Andrew Petrosoniak @petrosoniak Twitter profile

Last Seen Profiles

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Andrew Petrosoniak

@petrosoniak

2 years

Just going to put this here… #GetVaccinated

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Andrew Petrosoniak

@petrosoniak

2 years

We keep hearing how our healthcare system is collapsing (which it is). But that does nothing to improve our understanding. Let’s use a hypothetical emergency department visit to highlight the disaster that is happening every day around the country. Here’s a thread 🧵:

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Andrew Petrosoniak

@petrosoniak

2 years

People ask me how is the emergency department these days, is there much #COVID19 anymore? My observations below in a short🧵 TL/DR = the healthcare system is a disaster and it will be years before it improves...so buckle up. 1/

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Andrew Petrosoniak

@petrosoniak

8 months

I just finished an emerg shift in rural Ontario today. I saw an elderly patient who didn’t have a family doctor. I asked the nurses if there’s a clinic accepting patients RN: No but they can put their name on the wait list. Me: How long is that? RN: About 4yrs. What?

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Andrew Petrosoniak

@petrosoniak

1 year

The Thai Cave Rescue might be one of the most impressive examples of high stakes decision making & human performance in recent memory. The exact details of what happened are truly amazing and warrant a deeper dive. What can we learn from this unbelievable success story? 🧵 1/

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Andrew Petrosoniak

@petrosoniak

2 years

As a fellow emerg doc, I'm extremely disappointed to see this inaccurate focus on COVID related illness as the main cause for incr ED wait times and staff shortages. Rather the link to COVID is that it exposed a system that has always been non functional, but now just more so.🧵

André Picard

@picardonhealth

2 years

'I’m a veteran ER doctor. I can’t believe what I'm seeing' -- There's a crisis in Canadian health care and a new wave of #COVID19 is making a dire situation worse, by @KashPrime via @macleans @johnadams51677 #cdnhealth #CanadaWAITS

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Andrew Petrosoniak

@petrosoniak

2 years

I'm sad for the people of #ontario as they must get used to waiting >6-12hrs for emergency department visits for the foreseeable future. A friend visited a GTA hospital recently with chest pain....and left after 12hrs before seeing an MD. This is a problem.

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Andrew Petrosoniak

@petrosoniak

8 months

Make no mistake the recent words of the premier touting the strength of our healthcare system are not anchored in reality. The many amazing healthcare workers battle a dysfunctional system to continue to deliver care despite the govt Let me help the premier understand better 1/

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Andrew Petrosoniak

@petrosoniak

3 years

THREAD: Some thoughts on the 3rd wave... I'll be completely honest, I didn't think 3rd wave was a thing a few wks ago...and I work in the emergency dept. Full disclosure, it now appears I was very wrong (for anyone who knows me...i hate being wrong...)

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Andrew Petrosoniak

@petrosoniak

8 months

I’m watching this after my last shift when there were 12hr waits, we closed an entire section of our ED bc we didn’t have enough nurses and I’ve worked 3 shifts in the last 3wks in EDs that would’ve temporarily closed otherwise. This is not a system we should be proud of.

Doug Ford

@fordnation

8 months

When it comes to accountability and why the people of Ontario can trust this government, our track record speaks for itself.

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Andrew Petrosoniak

@petrosoniak

1 year

I woke up this morning and almost spit out my coffee... I was shocked that Nadia Surani, @ONThealth official had the audacity to put these thoughts in a formal request...and was actually serious.. My wife and my dad are both primary care docs. A 🧵 1/

Ontario asks family medical clinics to work nights, weekends to help overwhelmed hospitals | CBC...

Ontario has asked thousands of family health-care workers to work evenings and weekends to help ease the burden on overwhelmed children's hospitals.

www.cbc.ca

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Andrew Petrosoniak

@petrosoniak

10 months

Please tell me this is a joke. Let me rephrase… EDs that move people thru quicker and provide faster visits (regardless of quality) will get more funding. Oh good. This just represents a complete misunderstanding of ED care. I don’t even know where to start. 1/

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Andrew Petrosoniak

@petrosoniak

2 years

Might be time to start “bring a politician to work” days…so they can get a firsthand look at what’s happening in Canada’s emergency departments… Spoiler alert: it’s not good. @alandrummond2 @davidcarr333

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Andrew Petrosoniak

@petrosoniak

2 years

"Boosted" is the new fully vaccinated. It's time to change that narrative. We have ~30% fully vaccinated in #ontario .

