The February 24th VMDAS quarterly meeting focused on two areas of interest to members. Dr. Shaqil Peermohamed presented information on VCH’s Firstline app, after which members of VCH’s People Safety Team and mPOSH talked about violence prevention.

Firstline app: Fighting antimicrobial resistance

There are estimates that by 2050 10 million deaths will be attributable to antimicrobial resistance. Canadian stats are no less overwhelming. Resistance to first-line antibiotics in 2018 was 29 per cent; it is expected to rise to 40 per cent by 2050 and lead to 13,700 deaths. The additional health-care costs will be $7.6 billion.

This was the background ASPIRES member Dr. Peermohamed provided before launching into his talk on the Firstline app, which is designed to curb antimicrobial resistance. By downloading the app, medical providers can tap into VCH’s infectious disease guidance and antimicrobial dosing information. The app assists in making better decisions for patient outcomes, reduces the burden of antibiotic-resistant infections on our health system, and minimizes adverse events.

VCH launched its customized version of Firstline last November, and there are now over 1,000 users in our health authority. Dr. Peermohamed encouraged VMDAS members to become antimicrobial ambassadors by downloading the app, sharing it with colleagues, using it while rounding, and discussing questions about guidance and treatment recommendations. The app includes his contact information, and he is happy to hear ideas for further customization.

Violence prevention

VCH Director of Employee Safety David Vigor, Manager of People Safety Ray Chow, Program Leader, Safety & Prevention, Humberto Ramirez, and mPOSH’s Dr. Annalee Yassi all contributed to the discussion on violence prevention.

Code White (aggressive/hostile person) and Code Silver (person actively attacking with a weapon) were explained along with the appropriate responses to these situations. Know your local site-specific response plans and response teams.

Best practices rely on all of us to conduct point-of-care risk assessments during engagement with patients for potential changes in behaviour. Proactively seek assistance if you feel the situation could escalate. We should also know our local resources. Portable panic/duress buttons are available from the violence prevention team.

During a Code Silver, dial the designated emergency number for your facility or have someone else make the call. Responses during a Code Silver include running, hiding, or—as a last resort—fighting. We are not expected to engage the attacker, and we are advised to prioritize personal safety as well as helping patients or others if possible.

Cerner offers a tiered violence alert to provide more immediate information. A Violence Risk Care Plan is triggered for completion once a violence alert is initiated. A recording of how this works is included on the oneVCH Safety intranet page and there is also a recording of a regional education webinar.

mPOSH supports medical staff at VCH. Created during the COVID-19 pandemic, its primary function has been to provide infectious disease contact tracing and exposure, but it also follows up on incidents of workplace violence affecting medical staff. mPOSH gathers details and offers support and, with consent, shares details with the VCH Safety Team. To date, mPOSH has followed up on 599 incidents of workplace violence. The vast majority of incidents occurred in Psychiatry, followed by Emergency Medicine. Most were in Vancouver Acute, with 61 per cent taking place at VGH.

mPOSH is piloting an app in the VGH Emergency Department for reporting violent incidents. It hopes to roll out the app soon to a wider audience.

Meeting attendees asked several questions on this important topic. A workplace weapons policy is in its final review and a weapons response plan is in the works.

VMDAS President Dr. Ka Wai Cheung reminded members that VCH’s violence prevention team can come to departments to do safety environmental scans and assessments. They also offer standardized as well as customized training. VMDAS is also offering sessional support for physicians to participate on VCH’s violence prevention committees. You can learn more about these opportunities here.

Member engagement

The following opportunities are currently available to VPSA members:

• Funding to start or continue a commensality group. Apply here before March 11.
• Apply here for funding for a Small Steps, Big Idea quality improvement project.
• Recruitment and retention funding is available – if you have ideas, encourage your department or division head to apply.
• Wellness funding is also available; please see your department or division head to discuss your ideas and to apply.

Next meeting

Mark your calendars: the next VMDAS quarterly meeting will be held on May 26. Watch your inbox as well as your weekly Checkup e-newsletter for further information.