DEPARTMENTAL REVIEW 2013-2014
Academic Department of Emergency Medicine Essential partners in an integrated health care system
ENHANCING PATIENT CARE EDUCATING DOCTORS AND HEALTH ADVANCING RESEARCH STRENGTHENING OUR PEOPLE AND CARE TEAMS OF THE FUTURE ORGANIZATIONAL GOVERNANCE
emergency.medicine.dal.ca
CONTENTS
THE DEPARTMENT RESEARCH 4 What is Emergency Medicine 20 Advancing Research 5 The Evolving World of Emergency Medicine 21 Research 22 Publications PATIENT CARE 22 Editorials 6 Integrated Network of Emergency Medical Care 23 Abstracts 7 Enhancing Patient Care 24 Studies and Projects in Development 8 Patient Care Halifax Infirmary Site 25 Research Saint John 9 Emergency Department Volumes and Flow 26 Division of Emergency Medical Services 10 Emergency Department Triage Acuity, Admission Rates and Wait Times GOVERNANCE 11 Patient Care IWK Site 27 Strengthening Our People and 12 Patient Care Saint John Site Organizational Governance 13 Global Health and the Department of Emergency Medicine OUR PEOPLE 28 More Faces of Emergency Medicine EDUCATION 14 Educating Doctors and Health Care Teams of the Future 15 Post Graduate Medical Education 16 Under Graduate Medical Education 17 Interprofessional Team Based Learning 18 Simulation 19 Clinical Cadaver Program 19 Airway Management
Departmental Review 2013-2014 Academic Department of Emergency Medicine 3 THE DEPARTMENT What is Emergency Medicine?
• Critical decision making in the • Expertise in resuscitation • Design and coordination of undifferentiated and unexpected and stabilization of the integrated systems of patient health event. critically ill and injured. management across the continuum of acute care.
Our Vision Our Values Improved health outcomes INTEGRITY: We are commit- CRITICAL THINKING: INITIATIVE: We have the for patients of all ages ted, trustworthy, reliable and We systematically and power to energetically begin through influential act conscientiously, consis- continually assess our a plan, or change what isn’t research, education and tently, and in accordance with thinking for clarity, accuracy, working in ourselves, our the development of leaders our values. bias, precision, logic, and department, or our system, in Emergency Medicine. relevance. and see it through. ACCOUNTABILITY: We accept responsibility for our EVIDENCE-BASED DECISION PROFESSIONALISM: We are Our Mission actions, follow through on our MAKING: We effectively committed to the health and commitments, and measure retrieve, evaluate, integrate, well being of individuals To save and improve lives up to your expectations. weight and apply knowledge and society through ethical through timely patient – to patient care and system practice, respect, collegiality COLLABORATION: We work centered Emergency care design in the context of and high personal standards together and value different driven by educational patient and social/cultural of behaviour. perspectives to better innovation and practice values. changing research. understand and find solutions to complex problems. ADVOCACY: We speak up for patient and population interests. Pushing for effective change from providers and policy makers.
4 Academic Department of Emergency Medicine Departmental Review 2013-2014 What is Emergency Medicine? The Evolving Role of Emergency Medicine THE DEPARTMENT A message from Dr David Petrie: Department Head
care providers in providing the best care now, and in the DEPARTMENT HEAD future, and in discovering and translating the unique body of AND DISTRICT CHIEF OF knowledge that defines Emergency Medicine. EMERGENCY MEDICINE: As the discipline evolves with the challenges facing our DAVID PETRIE, MD, FRCP Health Care system, and the important trends in medical Dr David A. Petrie is the education and outcomes research, we will fulfill our mission Professor and Head of the through our four strategic directions: Dalhousie Department of Emergency Medicine and the Chief of the Central 1. Enhancing patient care – providing more timely access to Zone, NSHA. After medical high quality Emergency Medicine embedded in integrated school at Dalhousie and Emergency Medicine (EM) is at the interface of many parts an Internship in Ottawa networks of care. of the evolving Health Care system. EM is often a decision- he worked for two years in small town Ontario making point that potentially connects primary care with 2. Educating doctors and health care teams of the future and Nova Scotia. Since – being at the forefront of medical education ensuring tertiary care, pre-hospital care with in-hospital care, acute his specialty training in care with chronic care, and disease/service based care competence, inspiring excellence, and developing leaders Emergency Medicine at with whole person care. In that context, EM is a generalist in Emergency Medicine. the University of Western Ontario 1992-1996, he has discipline with respect to the breadth of knowledge-base/ 3. Advancing Research – developing a productive and been a faculty physician and scope of practice, and a specialty with respect to its depth collaborative research engine that emphasizes improving Trauma Team Leader at the of knowledge and approach to the acute/unforeseen and patient outcomes through research and knowledge QEII Health Sciences Centre undifferentiated health care event. Furthermore, by its nature, translation. in Halifax. Dr Petrie has Emergency Care is often delivered in multi-disciplinary teams been Medical Director of 4. Strengthening our people and organizational collaborating and coordinating their efforts in the service of the Halifax Regional ground governance – supporting an effective, efficient and EMS system and Medical improving patients and population outcomes. adaptable approach to the Department of Emergency Director of the LifeFlight It is an exciting time for Academic Emergency Medicine. Medicine’s CORE initiatives by engaged leaders and teams Critical Care transport Internationally, the critical role of our speciality is increasingly program. His academic who create the conditions for emergence. being recognized and relied upon. We are no longer seen interests are prehospital as merely the passive canary in the coal mine of a broken and trauma systems research, the impact of system, but rather, as active partners in collaboration critical thinking on clinical and catalysts in designing and improving the system. The decision making, and the Dalhousie Department of Emergency Medicine (established implications of complex in 1998) continues to be a leader in Emergency Health adaptive systems modeling System innovations in educating doctors and other health to Health Care System Reform.
Departmental Review 2013-2104 Academic Department of Emergency Medicine 5 PATIENT CARE Integrated Network of Emergency Care
Academic Emergency Physicians are integral to moving toward a single coordinated, comprehensive, and accountable emergency care system with many access points.
Lifeflight To provide critical care to ill and injured patients, immediate Lifeflight clinical expertise, Categorized and decision-making Coordinated Emergency support and safe, Departments Nova Scotia timely transport via Trauma rotor wing, fixed wing EHS Bases Program or ground ambulance. Emergency Departments Nova Scotia Trauma Program The Nova Scotia Trauma Program facilitates the provision of optimal trauma care through leadership in patient care, education, research, EHS injury prevention and the continuous development and improvement of our trauma system. EHS (Emergency Dalhousie Department Health Services) IWK Regional of Emergency IWK Regional Medicine EHS will assure the best Poison Centre Poison Centre possible care to the To provide optimal communities we serve individualized care in through collaboration, the event of a real or regulation, operations, potential poisoning. evaluation and research.