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Andrew Petrosoniak

@petrosoniak

2 years

25/ You hope the pain doesn't come back. You never want to go through that process/visit again. The ED staff will be back. At least the ones who haven't left for good. There's no happy endings here. End/

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Andrew Petrosoniak

@petrosoniak

2 years

Still waiting for someone to ask me the brand name of tetanus vaccine they get in emerg… And I can’t remember the last time someone declined a tetanus vaccine for a disease that has about 50 cases/yr in the US. Humans aren’t always great at risk appraisal

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Andrew Petrosoniak

@petrosoniak

1 year

To the staff member who wrote this… Medical school comes first. Then med students apply for residency positions. If this tweet is our barometer of govt understanding medicine and assoc training…we have a problem

Doug Ford

@fordnation

1 year

Too many Ontario students are having to go abroad for medical school because they can’t find residency spots here at home. That’s why we’re expanding the number of medical school spots and putting qualified Ontario students at the front of the line.

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Andrew Petrosoniak

@petrosoniak

2 years

Seeing multiple EDs across the province closing represents nothing short of a crisis. These EDs and ICUs were built for a reason and to imagine we are now closing them despite rising volumes and demands leaves me speechless. Here's a 🧵 on crisis management 1/

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Andrew Petrosoniak

@petrosoniak

2 years

We're basically watching a mass exodus from #healthcare . This should worry every single one of us. I'm looking at all of you politicians...its time to devote more time/resources to fix a broken system than ever. If you thought #covid19 was a crisis...naw, we got it beat 11/

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Andrew Petrosoniak

@petrosoniak

2 years

This is an incredible and awful state of affairs in a UK ED (not too different in Canada). However, let's breakdown this outstanding communication (content & delivery): 🧵 - Clear & loud delivery of the message - Used SBAR Situation/Background/Assessment/Recommendations 1/

Gary Sitton

@SittonGary

2 years

@AdamBienkov My local A&E last night.

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Andrew Petrosoniak

@petrosoniak

2 years

Top 5 regrets looking back at life. I recently read this work again by Bronnie Ware, an Australian palliative care nurse who wrote about what her patients told her at the end of their lives. She's distilled it down into 5 themes. I think about these to maintain perspective

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Andrew Petrosoniak

@petrosoniak

2 years

This is the most thorough and accurate depiction of our failing healthcare system. It’s told thru the lens of ⁦ @alandrummond2 ⁩ who has been witness to it all and also an amazing advocate along the way. Now it’s time for our govts to step up

State of Emergency: Inside Canada’s ER Crisis - Macleans.ca

I’ve been an urgent-care doctor for 39 years, and my department has never been closer to collapse. We’re not alone.

www.macleans.ca

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Andrew Petrosoniak

@petrosoniak

4 years

Last week, we posted about the opening of our new trauma bay @UnityHealthTO , a space that we “purposely designed, extensively tested, revised with end-user feedback.” – @HumanFact0rz #design #trauma #emergencymedicine Here's a thread with more details 1/

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Andrew Petrosoniak

@petrosoniak

1 year

Starting March 31st @ONThealth announced they will purposefully & systematically reduce healthcare access to those who are marginalized or under resourced. Ont govt will end a program that provided healthcare access to the uninsured. Here’s a 🧵 on what this means. 1/

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Andrew Petrosoniak

@petrosoniak

1 year

A few reflections as I look around a dysfunctional healthcare system. I see firsthand every day how terrible the situation is yet one of the unfortunate features of staffing a system with such resilient healthcare workers...is that it will never truly "collapse"... 🧵

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Andrew Petrosoniak

@petrosoniak

2 years

This isn't a thread with answers. I'm reminded of this quote when I hear people pitch "a quick fix" for healthcare. We would benefit however from going back to first principles, breaking it down into components and engaging end-users (clinicians & patients) in the process. End

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Andrew Petrosoniak

@petrosoniak

6 days

I'm often asked about how stressful it is to work in the emergency dept. I answer yes, but not for the reason ppl think Patients near death when minutes matter...that's not stressful...it's what we do A system that inadvertently makes work more difficult is why it's stressful

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Andrew Petrosoniak

@petrosoniak

8 months

I supervise ~ 3-4 family medicine residents/mo during their ED rotation It's been >5yrs since one told me they were planning to start a practice. Every single one plans to locum, hospitalist or work in EM. Primary care is in trouble. This won't help.

