Frequently Asked Questions

Patients should know that their hospital is safe, that the care they receive is topnotch, and that every effort is made to ensure the highest quality of care possible. Public reporting of hand hygiene compliance rates is another helpful measure to ensure the care provided to Ontario patients is even safer, and continues to improve over time. 

A low reported compliance rate does not necessarily mean that health care providers are not performing hand hygiene. The audit tool measures whether health care providers are performing hand hygiene at the right times and the right way. That is why it is vital that hand hygiene compliance rates are viewed in the context of other performance indicators. That said, the analysis of these rates, over time will certainly provide helpful information that can be used to make system improvements in each hospital.

 

Patient safety is a number one priority for all KGH. There are numerous checks and balances in place to ensure the safety of our hospital but hospital care is complicated and depends on many factors. The public reporting of hospitals’ checklist compliance rates is not intended to serve as a measure for hospitals to compare themselves against other organizations, or for the public to use as a measure of where to seek care. Like other patient safety indicators, it is important to look at checklist compliance rates in a broader context. The rates must be examined in order to get a sense of how hospitals are performing – where they excel and where improvements could be made. It is important to look at all of these indicators in combination.

Patient safety is a number one priority for all KGH. There are numerous checks and balances in place to ensure the safety of our hospital but hospital care is complicated and depends on many factors. The public reporting of hospitals’ checklist compliance rates is not intended to serve as a measure for hospitals to compare themselves against other organizations, or for the public to use as a measure of where to seek care. Like other patient safety indicators, it is important to look at checklist compliance rates in a broader context. The rates must be examined in order to get a sense of how hospitals are performing – where they excel and where improvements could be made. It is important to look at all of these indicators in combination.

Patient safety is a number one priority for all KGH. There are numerous checks and balances in place to ensure the safety of our hospital but hospital care is complicated and depends on many factors. The public reporting of hospitals’ checklist compliance rates is not intended to serve as a measure for hospitals to compare themselves against other organizations, or for the public to use as a measure of where to seek care. Like other patient safety indicators, it is important to look at checklist compliance rates in a broader context. The rates must be examined in order to get a sense of how hospitals are performing – where they excel and where improvements could be made. It is important to look at all of these indicators in combination.

The public reporting of our surgical checklist percentage compliance allows us to establish a baseline from which we can track over time. We will closely monitor our rates and should they decrease, we will look closely at our operating room processes and target areas for improvement. The checklist percentage compliance measures the degree to which all three phases (i.e., a briefing, a time out, and a debriefing) of the checklist were performed correctly and appropriately for each surgical patient. We are always striving for 100 per cent compliance. 

Hospitals will post their bi-annual percentage compliance at the end of July and January.

KGH implemented the checklist in one surgical specialty in November 2009. The checklist was implemented in all surgeries in April 2010.

As part of the Ministry of Health and Long-Term Care’s public reporting of patient safety indicators initiative, eligible hospitals are legally required to post their checklist compliance percentages. KGH strongly supports the provincial government’s strategy to publicly report patient safety Indicators because we believe it will enhance patient safety and strengthen the public’s confidence in our hospitals.

The Canadian Patient Safety Institute has a checklist template that has mandatory requirements for Ontario hospitals to use. KGH then adds additional items to this template that allows us to customize items to fit the type of surgeries performed here and have been declared to be important to the KGH patient population. 

If you undergo a surgery at Kingston General Hospital, you can expect that the surgical safety checklist will be used as part of the procedure. As a patient, you will be asked questions by a surgical team member so that they can complete a portion of the checklist with you.  It will then be used by your surgical team members before, during and after your surgery to help the surgical team members familiarize themselves with your medical history and any special requirements that may be needed for your individual case. 

Operating room teams have many important steps to follow in order to ensure a safe and effective surgery for every patient. The checklist is a useful tool that helps promote good communication and teamwork among the health care team to help ensure the best outcomes for patients.

