The Impact of Information Relevancy and Interactivity on Intensivists' Trust in a Machine Learning-Based Bacteremia Prediction System: Simulation Study.

Background: The exponential growth in computing power and the increasing digitization of information have substantially advanced the machine learning (ML) research field. However, ML algorithms are often considered "black boxes," and this fosters distrust. In medical domains, in which mistakes can result in fatal outcomes, practitioners may be especially reluctant to trust ML algorithms.

Airway injury from the presence of endotracheal tubes and the association with subglottic secretion drainage: a prospective observational study.

Purpose: Laryngeal and tracheal injuries are known complications of endotracheal intubation. Endotracheal tubes (ETTs) with subglottic suction devices (SSDs) are commonly used in the critical care setting. There is concern that herniation of tissue into the suction port of these devices may lead to tracheal injury resulting in serious clinical consequences such as tracheal stenosis.

Essential and Nonessential Blood Testing in the Clinical Teaching Unit.

Objectives: The aim of the study was to evaluate the essential and nonessential blood tests ordered on the internal medicine clinical teaching units (CTUs) at Kingston General Hospital. Our aim was to establish a baseline performance measure identifying appropriate use of laboratory tests that could be used to inform improvement over time.

Methods: For an 8-week period, 14 CTU attending physicians at Kingston General Hospital were surveyed.

Non-essential blood tests in the intensive care unit: a prospective observational study.

Purpose: Non-essential blood testing in the acute care setting can be a prominent source of morbidity, patient discomfort, increased workload for the healthcare provider, and wasteful spending. The magnitude of such non-essential blood testing has not been well described. We aimed to measure the extent of unnecessary blood testing in a 33-bed intensive care unit (ICU) at a tertiary-care teaching hospital in Ontario, Canada.

The prevalence of medical error related to end-of-life communication in Canadian hospitals: results of a multicentre observational study.

Background: In the hospital setting, inadequate engagement between healthcare professionals and seriously ill patients and their families regarding end-of-life decisions is common. This problem may lead to medical orders for life-sustaining treatments that are inconsistent with patient preferences. The prevalence of this patient safety problem has not been previously described.

Barriers to goals of care discussions with seriously ill hospitalized patients and their families: a multicenter survey of clinicians.

Importance: Seriously ill hospitalized patients have identified communication and decision making about goals of care as high priorities for quality improvement in end-of-life care. Interventions to improve care are more likely to succeed if tailored to existing barriers.

Objective: To determine, from the perspective of hospital-based clinicians, (1) barriers impeding communication and decision making about goals of care with seriously ill hospitalized patients and their families and (2) their own willingness and the acceptability for other clinicians to engage in this process.

Removing nonessential central venous catheters: evaluation of a quality improvement intervention.

Introduction: Nonessential central venous catheters (CVCs) should be removed promptly to prevent adverse events. Little is known about effective strategies to achieve this goal. The present study evaluates the effectiveness of a quality improvement (QI) initiative to remove nonessential CVCs in the intensive care unit (ICU).

Creating patient safety capacity in a nation's health system: A comparison between Israel and Canada.

Injuries to patients by the healthcare system (i.e., adverse events) are common and their impact on individuals and systems is considerable.

Handover patterns: an observational study of critical care physicians.

Background: Handover (or 'handoff') is the exchange of information between health professionals that accompanies the transfer of patient care. This process can result in adverse events. Handover 'best practices', with emphasis on standardization, have been widely promoted.

Increasing patient safety event reporting in 2 intensive care units: a prospective interventional study.

Purpose: The aims of this study were to increase the reporting of patient safety events and to enhance report analysis and responsive action.

Materials And Methods: A prospective, interventional study in 2 adult intensive care units (ICUs) in an academic center was used. A paper-based reporting system, adapted from a previously reported intervention, was introduced.

Evaluation of unnecessary central venous catheters in critically ill patients: a prospective observational study.

Introduction: Central venous catheters are used commonly in critical care. Evidence-based practices to prevent catheter-related bloodstream infections have been widely promoted. One such practice includes assessing the need for central venous catheters on a daily basis and removing those found to be unnecessary.

Prolonged time to alarm in infusion devices operated at low flow rates.

Objective: To evaluate the time to occlusion alarm for peristaltic infusion devices used in Toronto adult critical care units.

Design: Cross-sectional study.

Setting: Biomedical engineering departments of four Toronto teaching hospitals.

Knowledge translation in critical care: factors associated with prescription of commonly recommended best practices for critically ill patients.

Objective: To describe prescription rates of commonly recommended best practices (clinical interventions with a strong base of evidence supporting their implementation) for critically ill patients and determine factors associated with increased rates of prescription.

Design: A retrospective observational study.

Setting: A university-affiliated medical-surgical-trauma intensive care unit over a 1-yr period.

Brief history of patient safety culture and science.

The science of safety is well established in such disciplines as the automotive and aviation industry. In this brief history of safety science as it pertains to patient care, we review remote and recent publications that have guided the maturation of this field that has particular relevance to the complex structure of systems, personnel, and therapies involved in caring for the critically ill.