6 Academic Department of Emergency Medicine Departmental Review 2013-2014 Enhancing Patient Care PATIENT CARE
More timely access to high quality Emergency Medicine embedded in integrated networks of care. AT A GLANCE 2014 Patient Volumes Halifax Infirmary 72,349 IWK 28,362 Saint John Regional Hospital 55,944 Cobequid Community STRATEGIC INITIATIVES Health Centre 37,532 Optimize timely access to medical care in the Provide leadership in developing an “Integrated Networks Dartmouth Emergency Department through: of Emergency Care” system design model at the district, General Hospital • Catalyzing improvements in hospital patient flow initiatives, provincial and inter-provincial level by: 40,429 collaborating with related departmental/program leaders/ • Matching patient/population clinical needs with Hants Community colleagues, and advocating for system-wide change. departmental capacity, the district clinical services plan Hospital • Maximizing safe and patient-centered Emergency and provider expertise. 14,851 Department operational efficiencies. • Improving transitions of care prior to, during, and beyond • Provide, monitor, and continually improve high quality the Emergency Department. emergency medical care in the other dimensions of Health • Exploring safe, effective and efficient inter-disciplinary Care Quality (effectiveness, acceptability, cost-efficiency, models of care (including the potential use of mid-level appropriateness, and safety). providers). • Enhance and align (within our respective organizations) our Continuous Quality Improvement program. Create and maintain a positive, satisfying and enjoyable • Collect and monitor key process indicators of care (and working environment for all caregivers by: where possible measure outcomes) and benchmark • Optimizing the physical workspace and ergonomics of against national targets and recommendations. day-to-day clinical care. • Maximize the use of tools to support clinical care, such • Embodying and emphasizing professional behaviour from as clinical pathways, care maps, standing orders and all staff. electronic decision support tools. • Promoting an atmosphere of tolerance, respect and courtesy between staff members and when caring for patients.
Departmental Review 2013-2014 Academic Department of Emergency Medicine 7 PATIENT CARE Halifax Infirmary Site
CHIEF OF EMERGENCY MEDICINE: SAM CAMPBELL CCPF(EM), DIP PEC(SA), FCCHL Dr Sam Campbell went CLINICAL/OPERATIONAL HIGHLIGHTS: to medical school in South Africa and did his • Patient volumes continue to rise with record numbers of units. In most cases indicators of crowding vary directly emergency training at patients every month. The patient census in 2014 was over with the incidence of delayed movement of admitted St Paul’s in Vancouver. 72,000 at the Halifax Infirmary site. Also increasing are the patients. Capacity limitations also push decision making He is a Professor of Emergency Medicine, age of the patients as well as the complexity and acuity of toward earlier discharge of patients, increasing the risk of Dalhousie University, their complaints. repeat visits by patients for the same illness. Chief of Emergency Medicine, Halifax • Emergency demand is predictably unpredictable, • Improving ED efficiency is an ongoing area of commitment. Infirmary, a Trauma Team necessitating redundancy built into the system. With Initiatives at the Halifax Infirmary site include a chair-centric, Leader; and On-line inpatient units frequently over 100% capacity, the length (bed sparing) process, a Rapid Assessment Unit, where Medical Consultant of stay in the emergency department of admitted patients patients consulted to specialty services are held, the use to the IWK/Regional is a major challenge, as delay in freeing up ED beds of a Clinical Decision Unit to avoid potentially avoidable Poison Centre, EHS Nova Scotia Air Ambulance denies space and resources for waiting patients. This is hospital admission, having a senior internist stationed in and Ground Ambulance expressed in worrying indicators of our ability to process the ED, using Advanced Care Paramedics as physician services. His special the increasing patient volumes, including the time it takes extenders in a low acuity area, providing information on interests are: emergency for ambulances to offload their patients, the number and personal efficiency to physicians and clinical team leads, management of infectious percentage of patients that leave the ED without being and appointing emergency physicians specifically to address and respiratory disease, continuous quality seen by a doctor (LWBS), the times patients wait to be seen bottlenecks in flow at times of greatest patient demand. improvement and airway and the number of activations of an overcrowding protocol, Cooperation with inpatient units to help them manage their management. that involves pushing patients up into hallways in inpatient load has also become an important area of focus.
8 Academic Department of Emergency Medicine Departmental Review 2013-2014 Emergency Department Volumes and Flow PATIENT CARE
A. Monthly Census: Halifax Infirmary Myths about Emergency
6650 department Flow: 6500 6350 MYTH 1: Wait times 6200 6050 in the Emergency 5900 Department are just 5750 5600 an inconvenience. 5450 REALITY: Wait times 5300 5150 are associated 5000 4850 with morbidity and 4700 mortality rates. 4550 4400 Guttmann A, Schull 4250 MJ, Vermeulen MJ. JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC Association between waiting times and 2007 2013 2014 short term mortality and hospital admission after departure from emergency B. Length of Stay department: population A. Since the index year of 2007, patient volumes have based cohort study 36 from Ontario, Canada. increased 25 percent; from 57,936 patients per year 34 32 BMJ 2011; 342:d2983 to 72,349 patients per year. Our busiest months 30 28 MYTH 2: Emergency continue to be July through September and October 26 24 Department as shown in graph A. 22 20 overcrowding is caused 18 by low acuity patients. 16 14 REALITY: Published 12 B. Despite this significant increase in volumes, the 10 by the Canadian
90% ile LOS Admitted Pts (hrs) 8 Health Services Emergency Department length of stay of admitted 6 4 Research Foundation patients has been trending down over time due to 2 0 in Mythbusters 2009. improved hospital flow. Lack of surge capacity however, “Myth: Emergency Room Jul -11 Jul -12 Jul -13 Jul -14 Jan -11
Mar -11 Overcrowding is Caused Jan -12 Jan -13 Jan -14 Sep -11 Nov -11 Mar -12 Mar -13 Mar -14 Sep -12 Sep -13 Sep -14 May -11 Nov -12 Nov -13 Nov -14
is still a problem and our 90 percent performance does May -12 May -13 May -14 by Non-Urgent Cases”. not meet the 12 hour national standard proposed by the HALIFAX INFIRMARY Canadian Association of Emergency Physicians (CAEP).