The checklist is used at three distinct stages or phases during surgery:

• pre-induction (before the patient is put to sleep)
• time out (just before the first incision)
• and debriefing (during or after surgical closure)

Some examples of items contained in the checklist include:

The briefing phase:

• Verify with patient name and procedure to be done
• Allergy check
• Medications check
• Operation site, side and procedure
• Lab tests, X-rays

The “time out” phase:

• Patient position
• Operation site and side and procedure
• Antibiotics check

The debriefing phase:

• Surgeon reviews important items
• Anesthesiologist reviews important items
• Nurse reviews correct counts 

A surgical safety checklist is a patient safety communication tool that is used by a team of operating room professionals (nurses, surgeons, anesthesiologists, and others) to discuss important details about each surgical case. In many ways, the surgical checklist is similar to an airline pilot’s checklist used just before take-off. It is a final check prior to surgery used to make sure everyone knows the important medical information they need to know about the patient, all equipment is available and in working order, and everyone is ready to proceed. 

Patient safety is a number one priority for all KGH. There are numerous checks and balances in place to ensure the safety of our hospital but hospital care is complicated and depends on many factors. The public reporting of hospitals’ checklist compliance rates is not intended to serve as a measure for hospitals to compare themselves against other organizations, or for the public to use as a measure of where to seek care. Like other patient safety indicators, it is important to look at checklist compliance rates in a broader context. The rates must be examined in order to get a sense of how hospitals are performing – where they excel and where improvements could be made. It is important to look at all of these indicators in combination.

No. The HSMR results should not be used as a guide of choosing where to seek care. A higher than average HSMR result does not necessarily mean that a hospital is “unsafe” – nor does a lower than average HSMR mean a hospital is “safe.” Patients should know that KGH is safe and that the care they receive is top-notch. Every effort – on behalf of everyone serving patients in a hospital – is made to ensure patients receive the highest-quality care possible. Hospital care is complicated and depends on many factors, not all of which are reflected or accounted for by HSMR. That is why many indicators must be examined in order to get a sense of how hospitals are performing – where they excel and where improvements could be made. It is important to look at all of these indicators in combination. To judge performance on only one indicator would be misleading.

The HSMR is an overall quality indicator and measurement tool that allows for comparison of an acute care hospital’s mortality rate with the overall mortality rate among peer hospitals and regions in Canada. HSMR has been used by many hospitals in several countries to assess and analyze in hospital mortality rates and to help improve quality of care and enhance patient safety. Ontario hospitals are beginning to use the HSMR for internal benchmarking purposes: to show hospitals how their HSMR has changed, where they have made progress and where they can continue to improve.

Morbidity and mortality patterns are changing. Hospitals, like ours, have implemented a range of initiatives to reduce mortality and improve patient care. As a result, HSMR results across the country have been progressively improving. So, this year, CIHI updated the methodology used to calculate HSMR results. For example, Quebec is now included, more diagnoses are added and a new approach to logistic regression modeling is used.

The rate reported by CIHI for KGH has included patients whose secondary diagnosis included palliative care. These are patients whose hospitalization was for the purpose of palliative care for the majority of their hospital stay. Because palliative care was not the primary diagnosis, CIHI has included these patients in their calculation for KGH’s HSMR. At KGH, palliative patients accounted for 64 per cent of deaths last year. Without these palliative care deaths, the HSMR would be lower. 

The Hospital Standardized Mortality Ratio (HSMR) is an overall quality indicator and measurement tool used by all acute care hospitals and regions in Canada. HSMR has been used by many hospitals in several countries to help improve quality of care and enhance patient safety.

No. The HSMR results should not be used as a guide of choosing where to seek care. A higher than average HSMR result does not necessarily mean that a hospital is “unsafe” – nor does a lower than average HSMR mean a hospital is “safe.” Patients should know that KGH is safe and that the care they receive is top-notch. Every effort – on behalf of everyone serving patients in a hospital – is made to ensure patients receive the highest-quality care possible. Hospital care is complicated and depends on many factors, not all of which are reflected or accounted for by HSMR. That is why many indicators must be examined in order to get a sense of how hospitals are performing – where they excel and where improvements could be made. It is important to look at all of these indicators in combination. To judge performance on only one indicator would be misleading.

