Frequently Asked Questions

The checklist is used at three distinct stages or phases during surgery:

• pre-induction (before the patient is put to sleep)
• time out (just before the first incision)
• and debriefing (during or after surgical closure)

Some examples of items contained in the checklist include:

The briefing phase:

• Verify with patient name and procedure to be done
• Allergy check
• Medications check
• Operation site, side and procedure
• Lab tests, X-rays

The “time out” phase:

• Patient position
• Operation site and side and procedure
• Antibiotics check

The debriefing phase:

• Surgeon reviews important items
• Anesthesiologist reviews important items
• Nurse reviews correct counts 

Patient safety is a number one priority for all KGH. There are numerous checks and balances in place to ensure the safety of our hospital but hospital care is complicated and depends on many factors. The public reporting of hospitals’ checklist compliance rates is not intended to serve as a measure for hospitals to compare themselves against other organizations, or for the public to use as a measure of where to seek care. Like other patient safety indicators, it is important to look at checklist compliance rates in a broader context. The rates must be examined in order to get a sense of how hospitals are performing – where they excel and where improvements could be made. It is important to look at all of these indicators in combination.

The public reporting of our surgical checklist percentage compliance allows us to establish a baseline from which we can track over time. We will closely monitor our rates and should they decrease, we will look closely at our operating room processes and target areas for improvement. The checklist percentage compliance measures the degree to which all three phases (i.e., a briefing, a time out, and a debriefing) of the checklist were performed correctly and appropriately for each surgical patient. We are always striving for 100 per cent compliance. 

Hospitals will post their bi-annual percentage compliance at the end of July and January.

KGH implemented the checklist in one surgical specialty in November 2009. The checklist was implemented in all surgeries in April 2010.

As part of the Ministry of Health and Long-Term Care’s public reporting of patient safety indicators initiative, eligible hospitals are legally required to post their checklist compliance percentages. KGH strongly supports the provincial government’s strategy to publicly report patient safety Indicators because we believe it will enhance patient safety and strengthen the public’s confidence in our hospitals.

The Canadian Patient Safety Institute has a checklist template that has mandatory requirements for Ontario hospitals to use. KGH then adds additional items to this template that allows us to customize items to fit the type of surgeries performed here and have been declared to be important to the KGH patient population. 

If you undergo a surgery at Kingston General Hospital, you can expect that the surgical safety checklist will be used as part of the procedure. As a patient, you will be asked questions by a surgical team member so that they can complete a portion of the checklist with you.  It will then be used by your surgical team members before, during and after your surgery to help the surgical team members familiarize themselves with your medical history and any special requirements that may be needed for your individual case. 

Operating room teams have many important steps to follow in order to ensure a safe and effective surgery for every patient. The checklist is a useful tool that helps promote good communication and teamwork among the health care team to help ensure the best outcomes for patients.

The checklist is used at three distinct stages or phases during surgery:

• pre-induction (before the patient is put to sleep)
• time out (just before the first incision)
• and debriefing (during or after surgical closure)

Some examples of items contained in the checklist include:

The briefing phase:

• Verify with patient name and procedure to be done
• Allergy check
• Medications check
• Operation site, side and procedure
• Lab tests, X-rays

The “time out” phase:

• Patient position
• Operation site and side and procedure
• Antibiotics check

The debriefing phase:

• Surgeon reviews important items
• Anesthesiologist reviews important items
• Nurse reviews correct counts 

A surgical safety checklist is a patient safety communication tool that is used by a team of operating room professionals (nurses, surgeons, anesthesiologists, and others) to discuss important details about each surgical case. In many ways, the surgical checklist is similar to an airline pilot’s checklist used just before take-off. It is a final check prior to surgery used to make sure everyone knows the important medical information they need to know about the patient, all equipment is available and in working order, and everyone is ready to proceed. 

The checklist is used at three distinct stages or phases during surgery:

• pre-induction (before the patient is put to sleep)
• time out (just before the first incision)
• and debriefing (during or after surgical closure)

Some examples of items contained in the checklist include:

The briefing phase:

• Verify with patient name and procedure to be done
• Allergy check
• Medications check
• Operation site, side and procedure
• Lab tests, X-rays

The “time out” phase:

• Patient position
• Operation site and side and procedure
• Antibiotics check

The debriefing phase:

• Surgeon reviews important items
• Anesthesiologist reviews important items
• Nurse reviews correct counts 

The checklist is used at three distinct stages or phases during surgery:

• pre-induction (before the patient is put to sleep)
• time out (just before the first incision)
• and debriefing (during or after surgical closure)

Some examples of items contained in the checklist include:

The briefing phase:

• Verify with patient name and procedure to be done
• Allergy check
• Medications check
• Operation site, side and procedure
• Lab tests, X-rays

The “time out” phase:

• Patient position
• Operation site and side and procedure
• Antibiotics check

The debriefing phase:

• Surgeon reviews important items
• Anesthesiologist reviews important items
• Nurse reviews correct counts 

A bacteremia is the presence of bacteria in the bloodstream and is referred to as a bloodstream infection.