An extra year of training is coming for Canada's family doctors — but do they need it? | CBC News

The College of Family Physicians of Canada wants to increase the length of a family medicine residency from two years to three, as a way of preparing doctors for more complex patients. But the plan...

www.cbc.ca

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Andrew Petrosoniak

@petrosoniak

2 years

If we want to fix burnout in healthcare. Don't make us more resilient. Don't make us do more e-modules for wellness. No need for free food. Rather look at the micro-frustrations that accumulate as we attempt to complete seemingly easy tasks...that's where the money's at. END

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Andrew Petrosoniak

@petrosoniak

8 months

Categorically false. Support is NOT always available when ppl need it. Every day I see people in the ED who would benefit from outpatient counselling and psychiatric services who simply cannot get access to such help. Wait lists are months-yrs long. This needs to change.

Sylvia Jones

@SylviaJonesMPP

8 months

This #MentalIllnessAwarenessWeek , remember that support is always available when you need it. Through One Stop Talk, our government is connecting children, youth and their families to more convenient mental health counselling when and where they need it. #MIAW23

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Andrew Petrosoniak

@petrosoniak

2 years

22/ No one in the ED is happy about 10hr waits. No nurse, doctor, clerical or any other clinician wants this. Its just that the system is maxed. Beyond maxed. And the result is that there's too few resources to provide care to everyone in a timely manner.

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Andrew Petrosoniak

@petrosoniak

5 years

So this just happened. The trophy made the trip to @StMikesHospital . A thank you for the amazing response from all the staff last week. #WeTheNorth @Raptors

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Andrew Petrosoniak

@petrosoniak

2 years

3/ They’ve escorted out 3 people in 12hrs for assaulting HCWs. Those HCWs are still at work, b/c there’s no one to replace them. They’ve prevented an individual with a weapon from entering the ED and harming those inside. I wish I could say the hospital is always a safe place.

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Andrew Petrosoniak

@petrosoniak

2 years

9/ There's no slack in the system. Equipment is missing b/c supply chain is disrupted. Clinical spaces aren't getting cleaned b/c cleaning staff are gone. Nurses and doctors are understaffed today, so you’ll be waiting longer. But you won’t know that. We don’t advertise it.

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Andrew Petrosoniak

@petrosoniak

1 year

The complete disrespect towards clinicians & lack of understanding by @ONThealth of the current healthcare system disaster is shocking This request to work 24/7/365 would've been like asking the Titanic deckhands to work a little harder shortly after the iceberg was struck 3/

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Andrew Petrosoniak

@petrosoniak

2 years

7/ Also, the staff hate answering questions about wait times because they rarely predict right and the last time they gave an answer and were wrong - they were verbally abused by those waiting. Sometimes its not worth guessing.

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Andrew Petrosoniak

@petrosoniak

2 years

21/ Finally your nurse and doctor return to review your results with you. Your tests are normal and fortunately you’re feeling better. It’s been 10hrs. In the mind of your doctor and nurse, 10hrs from start to finish is pretty good. That’s our new normal.

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Andrew Petrosoniak

@petrosoniak

3 years

It’s probably time to start using the term “vaccine preventable deaths”. #COVID19 cc @HumanFact0rz @davidcarr333 @drmwarner @TorontoIDDoc @ASPphysician @shanxonline @IrfanDhalla

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Andrew Petrosoniak

@petrosoniak

2 years

11/ You watch others get angry too. In fact 2 people yell hateful slurs at the nurse and one tries to attack them as they’re assisting another patient. You think, this is crazy. It is. And it happens every day.

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Andrew Petrosoniak

@petrosoniak

2 years

At patient level This is an awful time. Wait lists are longer than I've ever seen. People have neglected their healthcare needs for 2.5yrs...or worse, the system has neglected it for them. 12/

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Andrew Petrosoniak

@petrosoniak

3 months

The situation for family physicians in Canada hits close to home. Thank you ⁦ @CTVNews ⁩ for the profile of my dad, Dr Peter Petrosoniak who’s been trying to retire for nearly 2yrs but doesn’t want to leave his patients. Yet no one wants to take it.