Departmental Review 2013-2014 Academic Department of Emergency Medicine 9 PATIENT CARE Emergency Department Triage Acuity, Admission Rates and Wait Times Myths about Emergency Department Flow: A. Total Census by CTAS Level at B. Admission Rate: Halifax Infirmary MYTH 3: The the Halifax Infirmary A. Canadian Triage and Acuity Emergency Department Scale (CTAS) distributions are is the most expensive TOTAL: 72,349 place to receive 5. 1. 70% seen in this pie graph with care in the system. 4% 1% 60% Acuity 1 being the most ill or REALITY: Bernstein 50% injured and Acuity 5 being
SL. “ED Care: % Admitted 40% the least. Available, Competent, 2. 20% Affordable”. Acad Emer 21% 4. 20% B. The corresponding admission Med 2014; 21(1):73-75 26% 10% MYTH 4: rates are seen for each 0% Emergency Department 1 2 3 4 5 triage level. For example, overcrowding is an 3. - 66.1% 26.9% 14.3% 1.9% 3.2% 14.3 of CTAS 3 patients are 48% Emergency Department CTAS admitted. problem. REALITY: Innes G. “Sorry - We’re Full! Access block and accountability failure C. Wait Times in the health care C. The wait time curve for CTAS system”. CJEM 2014; 100 3 patients is seen for all 16(0):30-47 90 four Emergency Department 80 facilities in the central zone. 70 60 At the Halifax Infirmary site 50 90 percent of patients are 40 seen within 2.5 hours. (The 30 CAEP target is 30 minutes for 20 10 CTAS 3 patients.) 0 % Patients Seen within Time (CTAS 3) % Patients Seen within Time (CTAS 15 30 45 60 75 90 105 120 135 150 165 180 195 210 225 240 255 270 285 300 315 Time to First Physician (Minutes) CCHC DGH HCH QEII
10 Academic Department of Emergency Medicine Departmental Review 2013-2014 IWK Site PATIENT CARE
CHIEF OF PEDIATRIC EMERGENCY MEDICINE: SHANNON MACPHEE MD, FRCPC(PEDS), PEM
Dr Shannon MacPhee graduated from medical school at Dalhousie University in 1999. She did her Pediatric residency and Pediatric Emergency Medicine Fellowship at the Hospital for Sick Children. Dr MacPhee was The IWK Department of Pediatric Emergency Medicine (PEM) mandate, and our members have a long history of providing recruited to the IWK in provides care to over 28,000 patients each year at the IWK excellent teaching to medical students and residents. 2005 and is currently an Assistant Professor in the Health Centre and serves as the only pediatric emergency The IWK Department of Pediatric Emergency Medicine is Department of Emergency department in the Maritime provinces. committed to continuously raising the standard of pediatric Medicine. She has been Our physicians have clinical expertise in managing a broad emergency care across the Maritimes. We operate in a Chief of Emergency range of conditions, from the neonatal period through to the research-rich environment and are in collaboration with Medicine at the IWK since teenage years. Many of our doctors have subspecialty training pediatric emergency departments across the country through 2009. With a keen interest in medical simulation she in pediatric emergency medicine, enabling us to provide Pediatric Emergency Research Canada (PERC). We participate has been a driving force expert care to children and youth. in numerous research studies. Most recently, the IWK Health for the development of the Our faculty consists of a mix of seasoned, highly Centre formed a partnership with the Saint John Regional program at the IWK Health experienced clinicians, as well as younger physicians who Hospital, Miramichi Regional Hospital and the Cape Breton Centre. Other interests possess additional specialized expertise in pediatric and Regional Hospital to expand knowledge on unscheduled include Knowledge Translation and optimizing emergency care at the IWK Health Centre. pediatric care in these centres. communication during We’re dedicated to Dalhousie Medical School’s academic patient interactions.
Departmental Review 2013-2014 Academic Department of Emergency Medicine 11 PATIENT CARE Saint John Site
CLINICAL ACADEMIC HEAD: MIKE HOWLETT, MD, CCFP(EM), MHSA Dr Mike Howlett is the Clinical Academic Head for the Department of Emergency Medicine, Horizon Health Network, Saint John Area. He is an Associate Professor The Saint John Regional Hospital is the largest tertiary care team training and training for less frequent, high acuity in the Department of hospital in New Brunswick and is the primary health care emergencies. With good investment into excellent equipment Emergency Medicine for Dalhousie University and referral centre for this area and to all New Brunswickers for we now have multiple on site and off site programs. We is a Clinical Assistant major trauma and cardiac care.The New Brunswick Trauma have simulators for adult, child and infant scenarios. We run Professor, Discipline of Program is located within the hospital. It is also the center bimonthly in situ simulations. These simulations take place Emergency Medicine for of Dalhousie Medicine New Brunswick’s distributed medical within the active clinical areas of the Emergency Department Memorial University in education program. and involve all members of the ED team. The focus for this is Newfoundland. Mike’s interests are in population The Saint John Regional Hospital Emergency Department team training and logistics. health, system planning, Ultrasound Program was established as one of our priority We have also commenced our own, in house Emergency ED crowding, staff health academic programs. Amongst our physician group are a airway simulation program. This has been developed to and quality improvement. number of national and international leaders in the field of improve confidence and maintain competence with difficult Point of Care Ultrasound (PoCUS). We run a growing number airway situations. In addition we are currently providing of PoCUS courses each year in Saint John. simulation based learning for Internal Medicine residents. The Simulation Program was started with the aim of
12 Academic Department of Emergency Medicine Departmental Review 2013-2014 Global Health and the Department of Emergency Medicine PATIENT CARE
JOHN ROSS, MD, FRCPC JOLENE COOK, MD, CCFP(EM) Dr John Ross trained as a Dr Jolene Cook is an Royal College Emergency Emergency Physician Physician at Queen’s at the Halifax Infirmary University. He has been and recently volunteered practicing Emergency her time to work in Medicine for almost 25 Port-au-Princes, Haiti years, primarily in Halifax with Team Broken Earth at the Halifax Infirmary, along with several of but also clinically and the Halifax Infirmary academically at South Emergency Department Shore Regional Hospital, nurses. Jolene is an active QE Hospital Charlottetown, member of Medecins UNIMAS in Sarawak Sans Frontieres/Doctors Malaysia, Muhimbili National Without Borders (MSF) Hospital, Dar es Salaam and recently completed Tanzania, and HEODRA in Leon Nicaragua. Some of John’s a mission at an MSF trauma hospital in Port-au-Princes various department and hospital administrative roles included in 2015. Prior to her involvement in these humanitarian Clinical Chief, Capital Health and Academic Head, Dalhousie organizations, she served in the Canadian Forces. She University 2004-09; Provincial Advisor on Emergency Care completed her CCFP (EM) training at Dalhousie University in to the Deputy and Minister of the Department of Health and 2012 and went on to do an Emergency Medical Services Wellness NS 2009-present and EM Royal College Residency (EMS) Fellowship in 2013. She continues to be involved in Program Director 2011-2014. Dr Ross has been a professor EMS on the local and international levels. in Emergency Medicine since 2005. His academic interests include airway, simulation, ultrasound education as well as select global health initiatives.
Departmental Review 2013-2014 Academic Department of Emergency Medicine 13 EDUCATION Educating doctors and health care teams of the future
Be at the forefront of medical education ensuring competence, inspiring excellence, and developing leaders in Emergency Medicine.
AT A GLANCE STRATEGIC INITIATIVES For the 2015 academic Develop exemplary Emergency Physicians and system Enhance and advance the appropriate and integrated use year we received: leaders through the support and innovation of our three of Simulation into all levels of medical education across CFPC (EM) PGME training programs and our EMS fellowship. sites and programs. Residency Program • Royal College of Physicians and Surgeons of Canada 95 CaRMs applications Specialist Certificate in Emergency Medicine Take a leadership role in promoting inter-professional for 4 available spots • Royal College of Physicians and Surgeons of Canada and multi-disciplinary education and clinical excellence RCPS (EM) Pediatric Emergency Medicine Residency throughout the province/Maritimes guided by the Residency Program • Canadian College of Family Physicians Certificate in improving patient outcomes imperative. 108 CaRMs applications for 2 available spots Emergency Medicine • Division of Emergency Medical Services Fellowship Foster a creative and supportive environment to grow innovative, effective, and enthusiastic educators who Align our strengths as a department (clinical care constructively challenge the status quo and are on the opportunities, educational priorities, and research leading edge of improvement in medical education. interests) to influence and support high impact undergraduate learning. Develop a Department-wide approach to ensure flexible, fair and sufficient support for advancing the scholarship of education.
