- ---

MRSA D7/F7, E5 ---

C. difficile --- ---

Norovirus --- ---

* Identified as meeting Ministry of Health and Long Term Care definition of outbreak As we work to manage clusters and outbreaks, we ask that patients and visitors please respect our Infection Control Visitor Protocols for those in-patient units on alert. Weare asking that patients in the affected units limit themselves to one visitor at a time during normal visiting hours (3-8 p.m.).

Patients in units not affected by the infection control precautions will continue to be permitted two visitors at a time from 3-8 p.m. as per our usual Visitor Guidelines .

When you visit, please clean your hands atone of the many hand washing stationsthroughout the hospital before, during and
http://www.ottawahospital.on.ca/wps/wcm/connect/8cf3f1804b25b20c8f18df1faf30e8c1/antibiotic-diarrhea-e.pdf?MOD=AJPEREShttp://www.ottawahospital.on.ca/wps/wcm/connect/8cf3f1804b25b20c8f18df1faf30e8c1/antibiotic-diarrhea-e.pdf?MOD=AJPEREShttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/PatientSafety/InfectionPreventionControl?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/clinicalservices/prgdepsrv/programs/infectionpreventioncontrol/avianinfluenza/avianinfluenzabirdfluhttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/PatientSafety/InfectionPreventionControl?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/clinicalservices/prgdepsrv/programs/infectionpreventioncontrol/avianinfluenza/avianinfluenzabirdfluhttp://www.ottawahospital.on.ca/wps/wcm/connect/ba5495804b25b2349074d51faf30e8c1/Pt+Info-Cdiff+2013-EN.pdf?MOD=AJPEREShttp://www.ottawahospital.on.ca/wps/wcm/connect/ba5495804b25b2349074d51faf30e8c1/Pt+Info-Cdiff+2013-EN.pdf?MOD=AJPEREShttp://www.ottawahospital.on.ca/wps/wcm/connect/c6f6df004b25b2709242d71faf30e8c1/MRSA-pt-e.pdf?MOD=AJPEREShttp://www.ottawahospital.on.ca/wps/wcm/connect/c6f6df004b25b2709242d71faf30e8c1/MRSA-pt-e.pdf?MOD=AJPEREShttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/clustersandoutbreaks/clustersandoutbreakshttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/clustersandoutbreaks/clustersandoutbreakshttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/clustersandoutbreaks/clustersandoutbreakshttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/centrallineinfections/centrallinebloodstreaminfectionshttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/centrallineinfections/centrallinebloodstreaminfectionshttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/cdifficileassociateddisease/cdifficileassociateddiseasehttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/cdifficileassociateddisease/cdifficileassociateddiseasehttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/handhygienecompliance/handhygienecompliancehttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/handhygienecompliance/handhygienecompliancehttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/hospitalstandardizedmortalityratio/hospitalstandardizedmortalityratiohttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/hospitalstandardizedmortalityratio/hospitalstandardizedmortalityratiohttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/mrsaandvre/mrsaandvrehttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/mrsaandvre/mrsaandvrehttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/surgicalsafetychecklist/surgicalsafetychecklistshttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/surgicalsafetychecklist/surgicalsafetychecklistshttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/surgicalsiteinfections/surgicalsiteinfectionshttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/surgicalsiteinfections/surgicalsiteinfectionshttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/vancomycinresistantenterococci/vrehttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/vancomycinresistantenterococci/vrehttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/ventilatorassociatedpneumonia/ventilatorassociatedpneumoniahttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/ventilatorassociatedpneumonia/ventilatorassociatedpneumoniahttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/MRSAAndVREhttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/MRSAAndVREhttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/MRSAAndVREhttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/CDifficile/http://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/CDifficile/http://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/CDifficile/http://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/CDifficile/http://www.health.gov.on.ca/http://www.health.gov.on.ca/http://www.health.gov.on.ca/http://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/PatientsAndVisitors/VisitingTheHospital/VisitingGuidelineshttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/PatientsAndVisitors/VisitingTheHospital/VisitingGuidelineshttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/PatientsAndVisitors/VisitingTheHospital/VisitingGuidelineshttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/PatientsAndVisitors/VisitingTheHospital/VisitingGuidelineshttp://www.health.gov.on.ca/http://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/CDifficile/http://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/MRSAAndVREhttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/ventilatorassociatedpneumonia/ventilatorassociatedpneumoniahttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/vancomycinresistantenterococci/vrehttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/surgicalsiteinfections/surgicalsiteinfectionshttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/surgicalsafetychecklist/surgicalsafetychecklistshttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/mrsaandvre/mrsaandvrehttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/hospitalstandardizedmortalityratio/hospitalstandardizedmortalityratiohttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/handhygienecompliance/handhygienecompliancehttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/cdifficileassociateddisease/cdifficileassociateddiseasehttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/indicatorreporting/centrallineinfections/centrallinebloodstreaminfectionshttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/Report/Reporting/!ut/p/c5/rZHNcqpAEIWfxQe4Ts8MMwNLvIP8yD8YkA2FogiRaIIl6tPHVKpuVRZJNrd7-dWpPn0OKtBjX6pL21Tn9vhSHVCOCl5KVVimrRAILMzAjqxlFBIBHjCUoRyUMuluJ_v-fI87kYy-u4LzOho9aV59WdtpmuDUUG5n4xr4rm_7buwlqRPCoOGneWToIc7rcpw8bq14OQMcL-jS8iwXz8GWjkfDiAFY_BcnDiradT8dN_0UplxQwgklCmWEaqChFSrEt2qTo_Q__vHFCVUFFxoTmGFQuMJRFm4GTQ5eIw25H0g6mt2dOgbQsnnN9HnYtZYU8Z7wMKeJp2zY0J9KXXeDIK9v9a7e6JVWkUYOY2OMmZvxbZMClRHxK22Xm6_bxjuy8yE-MsMJ3hZXEWDYy7Jh62Rej4J3tL1dh1uLZ0ZzfnZ3C7WrU3grNH3tHK3DavLotPjI-kkYoM2wDoG9VMHWYyWSiUEh5j9zwj75v7RVT8pH2n9Vc2ZJDKB88p-a_uDwzeiAfOvYb9Gpv7jMvPSa3dp_9MnkHaufZd4!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/qualitysafety/reporting/clustersandoutbreaks/clustersandoutbreakshttp://www.ottawahospital.on.ca/wps/wcm/connect/c6f6df004b25b2709242d71faf30e8c1/MRSA-pt-e.pdf?MOD=AJPEREShttp://www.ottawahospital.on.ca/wps/wcm/connect/ba5495804b25b2349074d51faf30e8c1/Pt+Info-Cdiff+2013-EN.pdf?MOD=AJPEREShttp://www.ottawahospital.on.ca/wps/portal/Base/TheHospital/QualityAndSafety/PatientSafety/InfectionPreventionControl?1dmy&urile=wcm%3apath%3a/tohenglishlibrary/public/clinicalservices/prgdepsrv/programs/infectionpreventioncontrol/avianinfluenza/avianinfluenzabirdfluhttp://www.ottawahospital.on.ca/wps/wcm/connect/8cf3f1804b25b20c8f18df1faf30e8c1/antibiotic-diarrhea-e.pdf?MOD=AJPERES