Doctor with hundreds of patients puts off retirement, concerned about who will care for them

A Canadian family doctor originally planned to retire at age 72. He's putting it off because he hasn't been able to find any physicians willing to take over his practice.

www.ctvnews.ca

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Andrew Petrosoniak

@petrosoniak

2 years

15/ They ask you about your pain & your medical history. You’re surprised they don’t have it all available, isn't it all in the computer? Unfortunately not the ones from your specialist’s office. This shocks you. I wish it shocked me.

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Andrew Petrosoniak

@petrosoniak

4 years

And we were wondering whether kids could wear masks indoors? The resilience of children that is all too often tested in many parts of the world is nothing short of remarkable. An awful scene that provides a next level of perspective on how fortunate many of us are.

James Denselow

@jamesdenselow

4 years

Pupils start the new school year in Taez, Yemen

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Andrew Petrosoniak

@petrosoniak

1 year

This letter needs an apology to every hard working primary care physician and frankly to all healthcare clinicians acknowledging this was a mistake and that this in fact is NOT a solution. END

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Andrew Petrosoniak

@petrosoniak

2 years

The opportunity cost of spending this effort towards #covid19 means that everything (or nearly everything else) has been delayed, attention diverted or fallen off the priority list. What does that mean? Well not only have regular operational efforts been paused... 4/

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Andrew Petrosoniak

@petrosoniak

2 years

8/ You look around and its chaos. People running everywhere. Little has been improved in >2.5yrs. COVID took everyone's attention. Most staff have left. Those who remain are too tired to fix it.

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Andrew Petrosoniak

@petrosoniak

2 years

23/ You get a referral for follow-up but the wait is going to be 2-3 months. That’s the best they can do. The long wait times aren't unique to the ED. It's the entire system. Trust me, we're just as angry as you about this wait.

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Andrew Petrosoniak

@petrosoniak

2 years

16/ So your doctor asks yet you can’t really remember the details. The doctor examines you but before they can explain next steps, they’re called away. You hear “code blue” over head. This means nothing to you. To us, it means someone is dying and needs our attention.

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Andrew Petrosoniak

@petrosoniak

2 years

5/ They’re the only one working and haven’t eaten or a break 8hrs into the shift. They’re tired and angry, they were called in because it the dept was so short staffed. You register, get your vitals taken. You tell the nurse about your abdominal pain.

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Andrew Petrosoniak

@petrosoniak

2 years

4/ You make your way past security into the waiting room. You’re confused because there are people everywhere and there’s limited signage. It’s loud. Some yelling, others in pain. The waiting room is packed. Standing room only. The triage nurse is extremely busy.

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Andrew Petrosoniak

@petrosoniak

5 months

Why meet in a boardroom? Come on down to your nearest emergency dept. I will gladly you show you around the dumpster fire that is Ontarios healthcare system. There will be plenty of patients in hallways to meet for photo ops

Sylvia Jones

@SylviaJonesMPP

5 months

Yesterday, @fordnation and I sat down with Kimberly Moran and the Ontario Medical Association team on her first day as CEO. As a strong advocate for family doctors during her previous role, I know Kimberly will continue to be a champion for all of Ontario's physicians.

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Andrew Petrosoniak

@petrosoniak

2 years

it means that nearly all #innovation has been put on hold too. At the beginning of the pandemic, there were lots of stories of rapid innovation but as everyone got worn down, that stopped. Yes, we've still be doing some non-covid work for sure, but not like pre-pandemic. 5/

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Andrew Petrosoniak

@petrosoniak

2 years

Every process that I encounter on a regular basis is harder to do now than pre-covid. By ALOT. Combine that with a patient population who's tired, also burnout, stressed and in pain...its no wonder violence/verbal abuse among HCWs is on the rise 8/

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Andrew Petrosoniak

@petrosoniak

2 years

Post pandemic...run that same marathon without puffers but you're carrying your friend on your back...its not going to be pretty.. The efficiency in the system has diminished substantially and there's simply no slack to tolerate the multiple levels of added friction. 7/