A bacteremia is the presence of bacteria in the bloodstream and is referred to as a bloodstream infection.

Generally, people do not die if they infected with VRE. In severe cases of VRE bacteremias can lead to death. This is rare and tends to occur in those people with other severe health problems. The vast majority of people recover from VRE once their health is restored.

If a patient is simply carrying VRE, no treatment is necessary, as the organism will be cleared on its own when the person’s health is restored. If it is determined that the patient is infected (they have a blood infection, urine infection or wound infection etc.) then the patient will treated with the appropriate antibiotic as determined by a physician.

We do not routinely monitor or isolate persons who carry VRE. Patients with VRE infections are identified during their care and treated accordingly.

All infection prevention and control precautions or Routine Practices aim to limit the spread of any bacteria to other patients and to health care providers.  

Here at KGH we do not routinely place patients on precautions or isolate those who carry or are infected with VRE. Routine Practices are used because VRE, like other germs can be spread from one person to another by contact; hand hygiene is critical to preventing the spread of all infections in a healthcare setting. Health care providers are routinely required to clean their hands before, during and after patient contact. We also clean and disinfect all patient rooms and equipment to help stop the spread of VRE and other germs. 

VRE is spread from one person to another by contact, usually on the hands of health care providers (HCP). VRE can be present on the health care provider’s hands either from touching contaminated material excreted by the infected person or from touching articles contaminated by the skin of a person with VRE, such as towels, sheets and wound dressings. VRE can live on hands and objects in the environment.

Risk factors for VRE acquisition include severe underlying illness, presence of invasive devices, prior colonization with VRE, antibiotic use and longer hospital stay.

Enterococci are bacteria that are normally present in the human intestines and are often found in the environment. These bacteria can sometimes cause infections. Vancomycin is an antibiotic that is often used to treat infections caused by enterococci. In some instances, enterococci have become resistant to this drug and thus are called Vancomycin-resistant Enterococci (VRE).

A bacteremia is the presence of bacteria in the bloodstream and is referred to as a bloodstream infection.

For more information and other related topics we recommend you visit:

• Ministry of Health and Long-Term Care - Patient Safety 
• Public Health Ontario - Regional Infection Control Networks (RICN)

A bacteremia is the presence of bacteria in the bloodstream and is referred to as a bloodstream infection.

Most people do not die if they are infected with MRSA. However in severe cases of MRSA bacteremia, death can occur. This is uncommon and tends to occur in those people with other severe health problems. The vast majority of people recover from MRSA, once their health is restored.

If a patient is carrying MRSA, generally no treatment is necessary, as the organism is not causing an illness and often will be cleared on its own when the person’s health is restored. If it is determined that the patient is infected (they have a blood infection, skin infection or wound infection etc.) then the patient will treated with the appropriate antibiotic as determined by a physician.

Swabs are performed when patients are admitted to the hospital and periodically for patients whom are at risk. The swabs are sent to the laboratory for analysis and if positive, the laboratory notifies infection prevention and control so that the patient can be placed on Contact Precautions.

Contact Precautions aim to limit the spread of MRSA to other patients and to health care providers. You may be placed in a private room or with other patients who are also carrying the bacteria. A sign may be placed on your door to remind others who enter your room about these special contact precautions. Those caring for you as well as visitors will be asked to clean their hands, gown and glove before entering your room. Everyone who enters and leaves your room must clean their hands well. The room and equipment in the room will be cleaned and disinfected regularly.

Because MRSA is spread from one person to another by contact, hand hygiene is critical to preventing its spread in a health-care setting. KGH actively conducts regular surveillance to find cases of MRSA infection and to identify carriers of MRSA. If a patient is positive for MRSA they are placed on Contact Precautions.

MRSA is spread from one person to another by contact, usually on the hands of caregivers. MRSA can be present on the health care provider’s hands either from touching contaminated material from infected persons or from touching articles contaminated by a person carrying MRSA, such as towels, sheets and wound dressings. MRSA can live on hands and objects in the environment for extended periods of time.