14 Academic Department of Emergency Medicine Departmental Review 2013-2014 Post Graduate Medical Education EDUCATION
ROYAL CANADIAN PEDIATRIC Three tracks COLLEGE COLLEGE OF EMERGENCY in Emergency EMERGENCY FAMILY MEDICINE Medicine Training MEDICINE PROGRAM PHYSICIANS The Department of PROGRAM (EM) DIRECTOR: Emergency Medicine DIRECTOR: PROGRAM ERIN KILLORN continues to be a leader JANET DIRECTOR: MD, FRCPC in the 3 PGME programs: MACINTYRE BIJON DAS The Royal College of MD, FRCPC MD, CCFP(EM) Physicians and Surgeons specialist certificate in Dr Janet MacIntyre has been a faculty Dr Bijon Das is a Dalhousie University Dr Erin Killorn attended medical Emergency Medicine member at Dalhousie University and Medical school graduate. He also school at Dalhousie University, and and FRCP Pediatric Emergency Medicine an emergency physician at the completed his Family Medicine and completed her postgraduate training residency, as well as at the University of Western Ontario in Halifax Infirmary since completing Emergency Medicine training at the Canadian College of her specialty training in Emergency Dalhousie. Currently an Assistant London, Ontario, for both a residency Family Physicians with Medicine at Dalhousie University Professor at Dalhousie University, he in Pediatrics, and a fellowship in special competency in in 2005. Dr MacIntyre has been a works as an Academic Emergency Pediatric Emergency Medicine. She is Emergency Medicine. consultant for the IWK Regional Poison Physician at the Halifax Infirmary an Assistant Professor, Department of Centre since 2008, a medical control Emergency Department. He acts as Emergency Medicine, Trauma Team physician for the LifeFlight Critical Care the Program Director for the CCFP(EM) Leader and is currently completing transport program and a Trauma Team Emergency Medicine Residency a Masters in Health Professions leader at the Halifax Infirmary in Halifax Program. His research interests include Education through University of Illinois since 2011. Her academic interests ergonomic redesign of various aspects in Chicago. Her main interests centre are in the area of medical education of the Emergency Department. He has on learner education. Erin is the with an active role in undergraduate a strong interest in teaching and has Program Director for the Royal College medical education as the Unit Head for initiated and developed Clinical Teaching Pediatric Emergency Medicine Program Introduction to Clerkship and then PIER Rounds (CTRs) in the adult Emergency in the Department of Emergency 1 (Positioning, Integration, Evaluation, Department. Medicine. Research/Review) before becoming Program Director for the Royal College Emergency Medicine Residency Program at Dalhousie University in July 2014.
Departmental Review 2013-2014 Academic Department of Emergency Medicine 15 EDUCATION Under Graduate Medical Education
The department has increased its emphasis on the opportunity to contribute to UGME medical education. With a generalist approach to acute care issues and the Department’s already strong pedigree in critical thinking and clinical decision making, there is a natural UNDER GRADUATE COORDINATOR - ASSISTANT UNDER GRADUATE PEDIATRIC UNDERGRADUATE fit with the evolving CLERKSHIP DEAN - CLERKSHIP COORDINATOR - CLERKSHIP curriculum and many of CHRISTOPHER COX SIMON FIELD EMMA BURNS the recommendations MA, MD, DAEBM MD, CCFP(EM), FCFP, M.Ed MD, FRCPC in the Future of Medical Education in Canada Dr Chris Cox completed his medical Dr Simon Field graduated medical Dr Emma Burns graduated medical white paper(s). training at the Boston University School school at the University of Witwa- school at Dalhousie. Her Pediatric of Medicine and his Emergency Medicine tersrand in South Africa. He holds a residency was at Dalhousie University Residency at the New York University at Masters of Education, Curriculum Stud- and her Pediatric Emergency Bellevue Hospital, maintaining American ies from Acadia University. Currently, Medicine fellowship program was Board of Emergency Medicine (ABEM) Simon is a respected academic Emer- at the University of Ottawa. Now as Diploma Certification since 2001. Chris is gency Medicine Physician at the Halifax an Assistant Professor at Dalhousie currently the Undergraduate Emergency Infirmary and is known for his respect University, she is the Undergraduate Medicine Clerkship Coordinator, for others, his honesty and integrity as Medical Education Coordinator at the Dalhousie University. Some of his well as his sense of duty and responsi- IWK Emergency Department, and lead interests are in Emergency Department bility. He is an Associate Professor with physician for Pediatric Emergency point of care ultrasound for Trauma, the Department of Emergency Medicine Ultrasound Education and Simulation Cardiac, Pulmonary, First Trimester for Dalhousie University. Simon is cur- within the Pediatric Emergency pregnancy, renal system/abdominal pain, rently the Assistant Undergraduate Dean Medicine Fellowship. Her research vascular/thromboembolic disease, shock, of Clerkship for Dalhousie University. His interests include head injury in children orthopedic, and procedural applications, interests lie in the areas of Emergency and storytelling in medicine. Emma Pediatric EM, and EM Simulation. Chris department utilization; end-of-life care; is working to establish a bedside recently was co-author of the textbook assessment of learners; critical think- ultrasound program in the department. chapter “PoCUS in Early Pregnancy”. ing; and professionalism.
16 Academic Department of Emergency Medicine Departmental Review 2013-2014 Interprofessional Team Based Learning EDUCATION
Emergency Medicine, by its nature is a team sport. Emergency care is often started at the roadside or in the patient’s own home by paramedics and first responders. Different geographic locations call for different levels of response readiness and inter-professional teams. In regional and teaching hospitals there are often many overlapping but complementary roles and strengths of different members of the team. Communication, collegiality, and crisis resource management are a key aspect of inter-professional team paired learning which the Department of Emergency Medicine sees as a point of emphasis. In the Department of Emergency Medicine, we work with the belief that interprofessional collaboration and team based learning should begin early in a career. This early start not only gives the experience needed to collaborate effectively and efficiently, it also gives the opportunity to learn about the wide variety of people who work to enhance patient health within the province.
Departmental Review 2013-2014 Academic Department of Emergency Medicine 17 EDUCATION Simulation We have an active emergency simulation program. Our physicians are leaders in simulation training and contribute to learning at the undergraduate, postgraduate, and continuing education levels.