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Andrew Petrosoniak

@petrosoniak

6 months

I've started teaching my daughter effective learning techniques. Here's what the evidence tells us Best: practice testing, distributed practice Moderate: self-explanation, interleaved practice, elab interrogation Worst: summarizing, highlighting, rereading, mnemonics 🧵 1/

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Andrew Petrosoniak

@petrosoniak

3 years

Communications should now be heavily weighted towards directing people to less risky behaviour. Let ppl know "how they can socialize"...e.g. outdoors. Its a vastly different mindset once we adopt a harm reduction approach (which is well supported by evidence) 9/

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Andrew Petrosoniak

@petrosoniak

2 years

2/ Imagine you have abdominal pain. You make the decision to go emerg. You arrive by car and walk up to the doors. You’re greeted by security. Maybe you might find this uninviting for a hospital. Well, these security guards are unfortunately necessary.

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Andrew Petrosoniak

@petrosoniak

4 years

THREAD: This wk, @SickKidsNews published a proposed approach to return to school. It generated a spectrum of opinions on social media & TV/radio. I'll discuss how this is a wicked problem and a #design approach should be used, at least in part. 1/

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Andrew Petrosoniak

@petrosoniak

2 years

6/ Your vitals are normal and return to the waiting area. Now you wait. For how long, you have no idea. And frankly no one working really knows either. We can give you an estimate…today, likely 4hrs but inevitably sicker people will come in & bump you down the queue

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Andrew Petrosoniak

@petrosoniak

2 years

It just isn't possible because there's just one crisis after another that's clamouring for our attention (e.g. staffing, new waves). Imagine you have an asthma attack while running a marathon...and you lost your puffers...that was our HC system pre-pandemic... 6/

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Andrew Petrosoniak

@petrosoniak

2 years

10/ You watch others who showed up after you seeming to go ahead. This doesn’t seem fair. The issue is that their condition was deemed more urgent or life-threatening. But on the surface, it seems unfair and it makes you frustrated especially since you’re in pain.

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Andrew Petrosoniak

@petrosoniak

2 years

The short answer in my experience/observation is, no we're not overwhelmed with #covid19 patients requiring ICU level care in the hospitals. But...that oversimplifies the current state. Let's look at it from the hospital, clinician and patient/family perspective... 2/

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Andrew Petrosoniak

@petrosoniak

1 year

Anyone that understands complex systems...and its clear Nadia Surani does not...knows that relying on individuals to make up for system level dysfunction is a nonstarter In fact, such a "strategy" leads to nothing more than resentment, burnout and in fact worse outcomes... 4/

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Andrew Petrosoniak

@petrosoniak

2 years

17/ Your doctor is angry because the computer system isn’t working. They’ve been yelled at all shift just like the nurses. They have nowhere to see other patients who are waiting and the number of patients just keeps growing. Its like running a marathon…except there’s no end.

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Andrew Petrosoniak

@petrosoniak

2 years

At a clinician level, we've all heard about the staffing crisis that hospitals/clinics across the country are experiencing. Nurses, physicians, clinical support staff, and pretty much all clinical team members are exhausted and leaving. To where? I'm honestly not sure. 9/

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Andrew Petrosoniak

@petrosoniak

2 years

But I'll tell you where they aren't...doing the same clinical work they were doing pre-pandemic. Every week there's news reports of EDs closing or at risk of closing. I hear from patients every day that they're family doctor retired and they can't find a new one. 10/

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Andrew Petrosoniak

@petrosoniak

2 years

19/ And there’s only 1 CT technologist because, you guessed it, they’re short staffed too. Two critical patients bump you down the list, though you’ll never know this. You just wait. 7hrs later you get a CT scan. Then you wait more.

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Andrew Petrosoniak

@petrosoniak

2 years

At the system level Healthcare leadership, running large multi-million dollar organizations have spent the past 2.5yrs devoting most of their effort towards managing a crisis of epic proportions. 3/

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Andrew Petrosoniak

@petrosoniak

4 years

Thread A byproduct of the confusing #ontario govt #covid19 response is “well my kids are in school, so I can't limit my contacts, its pointless”. This is also known as “all or nothing” cognitive distortion. Specifically, it is evaluating ones life in extremes 1/

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Andrew Petrosoniak

@petrosoniak

2 years

24/ You’re discharged home. You ask whether everything will be forwarded to your family doctor. In a functional system, for sure…but in this one, there’s no guarantees

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Andrew Petrosoniak

@petrosoniak

2 years

This is an outstanding demonstration of how communication should occur during a high-risk/high stakes situation. It's honest. It's clear. It acknowledges the situational challenges. We'd benefit from similar comms techniques in Canadian ED waiting rooms (unfortunately).

