Sherman D Quan

• MSc
• Senior Manager at Accenture

BACKGROUND Hospitalized patients with complex care needs require an interprofessional team of health professionals working together to support their care in hospital and during discharge planning. However, interprofessional communication and collaboration in the inpatient setting is often fragmented and inefficient, leading to poor patient outcomes...

Background Hospitalized patients with complex care needs require an interprofessional team of health professionals working together to support their care in hospitals and during discharge planning. However, interprofessional communication and collaboration in inpatient settings are often fragmented and inefficient, leading to poor patient outcomes...

Background: Teamwork and interprofessional communication are important in addressing the comprehensive care needs of complex hospitalized patients. The objective of this study is to evaluate the impact of an electronic interprofessional communication and collaboration platform on teamwork, communication, and adverse events in the hospital setting....

Objectives: User involvement is vital to the success of health information technology implementation. However, involving clinician users effectively and meaningfully in complex healthcare organizations remains challenging. The objective of this paper is to share our real-world experience of applying a variety of user involvement methods in the des...

Objective To evaluate in patients who deteriorate and require transfer to the intensive care unit (ICU), how many have a critical text message communicating deterioration and what is the quality of this message? Is message quality, message response or the timeliness of rapid response team (RRT) activation related to death? Methods We conducted a r...

Objective: To describe the uses of institutional and personal smartphones on General Internal Medicine wards and highlight potential consequences from their use. Methods: A mixed methods study consisting of both quantitative and qualitative research methods was conducted in General Internal Medicine wards across four academic teaching hospitals...

BACKGROUND There is increasing interest in the use of information and communication technologies to improve how clinicians communicate in hospital settings.METHODS We implemented a communication system with support for physician handover and secure messaging on 2 general internal medicine wards. We measured usage and surveyed physicians and nurses...

Background: Smartphones are becoming ubiquitous in health care settings. The increased adoption of mobile technology such as smartphones may be attributed to their use as a point-of-care information source and to perceived improvements in clinical communication and efficiency. However, little is known about medical students' use of personal smartp...

Background Hospitals today are experiencing major changes in their clinical communication workflows as conventional numeric paging and face-to-face verbal conversations are being replaced by computer mediated communication systems. In this paper, we highlight the importance of understanding this transition and discuss some of the impacts that may e...

Evaluating the features and performance of health information systems can serve to strengthen the systems themselves as well as to guide other organizations in the process of designing and implementing surveillance tools. We adapted an evaluation framework in order to assess electronic immunization data collection systems, and applied it in two Ont...

As part of a series of feasibility studies following the development of Canadian vaccine barcode standards, we compared barcode scanning with manual methods for entering vaccine data into electronic client immunization records in public-health settings. Two software vendors incorporated barcode scanning functionality into their systems so that Algo...

Background We describe our experiences with identifying and recruiting Ontario parents through the Internet, primarily, as well as other modes, for participation in focus groups about adding the influenza vaccine to school-based immunization programs. Objective Our objectives were to assess participation rates with and without incentives and softwa...

Vaccination of health care workers (HCWs) is an important patient safety initiative. It prevents influenza infection among patients and reduces staff illness and absenteeism. Despite these benefits, HCW influenza immunization uptake is low. Therefore, strategies to achieve high immunization coverage in HCWs, barriers to uptake, and perceptions of m...

Medical trainees increasingly use smartphones in their clinical work. Similar to other information technology implementations, smartphone use can result in unintended consequences. This study aimed to examine the impact of smartphone use for clinical communication on medical trainees' educational experiences. Qualitative research methodology using...

Background Although interruption of endemic measles was achieved in the Americas in 2002, Quebec experienced an outbreak in 2011 of 776 reported cases; 80% of these individuals had not been fully vaccinated. We analyzed readers’ online responses to Canadian news articles regarding the outbreak to better understand public perceptions of measles and...

Institutions have tried to replace the use of numeric pagers for clinical communication by implementing health information technology (HIT) solutions. However, failing to account for the sociotechnical aspects of HIT or the interplay of technology with existing clinical workflow, culture, and social interactions may create other unintended conseque...