The Dalhousie University Department of Emergency Medicine ADULT SIMULATION LEADER: has embraced contextual experiential education through the STEPHEN G. MILLER adoption of simulation-based medical education. Supported BSc, MD, FCFP(EM), MEd in part by the Simulation Education Network, CDHA, and Dal- Dr Stephen Miller is an Assistant housie Medical School DEM is poised to have an explosion of Professor of Emergency Medicine simulation and will be on the leading edge of simulation based with a cross-appointment to the teaching and learning in Canadian academic medical institu- Division of Medical Education, tions. Our in Canadian academic medical institutions use of Dalhousie University. He works as an high fidelity simulators, combined with clinical grade cadavers, Emergency Physician at the Halifax and a stellar internationally recognized interprofessional teach- Infirmary in Halifax. Steve also holds ing faculty results in an unmatched educational experience. a Masters of Health Professions Our Department boasts the first undergraduate high Education (Curriculum Studies) from Acadia University and is fidelity simulation based curriculum, and we have active post the Medical Director of Emergency Medicine Simulation. graduate, and in situ simulation based learning occurring on a regular basis. Core EM material is being delivered through high fidelity simulation, which enriches learner outcomes while improving patient safety. With the creation of a new full PEDIATRIC SIMULATION LEADER: VERED GAZIT time simulation coordinator position for our very active ED MD Simulation Bay, we are able to devote attention to the details of Simulation Based Medical Education (SBME), and as we are Dr Vered Gazit is an Assistant soon to break ground on our new state of the art simulation Professor in the Department of bay, the demand for such programming across the Faculty of Emergency Medicine at Dalhousie Medicine delivered via EM staff will only increase. University. She is a Pediatric Finally, DEM interprofessional faculty have been instrumental Emergency Medicine Physician at in delivering simulation support and expertise to Dalhousie the IWK Health Centre. Vered is the UGME throughout areas such as PIERS and OSCE, and have Director for the Pediatric Simulation played leading roles in simulation based CPD such as the Program at the IWK Emergency Halifax Resuscitation Course, and Simulation Leader Instructors Department in addition to being the Physician Co-Lead for the Course, which have all worked to bring faculty together IWK Centre-wide Simulation Program. Vered also is the Disaster enriching the learning of all. Management Liaison for the IWK Emergency Department.
18 Academic Department of Emergency Medicine Departmental Review 2013-2014 Clinical Cadaver Program EDUCATION
Since 2007, the Dalhousie Division of Anatomy, in CGCs are now being used in a hospital setting to provide a collaboration with the Departments of Emergency Medicine multidisciplinary simulation environment for learners. and General Surgery, have been using “clinical grade There is no higher-fidelity simulation than one that cadavers” (CGC). These CGCs are preserved using a uses the human body as a medium for learning. Clinical newly-adapted embalming technique that retains a natural cadavers provide a cost-effective, safe solution for teaching compliance and texture that is very similar to that of living and learning lifesaving skills and address an experience/ human tissues. This embalming process preserves the competency gap where educational opportunities are body’s clinical condition for up to a month after the donor’s inadequate or simply not available in adequate numbers to death. The result is a truly realistic model that can replace attain or maintain competency. or augment the use of other simulators. At our institution, GEORGE J. KOVACS MD, MHPE, FRCP Dr George Kovacs is a Professor of Emergency Medicine Airway Management and is cross-appointed in the Departments of Anesthesia, Medical Neuroscience and Medical Halifax has an international reputation as a hotbed for airway management Education at Dalhousie education and research. This status has roots dating back 25 years when several University. George holds staff worked and trained as both Anesthesiologists and Emergency Physicians. This a Masters of Health Professions Education from collaborative spirit has continued with several members cross-appointed in the the University of Illinois. Departments of Emergency Medicine and Anesthesia. The AIME program (Airway In addition to being an Management & Interventions in Emergencies) was co-developed by Dr Adam Emergency Physician at the Law and Dr George Kovacs and has been providing hands-on, skill-based clinical Halifax Infirmary, George is learning experience to thousands of practitioners across the country for fifteen years. an award winning educator and is the Co-developer AIME is not a ‘physicians only’ program. It has been adopted as core curriculum of Airway Intervention for airway management in various places around the world helping clinicians in & Management in prehospital medicine, critical care transport and nursing take care of the acutely ill Emergencies (AIME) as well and injured. An accompanying textbook entitled Airway Management in Emergencies as being a text book author has been published in two editions with a 3rd on the way. Numerous staff members of Airway Management in make up a national faculty and are actively involved in airway management education Emergencies. and research.
Departmental Review 2013-2014 Academic Department of Emergency Medicine 19 RESEARCH Advancing Research
A productive and collaborative research engine that emphasizes improving patient outcomes through research and knowledge translation.
AT A GLANCE STRATEGIC INITIATIVES Grants Captured Enhance research structure and process via Dalhousie Build a sustainable research infrastructure. 25 department-wide communications, governance and a • Enhance the securing of grant funding through the Total Grant Funding common vision/approach. promotion and support of grant applications. $4,127,211 • Establish a functional steering committee with clear roles • Develop a Department-wide approach to ensure a critical Publications and responsibilities to steward and support the “Advancing mass of researchers with flexible, fair and sufficient salary 66 Research” section of the Deptartment of EM strategic plan. support. Abstracts • Establish a pragmatic process of nurturing the research 72 cycle from curiosity to idea/question to project (protocol/ Increase the quality/quantity of achievements and On Going Studies ethics/grant) to presentation/manuscript. activities. 97 • Establish a clear and shared vision of priority research foci within the Department (through natural selection but Promote and support research education at the ultimately emphasizing outcomes research). undergraduate, postgraduate, and faculty development • Continue to seek out and promote strategic inter- levels. departmental and inter-disciplinary research opportunities and alliances on a regional, national and international Enhance knowledge translation to health care providers basis. of all disciplines and levels.
20 Academic Department of Emergency Medicine Departmental Review 2013-2014 Research RESEARCH
HALIFAX INFIRMARY SITE STACY ACKROYD Since its inception, DIRECTOR EMERGENCY BSc(OT) MSc PhD the Department of MEDICINE RESEARCH: Emergency Medicine Dr Stacy Ackroyd is an occupational KIRK MAGEE has demonstrated an therapist and scientist with the exceptional commitment MD, MSc, FRCPC Department of Emergency Medicine. to building research capacity and advancing Dr. Kirk Magee is an Emergency She is Canada’s first post doctorate Medicine Physician, Halifax Infirmary. knowledge in emergency in patient safety, and was awarded medicine. Kirk completed his FRCPC in the Dr. David Rippey Patient Safety Our investigators Emergency Medicine and a Masters Fellowship Award for her proposal have a broad range of Science in Epidemiology at “Safer Medication Use in Emergency of research interests that reflect the diverse the University of Alberta. He is an Departments”. She received her Associate Professor, Department nature of clinical MSc in Community Health and Epidemiology at Dalhousie practice in emergency of Emergency Medicine with Dalhousie University and after University and has worked as a researcher since 1997. Her departments and in completing his term as the Program Director for the Royal present health services research focuses on patient safety for pre-hospital care. Our College Emergency Medicine Program, he serves as the Halifax older patients in the ED and acute care setting. She is involved particular research strengths are in the Infirmary Site Director of Research, Department of Emergency in patient safety education for medical students and with the areas of: Medicine, Dalhousie University and is a member of the Trauma Advancing Safety for Patients in Residency Education (ASPIRE) Team with the Nova Scotia Trauma Program. Kirk is also an Program with the RCPSC. • EMS and trauma Editor with the Cochrane Heart Group, and has an interest in systems systematic reviews. • resuscitation • advanced airway management • patient safety and clinical decision- making
We collaborate closely with EMS colleagues across Nova Scotia, Canada and the United States.
Departmental Review 2013-2014 Academic Department of Emergency Medicine 21 RESEARCH Publications A sample of the 66 peer reviewed manuscripts that have been published in 2013-2014.