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Andrew Petrosoniak

@petrosoniak

1 year

I mean she’s welcome to come to work with me and tell the patients who have been waiting 8-10hrs to “stop their complaining”…🤣🤣🤣 Who is this? And is she serious? I’m sorry she’s tired of listening to “the complaining”…maybe tell @alandrummond2 lol

MPP Catherine Fife

@CFifeKW

1 year

This is what we’re dealing with at Queen’s Park…a health care parliamentary assistant who makes a mockery of the challenges in our system. #onpoli

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Andrew Petrosoniak

@petrosoniak

3 years

The current situation is looking very worrisome. On top of that, most ppl are just fed up. I dont blame them. But I'd say we're past hoping and relying on individuals to behave in the preferred way...its probably time for our behavior to be defaulted towards what's needed. END

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Andrew Petrosoniak

@petrosoniak

2 years

PSA: for anyone visiting an ED in #ontario in the next few months (hopefully not years...but likely)... 3hrs is the new 30min wait time. For non life threatening issues, if you see an MD within 3hrs...consider yourself lucky...unfortunately.

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Andrew Petrosoniak

@petrosoniak

1 year

Anyone who's recently been to an emergency dept in Ontario recently knows things aren't exactly going well. It's remarkable that the gov't is cutting physician hours (not how much we get paid) but rather how many MDs we can staff in many EDs around ON. TL/DR - bad idea. 1/

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Andrew Petrosoniak

@petrosoniak

2 years

Healthcare today and for the foreseeable future.

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Andrew Petrosoniak

@petrosoniak

2 years

18/ 1hr later, some seemingly random person (though dressed in scrubs) tells you that you’re going for a CT scan. You’re next on the list. What you don’t know is that one of 2 CT scanners is broken tonight...

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Andrew Petrosoniak

@petrosoniak

8 months

This week almost every patient I saw in the ED waited >6hrs. I told each patient I'm sorry they had to wait. Not because I felt responsible but because I felt bad for them. A "system" delivering "emergent" care regularly >6-12hrs is no long a system but rather a failure.

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Andrew Petrosoniak

@petrosoniak

2 years

TL/DR: Canada's healthcare system is broken, flawed & needs an honest review My dad is a family doc in a small ON town. He's worked for >40yrs. He knows the HC system better than most. Last week he called to ask me for help for a neurologist referral. I'm an emerg doc 🤷‍♂️ 1/

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Andrew Petrosoniak

@petrosoniak

2 years

13/ They also have 7 other patients (way too many but there’s just no other nurses left) so they don’t have much time for you. They wish they did. They ask if you need pain meds then leave.

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Andrew Petrosoniak

@petrosoniak

3 years

THREAD: Spent the past 2 days co-designing & testing the #CovidVaccine administration process @UnityHealthTO using #simulation informed #design . A huge multi-disciplinary effort coordinated by @Sim_StMikes . cc: @IrfanDhalla Here's some insights into the process 1/

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Andrew Petrosoniak

@petrosoniak

2 years

The challenges to access care from primary care, to diagnostics to speciality care... straight up...is bananas. Add on the numbers of HCWs leaving...and its no wonder waitlists are shifting from wks to months to years... 13/

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Andrew Petrosoniak

@petrosoniak

2 years

12/ The security guards you met earlier remove the individuals. The waiting room calms briefly. Finally, after 3 hours with little understanding about your wait, you move into a room. Another nurse comes in, takes blood tests & starts an IV. They ask you more about your pain.

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Andrew Petrosoniak

@petrosoniak

3 years

THREAD: Here’s a bit of a systems take on what we’re seeing in the Ontario healthcare system. #covid19 A system that is under stress behaves differently than one that is working efficiently. 1/

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Andrew Petrosoniak

@petrosoniak

2 years

20/ You see people in pain lying in the hallways. Another nurse tells you, it won’t be much longer until the results are back. “not much longer” could mean 15min or 3hrs.