Background: Immunization rates are used to assess the level of protection against influenza, but limited data exist on how such rates are measured in health care organizations. We conducted key informant interviews with campaign planners to learn about processes for collecting immunization data, including barriers and facilitating factors for meas...

Background: Effective clinical communication is critical to providing high-quality patient care. Hospitals have used different types of interventions to improve communication between care teams, but there have been few studies of their effectiveness. Objectives: To describe the effects of different communication interventions and their problems....

Individual-level immunization data captured electronically can facilitate evidence-based decision-making and planning. Populating individual-level records through manual data entry is time-consuming. An alternative is to use scannable forms, completed at the point of vaccination and subsequently scanned and exported to a database or registry. To ex...

Background Although many studies have demonstrated the benefits of reminder/recall (RR) measures to address patient under-immunization and improve immunization coverage, they are not widely implemented by healthcare providers. We identified providers’ perceived barriers to their use from existing literature. Methods We conducted a systematic revie...

Introduction: Through our research into the design and evaluation of technology systems to improve the quality and safety of clinical communication, we have discovered that physicians and nurses differ in perspective regarding clinical prioritization and desirable response times. This has a number of important consequences including unnecessary in...

Background: The success of influenza vaccination campaigns may be suboptimal if subgroups of the population face unique barriers or have misconceptions about vaccination. We conducted a national study to estimate influenza vaccine coverage across 12 ethnic groups in Canada to assess the presence of ethnic disparities. Methods: We pooled response...

Background: Immunizing health care workers against influenza is important for preventing and reducing disease transmission in health care environments. We describe the ability of Canadian health care organizations to measure influenza immunization coverage among health care workers and identify factors associated with comprehensive influenza immun...

To conduct a systematic review of the literature to identify, describe and assess interventions of information and communication technology on the processes of communication and associated patient outcomes within hospital settings. Studies published from the years 1996 to 2010 were considered and were selected if they described an evaluation of inf...

Clinical communication is recognized as a major source of errors in hospitals. The lack of documentation of communication, especially among verbal interactions, often creates hindrances and impedes improvement efforts. By providing smartphones to residents and encouraging nurses to communicate with residents by email shifted much of the communicati...

In response to the need for improved quality of vaccine inventory and client immunization records, barcodes containing a unique identifier and lot number will be placed on all vaccine vials in Canada. We conducted feasibility studies to examine integration of barcode scanning into inventory recording workflow for mass immunization clinics. During t...

One in seven pages are sent to the wrong physician and may result in unnecessary delays that potentially threaten patient safety. The authors aimed to implement a new team-based paging process to reduce pages sent to the wrong physician. The authors redesigned the paging process on general internal medicine (GIM) wards at a Canadian academic medica...

The 2009 H1N1 pandemic vaccination campaign was an excellent opportunity to witness the many benefits of collecting individual-level immunization data at the point of vaccination. Most provinces and territories required the reporting of at least partial demographic vaccination data from their local public health agencies, so timely vaccine coverage...

During the pandemic (H1N1) 2009 influenza vaccination campaign, health regions in Canada collected client-level immunization data using fully electronic or hybrid systems, with the latter comprising both electronic and paper-based elements. The objective of our evaluation was to compare projected five-year costs associated with implementing these s...

A critical component of the 2009 H1N1 vaccination campaign was the collection of immunization data at the point of care. To meet reporting requirements and to ensure timely availability of coverage information, many jurisdictions across Canada employed new or modified approaches to vaccine data collection. The objective of this study was to observe...

Communication between clinicians is critical to providing quality patient care but is often hampered by limitations of current systems. Smartphones such as BlackBerrys may improve communication, but studies of these technologies have been limited to date. Our objectives were to describe how smartphones were adopted for clinical communication within...

General internists perform a large number and variety of procedures in the ward and emergency department settings. Initiatives are needed to facilitate learning and increase efficiency of procedural skill acquisition by trainees. In this article, we describe our experience developing and implementing a low-cost multimodal procedure cart in an acade...

For patients with critical laboratory abnormalities, timely clinical alerts with decision support could improve management and reduce adverse events. The authors developed a real-time clinical alerting system for critical laboratory abnormalities. The system sent alerts to physicians as text messages to a smartphone or alphanumeric pager. Decision...