Risk factors for MRSA infections include invasive procedures, prior treatment with antibiotics, prolonged hospital stay, stay in an intensive care or burn unit, surgical wound infection and close proximity to someone who is carrying MRSA. 

A bacteremia is the presence of bacteria in the bloodstream and is referred to as a bloodstream infection.

Staphylococcus aureus is a germ that lives on the skin and mucous membranes of healthy people. Occasionally, Staphylococcus aureus is a  cause of human infection. When Staphylococcus aureus develops resistance to certain antibiotics, it is called Methicillin-resistant Staphylococcus aureus or MRSA.

For more information and other related topics we recommend you visit:

• Ministry of Health and Long-Term Care - Patient Safety 
• Public Health Ontario - Regional Infection Control Networks (RICN)

Central line infections occur when a central venous catheter (or “line”) is placed in the patient’s vein and the line gets infected. Patients in the intensive care unit (ICU) often require a central line since they are seriously ill and require a lot of medication for a long period of time. When a patient requires long-term access to medication or fluids through an intravenous (IV), a central line is put in place. A central line infection can occur when bacteria and/or fungi enters the blood stream. The bacteria can come from a variety of places (skin wounds, environment etc.), though it most often comes from the patient’s own skin.

Central line infections occur when a central venous catheter (or “line”) is placed in the patient’s vein and the line gets infected. Patients in the intensive care unit (ICU) often require a central line since they are seriously ill and require a lot of medication for a long period of time. When a patient requires long-term access to medication or fluids through an intravenous (IV), a central line is put in place. A central line infection can occur when bacteria and/or fungi enters the blood stream. The bacteria can come from a variety of places (skin wounds, environment etc.), though it most often comes from the patient’s own skin.

Patients should always follow instructions given to them by your health care team.  Frequent hand cleaning is another way to prevent the spread of infection. Hand hygiene involves everyone in the hospital, including patients.

Treatment depends on the type of catheter, the severity of the infection and the patient’s overall health. Generally, your doctor will prescribe antibiotics to fight the infection and the central line may need to be removed. In some cases, the line is flushed with high doses of antibiotics to kill the germs causing the infection so that the line does not have to be removed

• Ask lots of questions.
• Find out why you need the line and where it will be placed.
• Learn what steps the hospital is taking to reduce the danger of infection.
• Wash your own hands often. Use soap and water or an alcohol-based hand rub containing at least 60 per cent alcohol.
• Try not to touch your line or dressing. 

• All health care providers should practice proper hand cleaning techniques.
• Everyone who touches the central line must wash their hands with soap and water or use alcohol-based hand rub.
• Wear sterile clothing – a mask, gloves and hair covering – when putting in the line.
• The patient should be covered with a sterile drape with a small hole where the line goes in.
• The patient’s skin should be cleaned with “chlorhexidine” (a type of soap) when the line is put in.
• Choose the most appropriate vein to insert the line.
• Check the line every day for infection.
• Replace the line as needed and not on a schedule.
• Remove the line as soon as it is no longer needed.  

Health care providers who insert a central line in the vein of a patient fill out a central line insertion check list and procedure note which dates, tracks and documents the procedure.

Anyone who has a central line can get an infection. The risk is higher if you:

• Admitted to the ICU
• Have a serious underlying illness or debilitation
• Receiving bone marrow or chemotherapy
• Have the line in for an extended time 

• Redness, pain or swelling at or near the catheter site
• Pain or tenderness along the path of the catheter
• Drainage from the skin around the catheter
• Sudden fever or chills 

Central line infections occur when a central venous catheter (or “line”) is placed in the patient’s vein and the line gets infected. Patients in the intensive care unit (ICU) often require a central line since they are seriously ill and require a lot of medication for a long period of time. When a patient requires long-term access to medication or fluids through an intravenous (IV), a central line is put in place. A central line infection can occur when bacteria and/or fungi enters the blood stream. The bacteria can come from a variety of places (skin wounds, environment etc.), though it most often comes from the patient’s own skin.

Central line infections occur when a central venous catheter (or “line”) is placed in the patient’s vein and the line gets infected. Patients in the intensive care unit (ICU) often require a central line since they are seriously ill and require a lot of medication for a long period of time. When a patient requires long-term access to medication or fluids through an intravenous (IV), a central line is put in place. A central line infection can occur when bacteria and/or fungi enters the blood stream. The bacteria can come from a variety of places (skin wounds, environment etc.), though it most often comes from the patient’s own skin.

Yes, referrals are required for both the non-urgent and urgent Adult Mental Health Program streams.

• The non-urgent stream requires a referral from a medical doctor or nurse practitioner. If you do not have a family physician, we accept referrals from walk-in clinics.