7/10

after your visit. If you are unwell, please donot visit patients in the hospital.

Central line infect

When a patient requires l ong-term access to medication or fluids through an IV, a central line is put in place to provide easy access to a vein. It is pla ced into a large veinin the neck, chest, groin, arm or abdomen. This is used instead of having to frequently insert needles for treatments such as chemotherapy, antibiotics and intravenousfluids, and feeding, or to take samples of blood for testing.

A central line blood stream infection (CLI-BSI) can occur when bacteria and/or fungi enters the blood stream, causing a patient to become sick. The bacteria can comefrom a variety of places (e.g., skin, wounds, environment, etc.), though it most often comes from the patients skin.

Hospitals follow best practices on how to pr event bacteria from entering into a central line. Patients in the Intensive Care Unit (ICU) often require a central line sin ce theyare seriously ill, and will require a lot of medication, for a long period of time.

More patient-specific information is available a t www.ontario.ca/patientsafety and www.oha.com/patientsafetytips an dwww.oha.com/cleanhandsprotectlives .

In Ontario, all hospitals with ICUs are required to report into the Critical Care Information System (CCIS) a centralized data collection system where hospitals report avariety of critical care information. Included in the data is the CLI rate.

These Ontario hospitals are posting their quarterly CLI-BSI rate and case count for those infections acquired in their facility, using the following formula:

total # of ICU related CLI-BSIs after 48 hours of central line placement x 1000total # of central line days for ICU patients 18 years and older

Central line blood stream infection rates at The Ottawa Hospital

C difficile

C. difficile is just one of the many types of bacteria that can be found in the environment and the intestines. For most people, it does not pose a health risk. However,C. difficile associated disease (CDAD) can sometimes occur when antibiotics are prescribed. Antibiotics work by killing off bacteria the bad bacteria but also goodbacteria. This can allow the C. difficile bacteria to multiply, which may cause diarrhea and can damage the bowel.

CDAD is the most common cause of infectious diarrhea i n healthcare facilities. The effects of CDAD are usually mild bu t can sometimes be more sever e. In severe cases,surgery may be needed, and in extreme cases CDAD may cause death.

Rates of C. difficile are the first of eight patient safety in dicators that hospitals will be required to publicly report. All of these indicators will be posted on the Ministry ofHealth and Long-Term Web site and also on each hospitals own Web site.

Its important to understand that the reporting of these rates is not the overall solution to reducing the rates of healthcare associated infections. They are tools which willprovide hospitals with good information to assist them in understanding where patient safety issues exist and help them to take action to improve their safety standards.

The public reporting builds on other initiatives such as Just Clean Your Hands a hand hygiene program for all Ontario Hospitals that was launched in March 2008 and thecreation of 14 Regional Infection Control Networks across the province.

Rates of C. diff ic i le It is important to note that C. difficile rates, as is the case for all infections, can fluctuate over the course of a year for a number of reasons. For example in winter, we admitmore patients with respiratory infection than at other times of the year. An increase of respiratory infections often results in more antibiotics being prescribed, a leadingfactor in new cases of C. difficile. An increase in the rates of C. difficile may also be related to periods of increased occupancy levels. An increased number of patients mean that more patients are beingcared for closer together. Close physical proximity can result in C. difficile being spread more easily.When we experience cases of C. difficile, they are usually contained in a limited geographic area or unit of the hospital. Also, patients and families should know thatcompared to the overall number of patients admitted each year, these cases are relatively low in number.That said, The Ottawa Hospital pays close attention and follow a number of procedures to control and manage new cases of C. difficile. As described in the provincial bestpractice standards for managing C. difficile, we are:

Isolating individuals identified or suspected to have C. difficile, wearing gowns and gloves to enter their rooms. Ensuring that all patients suspected of having C. difficile in hospital are tested. Reminding all staff of the importance of proper hand hygiene.

Ensuring proper cleaning of all patient rooms, including rooms of C. difficile cases. Ensuring that visitors are instructed in hand washing and other control measures.

Providing education where needed so that all members of our team are up-to-date with current management strategies. Ensuring that all patients with C. difficile infection are appropriately treated.