Croskerry P. From Mindless to Mindful Practice - Cognitive Tallon J, Flowerdew G, Stewart R, Kovacs G. Outcomes in For a complete list of Bias and Clinical Decision Making. N Engl J Med 2013; Seriously Head-Injured Patients Undergoing Pre-Hospital publications visit: 368:2445-2448 Tracheal Intubation vs. Emergency Department Tracheal Intubation. Int J Clin Med 2013; 4(2):78-85 emergency.medicine.dal.ca Murphy L, Kovacs G, Reardon P, Law A. Comparison of the King Vision Video Laryngoscope with the MacIntosh Beatty L, Green R, Magee K, Zed P. A Systematic Review Laryngoscope. J Emer Med 2014; 47(2):239-46 of Ethanol and Fomepizole Use in Toxic Alcohol Ingestions. Emerg Med Int 2013; 2013 (Article ID 638057): 14 pages Howlett M, Doody K, Murray J, Leblanc-Duchin D, Fraser J, Atkinson P. Burnout in emergency health care professionals is Croskerry P, Petrie D, Reilly J, Tait G. Deciding About fast and associated with coping style: a cross sectional survey. Emerg Slow Decisions. Acad Med 2014; 89(2):197-200 Med 2015 Croskerry P. From Mindless to Mindful Practice - Cognitive Hurley K,, Magee K, Green R. Aminophylline for bradyasystolic Bias and Clinical Decision Making. N Engl J Med 2013; cardiac arrest in adults. Cochrane Database of Systematic 368:2445-2448 Reviews 2013; 2013(8): 1-42 Atkinson P, French J, Nice A. Procedural Sedation and Zed P, Black K, Fitzpatrick E, Ackroyd-Stolarz S, Murphy N, analgesia for adults in the emergency department. BMJ 2014 Curran J, MacKinnon N, Sinclair D. Outcomes of pediatric Ackroyd-Stolarz S, Bowles S, Giffin L. Validating patients presenting to the emergency department with a administrative data for the detection of adverse events in medication-related visit. CJEM 2013; 15(S1):EP01 older hospitalized patients. Drug Healthc Patient Saf 2014; 13(6):101-8
Editorials A sample of editorials published in 2013-2014.
Ross P, Atkinson P, Henneberry R. Coming of Age – Kovacs G. Airway management: “the times they are Emergency Point of Care Ultrasound in Canada. CJEM 2014; a-changin”. CJEM 2013; 0(0):1-4 16(4):265-268 Petrie D. Kreisberg J, Huffaker P. The First International Ackroyd-Stolarz S. Improving the prevention of pressure Congress on Whole Person Care - A Report. Perm J 2015; ulcers as a way to reduce health care expenditures. Spring;19(2):88-90 CMAJ 2014; 186(10):E370-1
22 Academic Department of Emergency Medicine Departmental Review 2013-2014 Abstracts RESEARCH A sample of the 72 abstracts that our research members have presented in 2013-2014.
Carter A, Jensen J, Greene J, Goldstein J, Swain J, Fidgen D, Jarvis C. Can a focused education program increase staff For a complete list of Richardson L, Cain E. State of the Evidence for EMS Care of familiarity with an emergency department disaster plan? abstracts visit: Respiratory Distress: An Analysis of Appraised Research from CJEM 2014; 16(S1):S93 emergency.medicine.dal.ca the Canadian Prehospital Evidence-Based Practice Project. Sowers N, Green R. Impact of the age of stored blood on PEC 2015; 19(1):166 trauma patient mortality: a systematic review. CJEM 2014; Campbell S, Magee K, Cajee I, Field S, Butler M, Campbell C. 16(S1):S108 The utility of measuring international normalized ratio (INR) as Loubani O, McVey J, Deveau B, Jensen J, LeRoux Y, Travers part of the investigation of patients with cardiac-type chest A. Paramedic Diagnostic Accuracy of ST-Elevation Myocardial pain. CJEM 2014; 16(S1):S30 Infarction on 12-Lead ECG: A systematic Review. PEC 2014; Atkinson P, Vailancourt C, Talbot J, Howlett M. Does increasing 18(1):124 age affect emergency physician willingness to work night Goldstein J, Carter A, Rockwood K, Travers A. Epidemiology shifts? CJEM 2014: 16(S1):S50 of prehospital emergency responses for older adults in a Loubani O, McVey J, Deveau B, Jensen J, LeRoux Y, Travers provincial EMS system. CJEM 2013; 15(S1):S72 A. Paramedic diagnostic accuracy of ST-elevation myocardial Travers A, Green R, Cain E, Campbell S, Jensen J, Petrie D. infarction on 12-lead ECG: a systematic review. CJEM 2014; Can paramedics diagnose sepsis in the prehospital setting? 16(S1):S54 A feasibility study. CJEM 2013; 15(S1):S55 Campbell S, Cajee I, Field S, Magee K, Butler M, Campbell Campbell S, Froese P, Butler M, Etsell G, LaPierre A, MacKinley C. The utility of chest x-ray as part of the investigation of R, Watson M, Magee K, Zed P, Kovacs G. Propofol is officially patients with chest pain suspected to be cardiac in origin. the “sedative of choice” in Halifax: An update from the Halifax CJEM 2014; 16(S1):S73 ED Procedural Sedation Registry. CJEM 2013; 15(S1):S46 Jensen J, Carter A, Rose J, Visintini S, McVey J, Bourdon E, Campbell S, Butler M, MacPhee S, Zed P, Froese P, Watson M. Brown R, Travers A. Alternatives to traditional EMS dispatch Is propofol for Emergency Department Procedural Sedation or transport to ED: a scoping review of published outcomes. any Less Safe in Older Teenagers than in Older Patients? CJEM 2014; 16(S1):S75 CJEM 2013; 15(S1):S46 Campbell S, Field S, Magee K, Cajee I, Butler M, Campbell C. Travers A, Green R, Cain E, Campbell S, Jensen J, Petrie D. The utility of routinely measuring serum electrolytes as part Can Paramedics Diagnose Sepsis in the Prehospital Setting? of the investigation of patients with cardiac-type chest pain. A Feasibility Study. PEC 2013; 17(1):109 CJEM 2014; 16(S1): S80 DeSousa N, Vaillancourt C, Atkinson P, Fraser J, Chandra Carter A, Gould J, Vanberkel P, Jensen J, Cook J, Carrigan S, K. Improving Emergency Department Care for Acute Wheatley M, Travers A. Offload zones in the emergency department Exacerbation of COPD. CJEM 2014; 16(S1) to mitigate emergency medical services (EMS) offload delay: a process map and hazard analysis. CJEM 2014; 16(S1):S80
Departmental Review 2013-2014 Academic Department of Emergency Medicine 23 RESEARCH Studies and Projects in Development
GRANTS IWK SITE DIRECTOR PEDIATRIC ELEANOR FITZPATRICK, EMERGENCY MEDICINE RN, MN, ENC(C) There have been 25 RESEARCH: Eleanor Fitzpatrick is the coordinator successfully captured KATRINA HURLEY grants from January 2013 MD, FRCPC of the IWK Health Centre Emergency to December 31, 2014. Department’s research program. • $4,127,211 as Primary Dr Katrina Hurley graduated She is one of the key players Investigator/or core from medical school at Memorial in the development of clinical research team based at University in Newfoundland. She Dalhousie research programs within the IWK pursued a residency in Emergency • Another $5,231,298 as Emergency Department. Prior to co-investigator/or core Medicine at Dalhousie University and her role in research she worked research team based at concurrently completed the Clinician as a pediatric emergency nurse another university Investigator Program and a Masters in Health Informatics. for 12 years. In addition to having an expertise in research She has been an Emergency Physician at the IWK since 2009 Some Examples: development and management, Eleanor has been an active and is an Assistant Professor in the Department of Emergency • Integrating Emergency investigator and collaborator on numerous clinical research health Services and Medicine. Katrina is the Division of Pediatric Emergency projects both locally, nationally and internationally. Her Palliative Care to Enhance Medicine Research Director and is author of the book “OSCE clinical research work is in the areas of parental uncertainty the End of Life Experience and Clinical Skills Handbook” published in 2011. Recently she in illness, patient safety, parent/family education and mental for Nova Scotia and has completed her second trip Prince Edward island health care in the Emergency Department. In addition to a to Haiti with the Broken Earth Cancer patients and research leadership role in the IWK Emergency Department Their Families. Organization and with her team she is presently a member of the IWK Research Ethics Board, Carter A, et all - they are beginning to campaign a member of the Translating Emergency Knowledge for Investigators for funds to be back in Haiti for Kids (TREKK) prioritization committee and a member of the Grant Provided by the the fall. Canadian Partnership Pediatric Emergency Research Canada (PERC) Executive. She Against Cancer has an academic appointment with the Faculty of Medicine at • Understanding Discharge Dalhousie University in the Department of Emergency Medicine. Instructions for Children and Caregivers in the Transition from Pediatric Emergency Care. Curran J, et all - Investigators Grant Provided by the Canadian Institute of Health Research (CIHR)
24 Academic Department of Emergency Medicine Departmental Review 2013-2014 Research Saint John RESEARCH
The Saint John Regional Hospital Department of Emergency Medicine’s Research Program has grown by leaps and bounds. The program has now proven to be well established with the appointment of Dr Paul Atkinson as Director of Research and Jacqueline Fraser, Research Coordinator. Studies have focused on bedside ultrasound, trauma, knowledge translation, and most importantly, improving patient care. The program provides research opportunities for many disciplines including medical residents and students. It is also recognized locally, nationally, and internationally as a leading program in Emergency Medicine research. Areas of collaboration / presentations of SJRH ED Research Program Collaboration has been a priority for the research program the Saint John Regional Hospital ED. The site also initiated as it helps raise awareness of the program. Partnerships have the formation of a Dalhousie DEM Ultrasound Research been developed with the Departments of Infectious Diseases working group which would see Atlantic Canada on the map & Pediatrics, Public Health, IWK, NB Trauma Program, for investigator initiated protocols and projects in the field of Department of Psychology, Research Services, Universities ultrasound. This group has just become a National Canadian of New Brunswick, Dalhousie, Calgary, Memorial, Capetown, Association of Emergency Physicians (CAEP) committee led and Cambridge, Canadian Centre of Vaccinology, and staff of by Dr Paul Atkinson.
SAINT JOHN SITE DIRECTOR EMERGENCY MEDICINE RESEARCH: PAUL ATKINSON, BSC(HONS), MB BCH BAO, MA(CANTAB), MRCP(UK), FCEM, CFEU
Dr Paul Atkinson’s career in Emergency Medicine has involved periods of learning, practicing medicine, teaching, and performing research, in internationally and regionally recognized teaching hospitals and tertiary centres such as the Royal Victoria Hospital in Belfast, Royal North Shore Hospital in Sydney, Australia, Addenbrooke’s Hospital, Cambridge University Hospitals in the UK, and now at Saint John Regional Hospital and Dalhousie University in Canada. Since receiving his Fellowship in Emergency Medicine, Paul has worked as a clinician, educator and researcher in the academic positions of Consultant and Associate Lecturer (Cambridge University), Professor (Dalhousie University) and Clinical Associate Professor (Memorial University).
Departmental Review 2013-2014 Academic Department of Emergency Medicine 25 RESEARCH Division of Emergency Medical Services (EMS) To advance the scientific knowledge of EMS by advocating for, facilitating and performing world class research, knowledge translation, education and leadership.
The Division of EMS seeks to improve patient care in DIRECTOR, DIVISION OF EMS: EMS through knowledge translation activities such as the ALIX CARTER Prehospital Evidence-based Practice (PEP) database, the MD, FRCPC, MPH introductory critical appraisal course Paramedic Evidence Dr Alix Carter is an emergency Based Practice (PEBP), and the hosting of journal clubs for physician working at the Halifax paramedics and others in EMS. Infirmary in Halifax. She is also Annually, the Division hosts an EMS Research Day, with an EMS physician and researcher, projects presented by local and national EMS researchers. working as Research Medical Through this opportunity, and chairing the Nova Scotia EMS Director at EHS Nova Scotia and Research Steering Committee, the Division works to advance Division Director at the Dalhousie EMS research and advocate for paramedic researchers. Division of EMS. Her research We also offer bursary support to paramedics who wish to interests are emergency health undertake post-graduate education, and to all researchers for system design and innovation. the performance or knowledge translation of research. The Division strives to educate EMS leaders for the future, providing opportunities for post-residency Fellowship, EMS The Department of Emergency Medicine / Division electives in medical school and residency, and research of EMS is proud that Dr Alix Carter (et all) is the opportunities for paramedics, physicians, or other scientists. successful recipient of a $1 million dollar grant The Division of EMS seeks to advance paramedicine provided by the Canadian Partnership Against as a health profession, and the discipline of EMS, valuing Cancer to improve and study the quality of life for innovation, mentorship, and interprofessional collaboration. palliative care patients. This is the culmination of significant work by many people and significant collaborations across disciplines, departments, and organizations.Most importantly, this innovative system level research will hopefully lead to improved quality of life and dignity of death in many patients that we often care for in the Emergency Department.
26 Academic Department of Emergency Medicine Departmental Review 2013-2014 Strengthening our People and Organizational Governance GOVERNANCERESEARCH
Effective, efficient, and adaptable support of the Department of Emergency Medicine CORE initiatives by engaging leaders and teams who create the conditions for emergence.
STRATEGIC INITIATIVES Entrench a governance as leadership model and board • Improve our communications activities to support the that meets the strategic, fiduciary, and generative department’s operational goals and strategic directions. challenges of the department. • Advocate for and influence important health system reform • Adapt the current organizational design to ensure through the strategic participation in university, district, streamlined processes are managed by appropriate provincial, national and international committees and leadership, committee structure, team members and working groups. administrative support. • Ensure ongoing fiscal responsibility through fair and • Strengthen faculty mentorship, career path counseling, competitive funding, transparent and priority-guided leadership development, and the wellness and resilience of budgeting and a transparent practice plan. physicians and teams.