• Referrals from the urgent stream are ONLY accepted internally from the KGH Emergency Department, HDH Urgent Care Centre, Inpatient Mental Health & Addiction Program, and the Consult/Liaison Psychiatry Team.

Once a non-urgent referral is received, the referring practitioner will receive correspondence either accepting the referral and advising of the current wait time or recommending alternate services that may better fit your needs.

Once we have accepted your referral, you will be placed on a waitlist for a telephone call from an intake nurse, which could take up to a year, dependant on the current referral volume.  At the time of intake call, you will either be given an appointment, or be placed on our waitlist for the next available appointment.

Once an urgent referral is received, you will be contacted by an intake nurse. We aim to contact patients referred from the Emergency Department or Inpatient Mental Health Unit within 72 hours, however this may take longer depending on when the referral was received, and whether we need to obtain collateral information.

At the time of intake call, you will either be given an appointment, be placed on our waitlist for the next available appointment or be advised that your case will be discussed during interdisciplinary rounds with an outcome to follow.

You can expect various outcomes, based on your referral and the intake information gathered:

• You may be booked with psychiatry
• You may be placed on a waitlist for a future appointment
• You may be enrolled in group psychotherapy
• We may recommend services that better meet your needs
• Your referral may be closed owing to adequate services already in place for you

The Adult Mental Health Program is unable to provide the following services:

• Disability follow-up appointments as part of employment Insurance

• Canada Pension Plan

• Workplace Safety & insurance Board

• Ontario Disability Support Program requirements

• Independent Medical Evaluations for Court & Child Welfare Assessments

• Forensics or Capacity Assessments.

The non-urgent stream does not offer counseling services, crisis services, or urgent appointments.

Length of treatment is patient-specific. Some patients have just one consult visit and some may have short-term follow-up. It is not within the program’s mandate or capacity to follow patients for a significant length of time. Our model always anticipates patient care will be resumed by a primary care provider.

The urgent stream is a brief intervention service.

The AMHP sees patients in the Kingston, Frontenac, Lennox & Addington area. If you reside outside of that area and have questions about what mental health agency is in your area, please contact our clinical intake coordinator at 613-544-3400 ext. 3700 or search the Connex Ontario website.

If your psychiatrist starts you on a medication, they may prescribe it themselves or they may recommend your referring practitioner initiate the medication. Once you have been discharged from the AMHP, it will be the responsibility of your referring practitioner to continue prescribing the medication. Should you not have a family physician, we recommend attending a walk-in clinic to access refills.

We are unable to book patients for a psychiatric assessment solely for the purpose of providing medication refills.

As part of KHSC, and in collaboration with Queen’s University, St. Lawrence College and other educational institutions we often have students and learners from across many disciplines participate in our various clinics.

• Psychiatry residents (licensed medical doctor that is undergoing their psychiatry training)

• Clinical fellows (a licensed psychiatrist who is training in a specialized psychiatric field)

In the Adult Mental Health program we have both international and Canadian doctors training in sub-specialty streams.

• Clerk/Medical student present for your assessment. All psychiatric care will be provided under the supervision of AMHP Staff Psychiatrist, who you may or may not see in-person.

• Allied Health care providers - Many of our allied health care providers also provide field placements or internships for several disciplines including nursing, occupational therapy, and social work which may involve learners working in the services being provided to you by our provided.

We have very high referral volume and a lengthy waitlist; therefore, it is important that you attend your appointments. However, if you must cancel, please notify us at least 24 hours prior, so that we can fill the vacant spot. If you cancel in advance, we will gladly rebook you, however, please be advised that you may have to wait several months.

A no-show for a new patient assessment will result in an automatic file closure, and a re-referral will be required to be seen again.

A group session allows people to learn new skills and hear from others who may have similar experiences dealing with mental health concerns. Participants may share their thoughts and feelings with others if they are comfortable.

Your appointment may occur in person or virtually.  This will be discussed during your telephone intake when your email address is collected by the intake nurse.  You will be provided an appointment notice letter with this information.

For a virtual appointment, the secretary will email you a link to attend. This link may not be sent until the day before your scheduled appointment and will provide clear instructions on how to proceed. Please note that you must use the internet browser Chrome for the virtual visit to be effective. 

Other resources can be found on the Community Resources page. 

A surgical safety checklist is a patient safety communication tool that is used by a team of operating room professionals (nurses, surgeons, anesthesiologists, and others) to discuss important details about each surgical case. In many ways, the surgical checklist is similar to an airline pilot’s checklist used just before take-off. It is a final check prior to surgery used to make sure everyone knows the important medical information they need to know about the patient, all equipment is available and in working order, and everyone is ready to proceed. 