The C. difficile infection rate is calculated as a rate per 1,000 patient days. The total patient days represents the sum of the number of d ays during which services wereprovided to all inpatients during the given time period.The rate is calculated as follows: Number of new hospital acquired cases of C. difficile in our facility x 1000Total number of patient days (for one month)
http://www.ontario.ca/patientsafetyhttp://www.ontario.ca/patientsafetyhttp://www.ontario.ca/patientsafetyhttp://www.oha.com/patientsafetytipshttp://www.oha.com/patientsafetytipshttp://www.oha.com/patientsafetytipshttp://www.oha.com/cleanhandsprotectliveshttp://www.oha.com/cleanhandsprotectliveshttp://www.oha.com/cleanhandsprotectliveshttp://www.ottawahospital.on.ca/wps/wcm/connect/2fc464004b25b23d9090d51faf30e8c1/cli-rates-e.pdf?MOD=AJPEREShttp://www.ottawahospital.on.ca/wps/wcm/connect/2fc464004b25b23d9090d51faf30e8c1/cli-rates-e.pdf?MOD=AJPEREShttp://www.health.gov.on.ca/en/public/programs/patient_safety/http://www.health.gov.on.ca/en/public/programs/patient_safety/http://www.health.gov.on.ca/en/public/programs/patient_safety/http://www.health.gov.on.ca/en/public/programs/patient_safety/http://www.health.gov.on.ca/en/ms/handhygiene/http://www.health.gov.on.ca/en/ms/handhygiene/http://www.health.gov.on.ca/en/ms/handhygiene/http://www.health.gov.on.ca/en/ms/handhygiene/http://www.health.gov.on.ca/en/public/programs/patient_safety/http://www.health.gov.on.ca/en/public/programs/patient_safety/http://www.ottawahospital.on.ca/wps/wcm/connect/2fc464004b25b23d9090d51faf30e8c1/cli-rates-e.pdf?MOD=AJPEREShttp://www.oha.com/cleanhandsprotectliveshttp://www.oha.com/patientsafetytipshttp://www.ontario.ca/patientsafety


8/10

C-difficile Rates at The Ottawa Hospital C-difficile Rates for All Ontario Hospitals

The Ot tawa Hosp i ta l Show s Pos i t ive Resul t s HSMR 2012TOH continues to see much fewer deaths than expected based on how sick patients are when they arrive for treatment. Overall , The Ottawa Hospital is seeing favourabletrends in its HSMR data, largely due to decreases in mortality at the Civic Campus. Mortality rates remain stable at the General Campus and the number of observed

deaths does not exceed the number expected. As TOH cares for the most seriously ill and injured in our region, the result is viewed positively overall.

TOH works to continuously improve outcomes in quality and patient safety and strives to better understand system factors that influence why patients die in hospital. TheHSMR results will support efforts to further reduce the mortality rate in our hospital and other hospitals in Canada.

It is important to note that in the time since TOH set its corporate HSMR target in March 2012, the Canadian Institute for Health Information (CIHI) revised the way itcalculates HSMR. CIHI changed its methodology to reflect the advances in care across all hospitals since they initially developed their approach. As a result, hospitals inCanada - including TOH - have recently recalculated their HSMR targets to reflect the new methods. At TOH, patient safety epidemiologists compared the old and newapproaches to determine a new target of 95. This level can be considered to mean that 5% fewer patients die than would be expected to based on how sick patients arewhen they arrive at the hospital.

HSMR* HSMR* 95% CI

2004 - 2005 120 113-127

2005 - 2006 114 108-121

2006 - 2007 117 111-124

2007 - 2008 104 98-110

2008 - 2009 107 101-114

2009-2010 104 98-110

2010-2011 100 94-106

2011-2012 92 86-97

Hospitals included in the corporat ion result : The Ottawa Hospital Civic CampusThe Ottawa Hospital General Campus

Notes:* Previously referred to as HSMR All Cases95% CI 95 percent confidence intervalThe result is statistically different from the 2004-2005 baseline HSMR of 100 (p


9/10

How is HSMR calcula ted?HSMR is a ratio of "observed" to "expected" deaths, multiplied by 100. A ratio greater than 100 means more deaths occurred than expected, while a ratio less than 100suggests fewer deaths occurred than expected.

HSMR =

Observed Deaths

x 100

Expected Deaths

HSMR is based on diagnosis groups that account for 80% of deaths HSMR is adjusted for factors affecting mortality (e.g. age, sex, length of stay)

To see the full report or for more information, please visit the Canadian Institute for Health Information (CIHI) Web site.

Methic i ll in-res is tan t S taphyloco ccus aureus (MRSA)MRSA stands for methicillin-resistant Staphylococcus aureus. Staphylococcus aureus is a common bacterium or germ which commonly lives in the nose and on the skin.Most people who carry the Staphylococcus aureus bacteria do not have an infection. Sometimes people develop infections with this bacterium and require treatment.Infection in the bloodstream is called bacteremia.