No. The HSMR results should not be used as a guide of choosing where to seek care. A higher than average HSMR result does not necessarily mean that a hospital is “unsafe” – nor does a lower than average HSMR mean a hospital is “safe.” Patients should know that KGH is safe and that the care they receive is top-notch. Every effort – on behalf of everyone serving patients in a hospital – is made to ensure patients receive the highest-quality care possible. Hospital care is complicated and depends on many factors, not all of which are reflected or accounted for by HSMR. That is why many indicators must be examined in order to get a sense of how hospitals are performing – where they excel and where improvements could be made. It is important to look at all of these indicators in combination. To judge performance on only one indicator would be misleading.

No. The HSMR results should not be used as a guide of choosing where to seek care. A higher than average HSMR result does not necessarily mean that a hospital is “unsafe” – nor does a lower than average HSMR mean a hospital is “safe.” Patients should know that KGH is safe and that the care they receive is top-notch. Every effort – on behalf of everyone serving patients in a hospital – is made to ensure patients receive the highest-quality care possible. Hospital care is complicated and depends on many factors, not all of which are reflected or accounted for by HSMR. That is why many indicators must be examined in order to get a sense of how hospitals are performing – where they excel and where improvements could be made. It is important to look at all of these indicators in combination. To judge performance on only one indicator would be misleading.

No. Patient safety is a number one priority for all Ontario hospitals. There are numerous checks and balances in place to ensure the safety of public hospitals but hospital care is complicated and depends on many factors. The public reporting of hospitals’ hand hygiene compliance rates is not intended to serve as a measure for hospitals to compare themselves against other organizations, or for the public to use as a measure of where to seek care. Rates can vary from hospital to hospital, month to month. Some hospitals will have lower observation opportunities because they do not have as much direct provider-to-patient care opportunities. Due to the types and patient populations (i.e. mental health) of these hospitals, their rates may seem lower. Like other indicators, it is important to look at hand hygiene compliance rates in a broader context. The rates must be examined in order to get a sense of how hospitals are performing – where they excel and where improvements could be made. It is important to look at all of these indicators in combination.

 

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 many infections. Patients and their visitors should also practice good hand hygiene before and after entering patient rooms.

More information is available at:

•  Ministry of Health and Long Term Care - Patient Safety  
• Public Health Ontario - Just Clean Your Hands campaign

KGH works hard-to create a culture of patient safety involves everyone – health care administration, health -care professionals, and, of course, patients and families. If low hand hygiene compliance rates are identified, we will review infection prevention and control practices to ensure that they align with best practices documents, as well as the Just Clean Your Hands program and introduce educational interventions and make appropriate revisions to our program.

For the purpose of public reporting, data will be reported on an annual basis. The decision was made to report annually so that hospitals were able to submit enough data and that the compliance rate was statistically valid.

Patients should know that their hospital is safe, that the care they receive is topnotch, and that every effort is made to ensure the highest quality of care possible. Public reporting of hand hygiene compliance rates is another helpful measure to ensure the care provided to Ontario patients is even safer, and continues to improve over time. 

A low reported compliance rate does not necessarily mean that health care providers are not performing hand hygiene. The audit tool measures whether health care providers are performing hand hygiene at the right times and the right way. That is why it is vital that hand hygiene compliance rates are viewed in the context of other performance indicators. That said, the analysis of these rates, over time will certainly provide helpful information that can be used to make system improvements in each hospital.