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Andrew Petrosoniak

@petrosoniak

4 years

I'm fascinated by how we can leverage evidence to inform behavior change. A thread based on literature & our #design of spaces & processes in high-stakes environments @AdvPerformHD @HumanFact0rz @ASPphysician @jyangstar 1/

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Andrew Petrosoniak

@petrosoniak

2 years

So, in summary: 1. declare the crisis 2. use transparent communication 3. hyperfocus on 2-3 priorities 4. Make a safe & quick first decision to buy time We can't afford to wait. END

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Andrew Petrosoniak

@petrosoniak

2 years

The result, clinicians repeat tests, repeat procedures and ultimately bill the govt. This is expensive. If there was one focus for any future govt is a uniform EMR across the province. Yes up its up front costs but it would yield massive long term savings 7/

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Andrew Petrosoniak

@petrosoniak

2 years

14/ Your wait continues. You move to another waiting area. Again its packed. There’s more people in pain, tired, angry. Eventually you move back to a room. Its now 4hrs. A doctor finally enters.

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Andrew Petrosoniak

@petrosoniak

3 years

Have we started giving #covid19 vaccines to patients upon discharge from hospital yet (or during their stay)? Seems like it would make things easier for people, no? #human -centered #design cc @AmolAVerma @IrfanDhalla @ASPphysician

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Andrew Petrosoniak

@petrosoniak

2 years

This should be of utmost concern to the govt and requires a hard look at why this is happening. Patients without family physicians don’t “inappropriately” use the ED…they just get sick and actually need hospitalization.

Pandemic spurred exodus of Ontario family doctors, study indicates | CBC News

Ontario family doctors left the profession at the start of the pandemic at double the rate of the years before COVID-19 hit, new research indicates.

www.cbc.ca

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Andrew Petrosoniak

@petrosoniak

3 years

I have had to revise my perspective. What is happening in the emergency dept over the past week...is very alarming. Patients who are completely healthy, and well under 50yrs getting admitted, requiring O2 and some ICU. In short...these variants are no joke... 4/

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Andrew Petrosoniak

@petrosoniak

2 years

This seems like a bit of a disaster waiting to happen…we discovered this during in situ #simulation testing this morning Manufacturers need to do better Under pressure, it’s predictable these 2 very different meds could get mixed up #clinical #design #HumanFactors

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Andrew Petrosoniak

@petrosoniak

2 years

Every day clinicians struggle with equipment, space and layout that encumbers, rather than helps them do their job. A 🧵on how we applied human factors principles, usability testing & #simulation informed design to our new pediatric resus tower 1/

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Andrew Petrosoniak

@petrosoniak

1 year

We're left with a system that is being propped up by the resiliency of a few. The greatest pitfall, is that it never truly collapses. HCWs will be victims of their own resiliency and patients will suffer along the way...unfortunately rarely obvious enough to motivate change

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Andrew Petrosoniak

@petrosoniak

2 years

Processes/systems and ultimately patients & clinicians suffer as a result. 14/ IMO the issues facing healthcare are not COVID's direct impact on staffing or illness, but the systemic issues which it has unfortunately exposed.

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Andrew Petrosoniak

@petrosoniak

1 year

And our social network includes many other... Like most other primary care docs, every night my dad and my wife work late into the evening doing notes, checking results, following up with patients and prepping for the next day...7 days/wk already... 2/

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Andrew Petrosoniak

@petrosoniak

9 months

Video review of critical events is a game changer in healthcare yet underutilized I've started routinely video recording intubations (my own & my trainees). Sports has long realized this benefit. Here are my thoughts and why its so effective 🧵 1/ #meded #deliberatepractice

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Andrew Petrosoniak

@petrosoniak

2 years

I've seen patients waiting months to see specialists, years for MRIs And on the regular, hours to days to even make it into a bed in the ED (if they ever do). 14/

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Andrew Petrosoniak

@petrosoniak

1 year

This is among the most impressive medical events I’ve come across at both a human performance and tactical level. Consider using some of the key decision making tactics described above when faced with your next crisis. And congrats to the heroes who made this happen END

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