Departmental Review 2013-2014 Academic Department of Emergency Medicine 27 OUR PEOPLE More Faces of Emergency Medicine
GRAHAM BULLOCK PAT CROSKERRY MD, FRCP(C) MD, PhD, FRCP(Edin) Dr Bullock came to Halifax in 1990, having completed Dr Pat Croskerry is a Professor in Emergency Medicine. specialty training in Emergency Medicine at the University In addition to his medical training, he holds a doctorate in of Western Ontario. During his time at Dalhousie, in addition Experimental Psychology with Fellowship training in Clinical to his clinical responsibilities he developed a keen interest Psychology. He has worked in the area of Patient Safety for the in medical education, specifically program design and last 15 years. He is senior editor on a major text ‘Patient Safety trainee assessment. In the late 1990’s, he helped found in Emergency Medicine’ published in 2008. He implemented the Faculty of Medicine’s Learning Resource Center and the first undergraduate course on medical error in Canada at led the development of its undergraduate Procedural Skills Dalhousie University. Pat received the Ruedy Award from the and Simulated Patient Programs. From 2003-2007, he was Association of Faculties of Medicine of Canada for innovation the RCPSC Program Director for Emergency Medicine at in medical education and then joined the teaching faculty for Dalhousie. He was a member of the RCPSC Examination the Canadian Patient Safety Officer Course in Ottawa, and, Board in Emergency Medicine from 1994-2000, and served the teaching faculty of the Netherlands Emergency Medicine as Chair from 2000-2004. A longstanding member of the Fellowship Training Program in Rotterdam. He is a past RCPSC Evaluation (now Assessment) Committee, he served Associate Editor of the journal Academic Emergency Medicine, as Chair from 2008-2013. In 2014, he left clinical practice to and currently a reviewer for several leading journals. He take the position of Medical Director – Physician Performance was appointed to the Board of the Canadian Patient Safety at the CPSNS, where he is responsible for College Institute (CPSI), then to Domain Co-Chair of the CPSI Safety assessment and educational programs. Dr Bullock continues Competencies initiative, and most recently to the CPSI Health to work in a consultative capacity to the Royal College as a System Innovation Advisory Committee. Senior Advisor on Examinations.
28 Academic Department of Emergency Medicine Departmental Review 2013-2014 OUR PEOPLE
The people who make up the Department of Emergency Medicine are its greatest strength.
JANET CURRAN RYAN J. HENNEBERRY RN, PhD MD, BSc, CCFP(EM), RDMS, Dip Sport Med Janet Curran is an Assistant Professor in the School of Nursing Ryan is a full-time Emergency Physician and Sports and the Department of Pediatrics and Emergency Medicine, Medicine Physician from Halifax. His primary practice is Dalhousie University. Janet also holds Affiliated Scientist rank at the Halifax Infirmary, Charles V. Keating Emergency & in Emergency Medicine at the IWK Health Centre and the Nova Trauma Centre and is the Director of PoCUS (Point of Care Scotia Health Authority. Her research is focused on developing Ultrasound) and the PGY1 Director for the Halifax Infirmary and evaluating interventions to improve transitions in care for Emergency Department. Ryan is also the chair of the patients and their caregivers. She was the 2015 recipient of the Canadian Association of Emergency Physicians (CAEP) PoCUS Pediatric Emergency Research Canada (PERC) Terry Klassen Committee and has contributed to various Emergency Critical Young Investigator Award and the Dalhousie University Faculty Care Ultrasound (ECCU), Emergency Department Echo (EDE), of Health Professions Early Career Research Excellence Award. Intensive Cardiad Care Ultrasound (ICCU), and the CAEP Janet’s research is supported by a CIHR New Investigator Emergency Department Targeted Ultrasound (EDTU). He has Award in Knowledge Translation and she currently leads a been an examiner for the CFPC (EM) qualifying exam, the CIHR-NSHRF funded multi-centred national study exploring best residency selection committee, medical school selection practice strategies for discharge communication in emergency committee, the Residency Progress Committee and Education practice settings. She is also collaborating with emergency Committee. Ryan also is a team physician for the Halifax clinicians and administrators from NSHA and IWK on a TRIC Moosehead’s Major Junior Hockey Club. funded study to improve care in the Emergency Department.
Departmental Review 2013-2014 Academic Department of Emergency Medicine 29 OUR PEOPLE More Faces of Emergency Medicine
CONSTANCE LEBLANC, JAN JENSEN FCFP, CCFP(EM), MAEd, Associate Dean, CPD ACP, MAHSR Dr Connie LeBlanc has been an Emergency Physician at the Jan L Jensen is the Performance Manager for EHS Operations Halifax Infirmary since 1989, is a Professor of Emergency Management in Nova Scotia. She is an Advanced Care Medicine and has served as Associate Dean for Continuing Paramedic and has worked in the EHS ground ambulance Professional Development (CPD) since 2010. She is a CAEP system in the Central region, serving in operations and Education Champion and a speaker for their EM Review Road continuing education leadership positions. Jan has worked Show new this year. She is a member of the IFEM CPD and in Nova Scotia’s prosperous EMS research program and has education committees and Chair of the Emergency Medicine received her Masters in Applied Health Services Research examination committee for the College of Family Physician from Dalhousie University. Her last most recent position was of Canada. Connie provides workshops and invited lectures as Research Leader for the EHS system. In addition, Jan is broadly and is involved in research in medical education she an Assistant Professor with the Dalhousie University Division has presented nationally and internationally. Her masters’ thesis of EMS (Department of Emergency Medicine). Her areas of focused on the Hidden Curriculum in Emergency Medicine. research are paramedic clinical decision making, evidence- She is currently the Education Director for the Department of based practice and health services research in EMS. Of note, Emergency Medicine for Dalhousie University in Halifax. Connie she was the principal investigator for the recent Canadian has been the recipient of several awards including a Freddie National EMS Research Agenda study, she is a senior editor Film Award for the PARTY program, a Clinical Scholar Award in of the Canadian Prehospital Evidence-based Practice (PEP) Education and was rated as Internet Gold for her presentation project, and she is a member of the International Liaison at the Essentials of Emergency Medicine in 2015. Committee on Resuscitation (ILCOR).
30 Academic Department of Emergency Medicine Departmental Review 2013-2014 OUR PEOPLE
CARL JARVIS NANCY MURPHY MSc, MD, CCFP(EM) MD, CCFP(EM), DABEM(TOX) Dr Carl Jarvis has been at the Halifax Infirmary Emergency Dr. Nancy Murphy is an Emergency Physician at the Halifax Department since 2005. He graduated from Dalhousie Medical Infirmary and the Medical Director of the IWK Regional Poison School in 1993 and Family Medicine in 1995. After practicing Centre. Nancy completed a fellowship in Medical Toxicology in the United States for eight years, he moved to Sudbury, and Clinical Pharmacology at the University of California in Ontario, in 2003 to study Emergency Medicine. In addition to San Francisco. She is the only American Board-Certified his clinical practice, he is the Medical Director of Emergency Medical Toxicologist in the Atlantic Provinces. Nancy serves Preparedness. He has served on several provincial working as a member of the Executive Council for the Academic groups, partnered in developing and delivering the federally Department of Emergency Medicine. Her interest focus is on sponsored METER program (Medical Emergency Treatment for antidote stocking and antidote use as well as adverse drug Exposure to Radiation) across Canada. Carl has also served as events and acetaminophen toxicity. an expert in disaster preparedness in variety of local, provincial and national projects. He is a director of the Center for Excellence in Emergency Preparedness, and Atlantic Regional Director for Canadian Medical Assistance Teams (CMAT). In March 2011, Dr Jarvis went to Japan as the Medical Lead of a CMAT medical team. His special interests include radiation emergencies, research, and ultrasound.
Departmental Review 2013-2014 Academic Department of Emergency Medicine 31 Academic Department of Emergency Medicine DEPARTMENTAL REVIEW 2013-2014
emergency.medicine.dal.ca