Intersections of creativity in the evaluation of the Wilson Centre Fellowship Programme.

OBJECTIVES: Comprehensive programme evaluation frameworks are increasingly important to inform the development of sophisticated programmes that educate the next generation of health professions education researchers. This paper highlights an innovative process undertaken by the Wilson Centre for Research in Education to evaluate its fellowship programme. This process incorporates the principles of programme theory and a framework drawn from the field of organisational development. METHODS: During the iterative and dynamic process of articulating the programme's theory, a hidden tension between structured and unstructured components of the fellowship programme was unearthed. This necessitated a secondary process beyond traditional programme evaluations involving the use of a method called 'Polarity Management®'. RESULTS: The use of this model allowed the team to identify priority actions for balancing both the structured and unstructured components, along with indicators which can serve as an early warning system to alert observers to any imbalance between the components. DISCUSSION: Lessons learned and implications for other health education programming and the practice of programme evaluation are discussed.

An evaluation of patient safety leadership walkarounds.

Patient safety leadership walkarounds (PSLWA) have been identified as an effective tool to improve patient safety culture. At Hamilton Health Sciences, after one year of monthly PSLWA in all clinical and service programs, 1,351 patient safety issues were identified, of which 64-80% have been resolved or have active improvement work in progress. Five hundred staff were invited to complete a process evaluation regarding the effectiveness of the current process of PSLWA. A total of 341 surveys were returned (68%). The overall evaluation demonstrated satisfaction with the process of PSLWA; 93% of those surveyed reported that they felt comfortable openly and honestly discussing patient safety issues and had an enhanced awareness of patient safety. Five areas of opportunity for process improvement were identified: scheduling, scripts, feedback, reporting and resolving issues deferred for an organization approach. PSLWA have offered an effective way to engage leadership and staff in open discussions about patient safety and collaborative approaches for solutions suggesting an enhanced patient safety culture.

Developing a patient safety plan.

Many healthcare organizations are focused on the development of a strategic plan to enhance patient safety. The challenge is creating a plan that focuses on patient safety outcomes, integrating the multitude of internal and external drivers of patient safety, aligning improvement initiatives to create synergy and providing a framework for meaningful measurement of intermediate and long-term results while remaining consistent with an organizational mission, vision and strategic goals. This strategy-focused approach recognizes that patient safety initiatives completed in isolation will not provide consistent progress toward a goal, and that a balanced approach is required that includes the development and systematic execution of bundles of related initiatives. This article outlines the process used by Hamilton Health Sciences in adopting Kaplan and Norton's strategy map methodology underpinned by their balanced scorecard framework to create a comprehensive multi-year plan for patient safety that integrates best practice literature from patient safety, quality and organizational development.

A framework for local accountability for patient safety.

Despite numerous publications outlining the magnitude of patient safety issues, the literature provides limited strategies for organizations to develop comprehensive, effective patient safety programs. Hamilton Health Sciences (HHS) has created a framework to foster local accountability called Patient Safety Triads and Networks. The Networks operationalize patient safety initiatives, develop knowledge and improve patient safety culture in a collaborative interdisciplinary team model. They have proven to be an effective way to support patient safety at the local level and to integrate organizational and local work on patient safety.