When common antibiotics are not able to destroy Staphylococcus aureus, the bacterium is called resistant, or MRSA. Infectio ns caused by MRSA are not more seriousthan infections caused by the regular Staphylococcus aureus bacterium. However, only a few antibiotics will treat MRSA infections.

Vanco my cin- res is tan t Enterococ cus (VRE)VRE stands for vancomycin-resistant enterococcus. Vancomycin is an antibiotic used to treat infections. Enterococcus is a common bacterium that is normally found in thelower intestine. Sometimes people develop infections with this bacterium and require treatment. Only a few antibiotics can effectively treat enterococcal infections, and oneof them is vancomycin. If the enterococcus bacterium develops resistance to vancomycin (vancomycin-resistant enterococcus), the antibiotic vancomycin will not be ableto destroy the bacteria. There are other antibiotics that will treat VRE infections.

Inform at ion for Pat ien ts and Famil iesFor more information about MRSA and VRE, who gets it and how it is treated, please visit Infection Prevention and Controls patie nt information sheets.

MRSA Patient Information VRE Patient Information

MRSA and VRE Rates MRSA Rates at The Ottawa Hospital

VRE Rates at The Ottawa Hospital MRSA/VRE Rates for All Ontario Hospitals

Surgical list

Building on the government's patient safety indicator initiative, The Ottawa Hospital is reporting on its surgical safety checklist compliance.

The surgical safety checklist covers the most common tasks and items that operating room teams carry out, and h as been shown to reduce rates of death andcomplications among patients. It is a one -page list of items that surgical teams must discuss at three key times:

1. Before the patient is given anesthesia with all team members present.

2. Before skin incision.

3. While all team members are present before closing the patient.

The Ottawa Hospital has been performing surgical safety checklists since 2005, but has been using the formal list being mandated by the province since June 2009. Byimplementing the new surgical safety checklist, The Ottawa Hospital will improve overall patient safety, teamwork and communication, and elevate surgical teams to aneven higher standard of performance.

The dedicated health professionals who work at The Ottawa Hospital are committed to providing the best possible care to patients, and they believe that a public reportingregime will inspire improved performance, enhance patient safety and strengthen the public's confidence.

Surgical Safety Checklists Public Reporting Ongoing monitoring and support of the surgical safety checklist process is essential to ensuring proper adherence. All Ontario hospitals that perform surgeries are requiredto report on their use of the surgical safety checklist to the Ontario government, and to the public.

