Building a Resilient Patient Safety Culture: A Large Healthcare Organization's Approach to Systematically Reviewing Serious Harm Events.

Across Canada, pressures related to staffing, burnout and funding continue to affect healthcare organizations and systems. These pressures impact the quality of care Canadians receive, most notably access to care. Evidence indicates that patients are more likely to suffer from preventable harm during periods of hospital overcrowding and, indeed, very recent data from the Canadian Institute for Health Information suggest that rates of preventable harm have increased modestly in Canadian hospitals. A key lever that can have a positive impact on patient safety culture and contribute to fewer preventable adverse events at an institutional level is systematic formal case reviews. This article describes a large healthcare organization's approach to systematically reviewing serious harm events. An evaluation of both quantitative and qualitative metrics suggests that Unity Health Toronto's critical incident review process has been effective at building a resilient patient safety culture that stood up to the challenges of the COVID-19 pandemic and continues to have a positive impact on patient safety at Unity Health Toronto.

Epidural steroid injections are useful for the treatment of low back pain and radicular symptoms: con.

Lumbar epidural steroid injections are commonly performed in the United States for treating radicular low back pain. However, the best available data suggest that the benefit afforded by these injections is quite limited; in fact, new data suggest that in geographic areas where many such injections are performed, more and not fewer spine surgeries are actually completed annually. We suggest that further high-quality studies are required and their results respected through their implementation in daily practice to better ensure that only appropriate patients are advised to undergo this procedure.

Letters.

ABPI: CORRECT TECHNIQUE ESSENTIAL MANAGING EPIDERMOLYSIS BULLOSA OCCLUSIVE DRESSINGS GIVE PAIN RELIEF CYCLE TIMES OF PRODUCTS USED FOR INTERMITTENT COMPRESSION TREATMENT.