Improving practice in the PICU is a passion of mine. There is a multitude of best practice work completed in critical care; the challenge becomes in implementing those foundational concepts to the bedside for best patient outcomes. This knowledge translation is one of the key pieces in the quality improvement initiatives that I have completed to date. Looking forward, I think a focus on the patient experience in their journey through a critical care unit will offer many unique and interesting insights upon which our next quality improvement initiatives can be anchored.


All hands on deck: A multidisciplinary approach to SARS-CoV-2-associated MIS-C
Paediatrics and Child Health (Canada)
Lopez, A.A. and Patel, M. and Rayment, J.H. and Tam, H. and Roberts, A. and Laskin, S. and Tucker, L. and Biggs, C.M. and Ahmed, M.A. and Barakauskas, V. and Galanis, E. and Goldfarb, D. and Halparin, J. and Harris, K.C. and Kissoon, N. and Lawrence, S. and McGuffin, D. and Meckler, G. and Noel, K. and Schrader, D. and Sherwood, M. and Singh, A. and Vercauteren, S.
DOI: 10.1093/pch/pxab110

Sepsis in the pediatric intensive care unit
Journal of Pediatric Infectious Diseases
Mona Singal and Yumiko Mizuno and Peter Skippen and Niranjan Kissoon
DOI: 10.3233/jpi-2009-0158

Culture, Communication and Safety: Lessons from the Airline Industry
The Indian Journal of Pediatrics
Lori G. d’Agincourt-Canning and Niranjan Kissoon and Mona Singal and Alexander F. Pitfield
DOI: 10.1007/s12098-010-0311-y

Commentaries on ‘Fluid therapy for acute bacterial meningitis’
Evidence-Based Child Health: A Cochrane Review Journal
Mona Singal and Peter Skippen and David Isaacs
DOI: 10.1002/ebch.304

Journal of Investigative Medicine
M. Singal and A. N. Prasad and V. Kamaya-Miyakawa and T. Benoit and A. Hanlon-Dearman and C. Prasad
DOI: 10.1097/00042871-200701010-00369

Do most premature babies get discharged by the expected date of delivery?
Journal of Perinatology
Patel, J. and Patel, M. and Tucker, L. and Kalikkot, R. and Desai, J.
DOI: 10.1038/s41372-020-0653-x


Improving communication from OR to PICU
This quality improvement initiative set the aim of reducing patient safety events relating to OR to PICU handover. Utilizing QI methodology, we were able to identify key areas of vulnerability and set a new handover standard to address those concerns. This new handover standard dubbed the “PATHQS” has been utilized in the PICU for over 2 years now with excellent impact in reducing safety events. The future direction for this work is to generate spread within the institution and beyond as the tool has excellent cross-applicability.

Time out for patient safety
Invasive procedures are carried out on patients frequently in the intensive care unit. These can be as simple as dressing changes or as complex as surgeries to implement life saving heart-lung bypass (ECLS). Regardless, these procedures are often done in an urgent fashion with teams unknown to one another coming together to serve the patient. This type of collaboration can be high-risk if there is not an alignment of understanding around the intended procedure and expected outcome. This project will address the need for a standardized “time out” that is specific to the needs and concerns of a PICU patient. In doing so, the hope is that team members will be clear on expectations and goals of the procedures and patients can have smooth delivery of care. All of this would be expected to reduce the risk of error over the course of the care.

Honours & Awards

Runner up, BCPSQC 2021 Quality Awards’ Excellence in Quality: Returning to Health and Wellness. Situation Critical: Improving Patient Safety for High-Risk Cardiac Patients (HRCP)

Storyboard Winner, BCPSQC Forum 2020: PATHQs – “Did I Miss Anything?” Improving Handover from the OR to the PICU

Runner Up, BC Children’s and Women’s Award of Excellence for Interprofessional Collaborative Practice: PICU Rounds Optimization