Medication-prescribing errors with adverse drug events impose substantial harms on patients and health systems. Medication errors resulting in preventable adverse drug events most commonly occur at the ordering stage. Electronic prescribing may prevent such errors but its impact has not been rigorously evaluated. We conducted a pragmatic cluster ra...

During the pandemic (H1N1) 2009 vaccination campaign, vaccine providers collected immunization data using hybrid (paper-based and electronic methods) and electronic data systems. We measured staff time in seconds spent on data collection tasks to compare system efficiencies. The sample consisted of 38 organizations across nine Canadian provinces/te...

Background During the 2009 H1N1 immunization campaign, electronic and hybrid (comprising both electronic and paper components) systems were employed to collect client-level vaccination data in clinics across Canada. Because different systems were used across the country, the 2009 immunization campaign offered an opportunity to study the usability o...

Communication between clinicians is hampered by the frequent difficulty in reaching the most responsible physician for a patient as well as the use of outdated methods such as numeric paging. The aim of this study was to evaluate the use of smartphones to improve communication on internal medicine wards. At the Toronto General Hospital, residents w...

Immunization information systems (IISs) are electronic registries used to monitor individual vaccination status and assess vaccine coverage. IISs are currently not widely used across Canada, where health jurisdictions employ a range of approaches to capture influenza immunization information. Conducted in advance of the 2009 H1N1 vaccination campai...

Perceptions of Pandemic (H1N1) 2009 Influenza Client Data Collection Methods Questionnaire Questionnaire to elicit perceptions of data collection method employed at the respondent's clinic.

H1N1 Immunization Clinic Data Collection Methods Observation Guide Guide used to direct the passive observation component of the study.

Collected Data Elements Questionnaire Questionnaire to determine what data are collected at the respondent's clinic, as well as key functionalities of the system employed.

The collection of individual-level pandemic (H1N1) 2009 influenza immunization data was considered important to facilitate optimal vaccine delivery and accurate assessment of vaccine coverage. These data are also critical for research aimed at evaluating the new vaccine's safety and effectiveness. Systems used to collect immunization data include m...

Timely and reliable communication of critical laboratory values is a Joint Commission National Patient Safety Goal. The objective was to evaluate the effect of an automated system for paging critical values directly to the responsible physician. A randomised controlled trial on the general medicine clinical teaching units at an urban academic hospi...

The collection of individual-level immunization data at the point of vaccination is ideal for immunization clinic operations, rapid and precise monitoring of vaccine coverage and the evaluation of vaccine safety and effectiveness. While this practice has been adopted for routine childhood and seasonal influenza immunization in selected Canadian jur...

The University Health Network equipped the Gastroenterology consult service with Apple iPhone devices and provided access to push e-mail, phone and Internet access to clinical content and applications. We used pre-post surveys to assess the iPhone's impact on clinical communication, and we held interviews to obtain subjective user feedback, compari...

Numeric pagers are commonly used communication devices in healthcare, but cannot convey important information such as the reason for or urgency of the page. Alphanumeric pagers can display both numbers and text, and may address some of these communication problems. Our primary aim was to implement an alphanumeric paging system. Continuous quality i...

Canadians are living longer with chronic medical conditions, which have led to an increasing complexity and volume of care for hospitalized patients. Effective in-patient care depends on the effective coordination of care through rapid and efficient communication between various care providers. A delay in coordinating this care has downstream effec...

Newer outpatient electronic prescribing software programs produce typewritten paper prescriptions with electronically created signatures. Current Canadian federal legislation forbids static (unchanging) signature images on prescriptions. We conducted a randomized trial of electronic prescribing in outpatients at a university-affiliated hospital. Th...

Medication errors, adverse drug events and potential adverse drug events are common and serious in terms of the harms and costs that they impose on the health system and those who use it. Errors resulting in preventable adverse drug events have been shown to occur most often at the stages of ordering and administration. This paper describes the pro...

Sunnybrook Health Sciences Centre developed and implemented a physician-focused web-based patient sign-out application in January of 2005 with 40 different groups throughout the hospital now using it. More groups are continuing to request access to the system, including nursing and other multidisciplinary groups. The success of the system is attrib...