CAHD-ACDH The national voice of Canadian hospital-affiliated dentists cahd@cahd-acdh.ca

Toronto 2019

Speakers

Craig Dale

Craig Dale RN PhD CNCC(C)

Dr. Dale is an Assistant Professor at the Lawrence S. Bloomberg Faculty of Nursing. He is also a CIHR IMHA Embedded Clinician Scientist in Oral Health at Sunnybrook Health Sciences Centre (Toronto) and a Scientist at the University of Toronto Centre for the Study of Pain (UTCSP).

Dr. Dale’s research focuses on fundamental patient care for acute and chronically critically ill adults including oral hygiene, pain, and communication. He specializes in qualitative, mixed-methods, and patient engagement research approaches.

Advancing the Evidence for Oral Care in ICU Patients

Evidence-based guidelines recommend routine application of chlorhexidine oral rinse to reduce the risk of ventilator-associated pneumonia (VAP) in mechanically ventilated patients in the intensive care unit (ICU). Recent reappraisal of the evidence in two independent meta-analyses suggest chlorhexidine may cause excess mortality in non-cardiac surgery patients and does not reduce VAP or treatment duration. This presentation will report on the results of the CHORAL study which aims to evaluate the impact of de-adopting chlorhexidine and implementing an oral care bundle (without chlorhexidine) on mortality, infection-related ventilator-associated complications (IVACs) and oral health status in critically ill adult patients.

Tony Eskander

Tony Eskander MD, ScM, FRCS(C)

Dr. Eskander is a head and neck oncologist and reconstructive microvascular surgeon with an interest in health services research, clinical epidemiology and quality improvement. He has extensively studied head and neck cancers in Ontario and published an ICES epidemiological atlas in conjunction with Cancer Care Ontario. As an otolaryngologist – head and neck surgeon his interests go beyond oncologic research. He is interested in studying access to care, disparities in care, adherence to guidelines, volume-outcome associations, and quality metrics. Ultimately, he would like these studies to lead to quality improvement initiatives that can improve the quality of care and outcomes.

HPV and Head and Neck Cancer

An interactive lecture reviewing the most up-to-date evidence of the role of HPV in head and neck cancer incidence, treatment, and prognosis with a focus on how this may impact the practice of a hospital dentist. The latest evidence and guidelines for testing of HPV status in suspected malignancies of the upper aerodigestive tract will be reviewed. Updated evidence on the utility of HPV in the work up and management of the unknown primary neck mass will be emphasized. The impact on prognosis (and staging) will be discussed with a focus on recent controversy surrounding HPV status on prognosis for non-oropharyngeal subsites. Recommendations on how the clinician should converse with patients (and families) regarding the diagnosis will be highlighted while reviewing evidence on how this impacts patient/partner sexual behavior. Vaccination recommendations will be bolstered with evidence from recent studies demonstrating no impact on sexual behavior of teens receiving the vaccine.

Wendy Levinson

Wendy Levinson MD, OC

Dr. Wendy Levinson is a general internist and past Chair of Medicine at the University of Toronto. Dr. Levinson is the Chair of Choosing Wisely Canada and leads an international collaboration of over 20 countries implementing Choosing Wisely. She is an Officer of the Order of Canada for her leadership in academic medicine.

Choosing Wisely Canada

Choosing Wisely Canada (CWC) is the national voice on reducing overuse of unnecessary tests and treatments that do not add value or can even be harmful to patients. Choosing Wisely is a national, clinician-led and grassroots which has partnered with over 70 clinician societies from different clinical specialties and disciplines to develop lists of tests and treatments that “Clinicians and Patients Should Question.” In 2018, the Canadian Association of Hospital Dentists joined the CWC campaign, releasing a list of ‘Eight Things Dentists and Patients Should Question’. Choosing Wisely has supported CAHD in disseminating the list and in engaging professionals, patients and the general public in dialogue about overuse in dentistry.

Dr. Levinson will provide an update on the activities of CWC and lead interactive discussion on opportunities for further involvement of Canadian dentists in Choosing Wisely initiatives.

Dr. Andrew Morris

Dr. Andrew Morris, MD, SM(Epi), FRCPC

Dr. Morris is a Professor of Medicine at the University of Toronto and the Medical Director of the Sinai Health System-University Health Network Antimicrobial Stewardship Program. He is currently Chair of the Antimicrobial Stewardship Committee for the Society for Hospital Epidemiology of America (SHEA) and chairs the Antimicrobial Stewardship Working Group for Accreditation Canada. He was appointed to the Canadian Government’s Expert Advisory Group on Antimicrobial Resistance (EAGAR) in 2015.

Dr. Morris is widely sought as a speaker and consultant on antimicrobial stewardship, behaviour change, implementation, and quality improvement. He is an author of over 100 peer-reviewed publications.

The Rise of Hospital Acquired Infections

Hospital-acquired infections are one of the most important patient safety and healthcare quality issues in 2019. Dr. Morris will discuss C. difficile infection, ventilator-associated pneumonia, and catheter-associated bloodstream infections as they are related to hospital dentists. He will also touch on contemporary issues in antimicrobial resistance, and what the hospital dentist needs to know.

Donald Redelmeier

Donald Redelmeier MD, MSHSR, FRCPC, FACP

Dr. Redelmeier is a staff physician, Division of General Internal Medicine, Sunnybrook Health Sciences Centre; a senior scientist at the Sunnybrook Research Institute and the Institute for Clinical Evaluative Sciences; Professor, Department of Medicine, University of Toronto; and the Canada Research Chair in Medical Decision Sciences.

His research focus is medical decision science. Other professional interests include clinical effectiveness, clinical economics, medical decision-making, health services delivery, pre-hospital/emergency care and public and population health.

Pitfalls of Reasoning in Dental Practice

Medical decision science explores how people reason, formulate judgments and make decisions. The term “medical” is used in the broad sense to include all actions that contribute to health. The term “people” is used in the broad sense to include clinicians, patients and policymakers. This field is not limited to doctors or confined to clinical care. The main rationale for this field is that medical care requires judgment, judgment raises the risk of error and error provides an opportunity for improvement.

Sharon Straus

Sharon Straus MD, FRCPC, MSc

Dr. Straus is a geriatrician and clinical epidemiologist who trained at the University of Toronto and the University of Oxford. She is the Director of the Knowledge Translation Program and Deputy Physician-in-Chief, St. Michael’s Hospital; Director, Division of Geriatric Medicine, University of Toronto; and Vice Chair and Professor, Department of Medicine, University of Toronto. She holds a Tier 1 Canada Research Chair in Knowledge Translation and Quality of Care and has authored more than 400 publications and 3 textbooks in evidence-based medicine, knowledge translation and mentorship. Since 2015, she has consistently been in the top 1% of highly cited clinical researchers as per Web of Science. She holds more than $57 million in peer reviewed research grants as a principal investigator.

Why #MeToo Matters in Health Care Education and Leadership

At Canadian universities, women have outnumbered men at the undergraduate level for over 25 years. However, there are fewer women than men who hold senior academic and leadership positions, even though enough time has passed for junior women to advance to such positions, indicating this isn’t a pipeline issue. If our faculty do not reflect our student pool and national population, we are depriving Canada of talent. Studies have also suggested that women are less likely to be promoted, be awarded grants and receive lower salaries than men. Women are also less likely to have access to informal networks, which may promote mentorship and career development and are also more likely to experience incivility from patients, colleagues and trainees. This session will include interactive discussion on the gender gap in academic medicine, contributing factors, and potential strategies to mitigate and monitor this gap.