No. Patient safety is a number one priority for all Ontario hospitals. There are numerous checks and balances in place to ensure the safety of public hospitals but hospital care is complicated and depends on many factors. The public reporting of hospitals’ hand hygiene compliance rates is not intended to serve as a measure for hospitals to compare themselves against other organizations, or for the public to use as a measure of where to seek care. Rates can vary from hospital to hospital, month to month. Some hospitals will have lower observation opportunities because they do not have as much direct provider-to-patient care opportunities. Due to the types and patient populations (i.e. mental health) of these hospitals, their rates may seem lower. Like other indicators, it is important to look at hand hygiene compliance rates in a broader context. The rates must be examined in order to get a sense of how hospitals are performing – where they excel and where improvements could be made. It is important to look at all of these indicators in combination.

Health care providers performing hand hygiene is a practice that continues to improve as we learn more about hand hygiene best practices. Both hospitals and the health care system have invested considerable resources to improve hand hygiene in hospitals.

The Public Health Ontario provincial hand hygiene campaign, Just Clean Your Hands, was designed to help hospitals and individuals overcome barriers to proper hand hygiene and improve compliance with hand hygiene best practices. The program recognizes that health care providers are busy and require immediate access to hand hygiene products at the right time in the patient care process.

At KGH, for example, where sinks used to be located inconveniently throughout hospitals, there is now fast and easy access to more than 2,200 alcohol-based hand rubs outside all inpatient rooms and adjacent to patients’ bedsides. There are also more freestanding hand cleaning stations located at all main entrances. In addition, ongoing education sessions are held to ensure health care providers know when and where to clean their hands to ensure patient safety.

Direct observation of hand hygiene practice is done by trained observers using the provincial audit tool. The observer conducts observations openly, recording what they see, with the identity of the health care provider is kept confidential.

The single most common transmission of healthcare-associated infections in a health care setting is via the hands of health care providers.

Health care providers acquire germs from contact with infected patients, or after handling contaminated material or equipment. Hand hygiene is an important practice for health care providers but also involves everyone in the hospital, including patients, families and visitors.

Effective hand hygiene practices in hospitals play a key role in improving patient and health care worker safety, and in preventing the spread of healthcare-associated infections.

Hand hygiene is the removal of visible soil and removal or killing of microorganisms from the hands. This can be accomplished using soap and water for visibly soiled hands or an alcohol-based hand rub.

No. Patient safety is a number one priority for all Ontario hospitals. There are numerous checks and balances in place to ensure the safety of public hospitals but hospital care is complicated and depends on many factors. The public reporting of hospitals’ hand hygiene compliance rates is not intended to serve as a measure for hospitals to compare themselves against other organizations, or for the public to use as a measure of where to seek care. Rates can vary from hospital to hospital, month to month. Some hospitals will have lower observation opportunities because they do not have as much direct provider-to-patient care opportunities. Due to the types and patient populations (i.e. mental health) of these hospitals, their rates may seem lower. Like other indicators, it is important to look at hand hygiene compliance rates in a broader context. The rates must be examined in order to get a sense of how hospitals are performing – where they excel and where improvements could be made. It is important to look at all of these indicators in combination.

 

No. Patient safety is a number one priority for all Ontario hospitals. There are numerous checks and balances in place to ensure the safety of public hospitals but hospital care is complicated and depends on many factors. The public reporting of hospitals’ hand hygiene compliance rates is not intended to serve as a measure for hospitals to compare themselves against other organizations, or for the public to use as a measure of where to seek care. Rates can vary from hospital to hospital, month to month. Some hospitals will have lower observation opportunities because they do not have as much direct provider-to-patient care opportunities. Due to the types and patient populations (i.e. mental health) of these hospitals, their rates may seem lower. Like other indicators, it is important to look at hand hygiene compliance rates in a broader context. The rates must be examined in order to get a sense of how hospitals are performing – where they excel and where improvements could be made. It is important to look at all of these indicators in combination.

 

Yes, the table weight limit is 400 lb. or 180 kg., with a maximum width restriction of 60 cm. For optimal images it is necessary for the area being examined to be within the magnets isocentre which is located directly in the centre of the scanner. For patient specific questions please contact our MRI bookings department.