Patient safety is a number one priority for all KGH. There are numerous checks and balances in place to ensure the safety of our hospital but hospital care is complicated and depends on many factors. The public reporting of hospitals’ checklist compliance rates is not intended to serve as a measure for hospitals to compare themselves against other organizations, or for the public to use as a measure of where to seek care. Like other patient safety indicators, it is important to look at checklist compliance rates in a broader context. The rates must be examined in order to get a sense of how hospitals are performing – where they excel and where improvements could be made. It is important to look at all of these indicators in combination.

The public reporting of our surgical checklist percentage compliance allows us to establish a baseline from which we can track over time. We will closely monitor our rates and should they decrease, we will look closely at our operating room processes and target areas for improvement. The checklist percentage compliance measures the degree to which all three phases (i.e., a briefing, a time out, and a debriefing) of the checklist were performed correctly and appropriately for each surgical patient. We are always striving for 100 per cent compliance. 

Hospitals will post their bi-annual percentage compliance at the end of July and January.

KGH implemented the checklist in one surgical specialty in November 2009. The checklist was implemented in all surgeries in April 2010.

As part of the Ministry of Health and Long-Term Care’s public reporting of patient safety indicators initiative, eligible hospitals are legally required to post their checklist compliance percentages. KGH strongly supports the provincial government’s strategy to publicly report patient safety Indicators because we believe it will enhance patient safety and strengthen the public’s confidence in our hospitals.

The Canadian Patient Safety Institute has a checklist template that has mandatory requirements for Ontario hospitals to use. KGH then adds additional items to this template that allows us to customize items to fit the type of surgeries performed here and have been declared to be important to the KGH patient population. 

If you undergo a surgery at Kingston General Hospital, you can expect that the surgical safety checklist will be used as part of the procedure. As a patient, you will be asked questions by a surgical team member so that they can complete a portion of the checklist with you.  It will then be used by your surgical team members before, during and after your surgery to help the surgical team members familiarize themselves with your medical history and any special requirements that may be needed for your individual case. 

Operating room teams have many important steps to follow in order to ensure a safe and effective surgery for every patient. The checklist is a useful tool that helps promote good communication and teamwork among the health care team to help ensure the best outcomes for patients.

The checklist is used at three distinct stages or phases during surgery:

• pre-induction (before the patient is put to sleep)
• time out (just before the first incision)
• and debriefing (during or after surgical closure)

Some examples of items contained in the checklist include:

The briefing phase:

• Verify with patient name and procedure to be done
• Allergy check
• Medications check
• Operation site, side and procedure
• Lab tests, X-rays

The “time out” phase:

• Patient position
• Operation site and side and procedure
• Antibiotics check

The debriefing phase:

• Surgeon reviews important items
• Anesthesiologist reviews important items
• Nurse reviews correct counts 

A surgical safety checklist is a patient safety communication tool that is used by a team of operating room professionals (nurses, surgeons, anesthesiologists, and others) to discuss important details about each surgical case. In many ways, the surgical checklist is similar to an airline pilot’s checklist used just before take-off. It is a final check prior to surgery used to make sure everyone knows the important medical information they need to know about the patient, all equipment is available and in working order, and everyone is ready to proceed. 

A surgical safety checklist is a patient safety communication tool that is used by a team of operating room professionals (nurses, surgeons, anesthesiologists, and others) to discuss important details about each surgical case. In many ways, the surgical checklist is similar to an airline pilot’s checklist used just before take-off. It is a final check prior to surgery used to make sure everyone knows the important medical information they need to know about the patient, all equipment is available and in working order, and everyone is ready to proceed. 

A surgical safety checklist is a patient safety communication tool that is used by a team of operating room professionals (nurses, surgeons, anesthesiologists, and others) to discuss important details about each surgical case. In many ways, the surgical checklist is similar to an airline pilot’s checklist used just before take-off. It is a final check prior to surgery used to make sure everyone knows the important medical information they need to know about the patient, all equipment is available and in working order, and everyone is ready to proceed. 

Induction is a form of using artificial means to get your labour started. This may be done by using drugs or by rupturing the membranes. You may require this if you or your baby has a medical condition that would benefit delivering the baby earlier than expected. This may also be done if you past your due-date. Your physician or midwife will discuss with you your eligibility for outpatient induction. For more information click here and scroll to the bottom of the page. 

Career Hub is KHSC’s internal portal where employees are able to review and apply for any internal job postings. For questions regarding the Career Hub portal, please reach out to the Recruitment team.