Surgical safety checklist rates at The Ottawa Hospital

Ventilator

For our public reporting purposes, ventilator associated pneumonia (VAP) is defined as a pneumonia (lung infection) occurring in patients in an intensive care
http://www.cihi.ca/http://www.cihi.ca/http://www.cihi.ca/http://www.ottawahospital.on.ca/wps/wcm/connect/b94159804b25b2709241d71faf30e8c1/MRSA-pt-e.pdf?MOD=AJPEREShttp://www.ottawahospital.on.ca/wps/wcm/connect/b94159804b25b2709241d71faf30e8c1/MRSA-pt-e.pdf?MOD=AJPEREShttp://www.ottawahospital.on.ca/wps/wcm/connect/739a6a004bbef054950bdd56b8a72a08/Patient+info+sheet+for+VRE+positive+patients+2012_an+%282%29.pdf?MOD=AJPEREShttp://www.ottawahospital.on.ca/wps/wcm/connect/739a6a004bbef054950bdd56b8a72a08/Patient+info+sheet+for+VRE+positive+patients+2012_an+%282%29.pdf?MOD=AJPEREShttp://www.ottawahospital.on.ca/wps/wcm/connect/e2fa80804b25b2709244d71faf30e8c1/mrsa-rates-e.pdf?MOD=AJPEREShttp://www.ottawahospital.on.ca/wps/wcm/connect/e2fa80804b25b2709244d71faf30e8c1/mrsa-rates-e.pdf?MOD=AJPEREShttp://www.ottawahospital.on.ca/wps/wcm/connect/57491a004b25b29993a0d71faf30e8c1/vre-rates-e.pdf?MOD=AJPEREShttp://www.ottawahospital.on.ca/wps/wcm/connect/57491a004b25b29993a0d71faf30e8c1/vre-rates-e.pdf?MOD=AJPEREShttp://www.hqontario.ca/public-reporting/patient-safetyhttp://www.hqontario.ca/public-reporting/patient-safetyhttp://www.ottawahospital.on.ca/wps/wcm/connect/bf90ff004b25b28b9322d71faf30e8c1/ssc-rates-e.pdf?MOD=AJPEREShttp://www.ottawahospital.on.ca/wps/wcm/connect/bf90ff004b25b28b9322d71faf30e8c1/ssc-rates-e.pdf?MOD=AJPEREShttp://www.ottawahospital.on.ca/wps/wcm/connect/bf90ff004b25b28b9322d71faf30e8c1/ssc-rates-e.pdf?MOD=AJPEREShttp://www.hqontario.ca/public-reporting/patient-safetyhttp://www.ottawahospital.on.ca/wps/wcm/connect/57491a004b25b29993a0d71faf30e8c1/vre-rates-e.pdf?MOD=AJPEREShttp://www.ottawahospital.on.ca/wps/wcm/connect/e2fa80804b25b2709244d71faf30e8c1/mrsa-rates-e.pdf?MOD=AJPEREShttp://www.ottawahospital.on.ca/wps/wcm/connect/739a6a004bbef054950bdd56b8a72a08/Patient+info+sheet+for+VRE+positive+patients+2012_an+%282%29.pdf?MOD=AJPEREShttp://www.ottawahospital.on.ca/wps/wcm/connect/b94159804b25b2709241d71faf30e8c1/MRSA-pt-e.pdf?MOD=AJPEREShttp://www.cihi.ca/


10/10

nit (ICU), requiring, external mechanical breathing support (a ventilator) intermittently or continuously, through a breathing tube for more than 48 hours.

VAP can develop in patients for many reasons. Because they are relying on an external machine to breath, their normal coughing, yawning, and deep breatheflexes are suppressed. Furthermore, they may have a depressed immune system, making them more vulnerable to infection. ICU teams have many ways tory to assist patients with these normal breathing reflexes, but despite this, patients are still at risk for developing pneumonia.

AP Rates All hospitals with ICUs required to report into the Critical Care Information System (CCIS) a centralized data collection system where hospitals report a

ariety of critical care information must publicly report the VAP indicator data.

These Ontario hospitals are posting their quarterly VAP rate and case co unt for those infections acquired in their facility, using the following formula:

otal # of ICU cases of V AP after 48 hours of mechanical ventilation x 1000otal # of ventilator days for ICU patients 18 years and older

More patient-specific information is available a t www.ontario.ca/patientsafety and www.oha.com/patientsafetytips andwww.oha.com/cleanhandsprotectlives .

Ventilator associated pneumonia rates at The Ottawa Hospital
http://www.ontario.ca/patientsafetyhttp://www.ontario.ca/patientsafetyhttp://www.ontario.ca/patientsafetyhttp://www.oha.com/patientsafetytipshttp://www.oha.com/patientsafetytipshttp://www.oha.com/patientsafetytipshttp://www.oha.com/cleanhandsprotectliveshttp://www.oha.com/cleanhandsprotectliveshttp://www.oha.com/cleanhandsprotectliveshttp://www.ottawahospital.on.ca/wps/wcm/connect/ebb17d804b25b2959370d71faf30e8c1/vap-rates-e.pdf?MOD=AJPEREShttp://www.ottawahospital.on.ca/wps/wcm/connect/ebb17d804b25b2959370d71faf30e8c1/vap-rates-e.pdf?MOD=AJPEREShttp://www.ottawahospital.on.ca/wps/wcm/connect/ebb17d804b25b2959370d71faf30e8c1/vap-rates-e.pdf?MOD=AJPEREShttp://www.oha.com/cleanhandsprotectliveshttp://www.oha.com/patientsafetytipshttp://www.ontario.ca/patientsafety

enhancing bedside manner with ipad

Documents