Most infections are treated with antibiotics – the type of medication will depend on the germ causing the infection. An infected skin wound may be reopened and cleaned. If an infection occurs where an implant is placed, the implant may be removed. If the infection is deep within the body, another operation may be needed to treat it.

Ask lots of questions. Learn what steps the hospital is taking to reduce the danger of infection.

• If your doctor instructs, shower or bathe with antiseptic soap the night before and day of your surgery. You may be asked to use a special antibiotic cleanser that you don’t rinse off.
• If you smoke, stop or at least cut down. Ask your doctor about ways to quit.
• Only take antibiotics when told by a health care provider. Using antibiotics when they’re not needed can create germs that are harder to kill. If prescribed, finish all your antibiotics, even if you feel better.
• After your surgery, eat healthy foods.
• When you return home, care for your incision as instructed by your health care provider.

Health care providers should be taking the following precautions to prevent SSIs:

• Practicing proper hand-hygiene techniques. Before the operation, the surgeon and all operating room staff scrub their hands and arms with an antiseptic soap.
• Cleaning the site where your incision is made with an antiseptic solution.
• Wearing medical uniforms (scrub suits), long-sleeved surgical gowns, masks, caps, shoe covers and sterile gloves.
• Covering the patient with a sterile drape with a hole where the incision is made.
• Closely watching the patient’s blood sugar levels after surgery to make sure it stays within a normal range. High blood sugar can delay the wound from healing.
• Warming IV fluids, increasing the temperature in the operating room and providing warm-air blankets (if necessary) to ensure a normal body temperature. A lower-than-normal body temperature during or after surgery prevents oxygen from reaching the wound, making it harder for your body to fight infection.
• Clipping, not shaving any hair that has to be removed. This prevents tiny nicks and cuts through which germs can enter.
• Covering your closed wound (closed with stitches) with sterile dressing for one or two days. If your wound is open, packing it with sterile gauze and cover it with sterile dressing.

The risk of acquiring a surgical site infection is higher if you:

• Are an older adult
• Have a weakened immune system or other serious health problem such as diabetes
• Smoke
• Are malnourished
• Are very overweight
• Have a wound that is left open instead of closed with sutures

• Increased soreness, pain, or tenderness at the surgical site.
• A red streak, increased redness, or swelling near the incision.
• Greenish-yellow or foul-smelling discharge from the incision.
• Fever of 101 degrees Fahrenheit (38.5 degrees Celsius) or higher

Symptoms can appear at any time from hours to days after surgery. Implants such as an artificial knee or hip can become infected up to 3 months or more after the operation.

Surgical site infections occur when harmful germs enter your body through the surgical site (any cut the surgeon makes in the skin to perform the operation). Infections can happen because germs are everywhere – on your skin, and on things you touch. Most infections are caused by germs found on and in your body.

Most infections are treated with antibiotics – the type of medication will depend on the germ causing the infection. An infected skin wound may be reopened and cleaned. If an infection occurs where an implant is placed, the implant may be removed. If the infection is deep within the body, another operation may be needed to treat it.

Most infections are treated with antibiotics – the type of medication will depend on the germ causing the infection. An infected skin wound may be reopened and cleaned. If an infection occurs where an implant is placed, the implant may be removed. If the infection is deep within the body, another operation may be needed to treat it.

Most infections are treated with antibiotics – the type of medication will depend on the germ causing the infection. An infected skin wound may be reopened and cleaned. If an infection occurs where an implant is placed, the implant may be removed. If the infection is deep within the body, another operation may be needed to treat it.

For the contact information of your union representatives, please refer to the Union Contact Information on the Employee and Labour Relations page of the Intranet.

*Please note that you will need google Authenticator in order to view this information if you are not currently at one of KHSC’s sites.

For the contact information of your union representatives, please refer to the Union Contact Information on the Employee and Labour Relations page of the Intranet.

*Please note that you will need google Authenticator in order to view this information if you are not currently at one of KHSC’s sites.