Air Quality Measurement Survey, 2006 Smoking Ban in Public Places
An investigation into the effect of government closure of designated smoking rooms (DSRs) in restaurants and bars in the Province of Ontario. Establishments with DSRs were identified using a systematic sampling procedure. Using air quality measurement equipment, staff measured carcinogens and pollutants and documented factors that may affect air flow before and after implementation of the smoking ban. A marked reduction of airborne carcinogens and pollutants was found thus demonstrating the success of the smoking ban.
Design of data-collection and program-implementation protocols and analysis for an education and intervention program to reduce red-cell use in the Province of Ontario. The ONTraC Program was designed to reduce unnecessary red-cell use in elective surgery by salvaging a scarce blood supply and reducing patient exposure to blood overall. A transfusion nurse conservation educational program was initially implemented in 23 hospitals in the Province. Our task was to establish procedures to 1) implement the program 2) measure the impact and 3) determine a feasible method to continue and expand the program across the Province. An in-hospital protocol allowing the nurses to educate patients and staff, monitor blood use and document relevant outcomes was developed. Blood use in elective (non-emergency) procedures was monitored over time. Analysis showed a significant reduction in red-cell use with related reduction in costs and patient exposure to blood. There is ongoing monitoring, and expansion to an array of elective procedures. ONTraC is now a mandated program in all Provincial hospitals.
Provincial Blood Use Data Analysis Project
Determination of baseline levels of red-cell use for planned surgical procedures over time and assessment of variation in red-cell use for similar procedures across institutions. The Provincial Blood Use Data Analysis Project was proposed, funded, and undertaken to assess Provincial trends in blood use. An analytic dataset of over 5 million hospital discharges was compiled between 2000 and 2005. Analysis of blood use in relation to surgical/clinical procedures was used to assist in forecasting of provincial blood needs and to serve as a template for ongoing review. The study found that there was an overall reduction in red cell use/procedure for specific surgeries over time. Furthermore, study findings showed great variation in red-cell use among hospitals for similar surgical conditions, indicating a need for education and standardization of transfusion practice.
Blood Conservation and Bloodless Medicine Program Evaluation (2003-2005)
12 projects funded by the Ontario Ministry of Health and Long Term Care (MOHLTC) were evaluated for their efficacy in reducing red cell use. Each project was assessed in terms of goals, program, analysis and outcome in terms of the original mandate of the funding program (to facilitate a reduction in red cell use without sacrificing patient safety). Six out of 12 projects were directly effective in reducing red-cell use. Others made educational and theoretical contributions that could lead to standardization (but not a reduction) of blood use. Findings indicated a need for the enhancement of future project requirements to those with the potential to directly reduce red cell use rather than generally address transfusion issues. This is relevant to future funding allocations intended to maximize the use of the blood supply.
Other EPI-STAT work includes projects such as:
Participation in the development of the provincial SARS Monitoring Database; investigation of adverse events of specific over-the-counter medication and acquisition of materials for U S litigation purposes; participation in ethics review of pharmaceutical trials; and consultation to assist in development of research in a treatment-oriented environment.