Mandatory reporting legislation in Canada: improving systems for patient safety?

Patient safety is a complex systems issue. In this study, we used a scoping review of peer-reviewed literature and a case study of provincial and territorial legislation in Canada to explore the influence of mandatory reporting legislation on patient safety outcomes in hospital settings. We drew from a conceptual model that examines the components of mandatory reporting legislation that must be in place as a part of a systems governance approach to patient safety and used this model to frame our results. Our results suggest that mandatory reporting legislation across Canada is generally designed to gather information about - rather than respond to and prevent - patient safety incidents. Overall, we found limited evidence of impact of mandatory reporting legislation on patient safety outcomes. Although legislation is one lever among many to improve patient safety outcomes, there are nonetheless several considerations for patient safety legislation to assist in broader system improvement efforts in Canada and elsewhere. Legislative frameworks may be enhanced by strengthening learning systems, accountability mechanisms and patient safety culture.

Review of meniscal injury and associated sports.

Meniscal injuries produce disability in a large portion of the population, and sports injuries are a common cause. Nicholas emphasized the importance of epidemiologic studies in an effort to better define the risk of various sports. There are significant regional differences in sports-related meniscal injuries depending upon the popularity of specific sports. Although publications in the European literature document some of these variations, there is little epidemiologic documentation of the variation in specific areas of the United States. Meniscectomies performed in Syracuse, New York, from 1973 to 1982 were reviewed. Sports-related meniscal injuries were tabulated and compared against all other causes. Our results indicate that the incidence of meniscal injury resulting in meniscectomy is 61 per 100,000 population. The sex ratio was three males to one female. Medial versus lateral meniscus injury was 81 versus 19%. Football had a 75% predominance of medial meniscectomy; basketball, 75%; wrestling, 55%; skiing, 78%; and baseball, 90%. Our data indicate that there are differences in the ratio of medial versus lateral meniscal disruption associated with specific sports activities. Medial meniscal injuries were, nevertheless, consistently more common in all of our categories except wrestling, where the frequency of lateral meniscal tear is nearly equal to that of medial meniscal tear. Additionally, the right knee is at a greater risk of meniscal injury in basketball than in other sports or the general population, and female skiers are at equal or greater risk of meniscal injury compared to male skiers.

Osteoblastoma of the metacarpal: A case report.

Osteoblastoma is a rare tumor, but the small bones of the hands and feet are the second most common location. Despite this, the diagnosis of osteoblastoma is rarely considered in the differential diagnosis of bone tumors of the hand. This is a case similar to Jaffe and Mayer's original report.