Clinical Concerns Committee Meeting Minutes Date: February 14, 2011 Time:1400 hrs Location: 4E2.

24 Attendees: Regrets: 1. 2. 2.1 2.2 Marcel Romaniuk, , Shirley Perry, Karina Black, MaryAnne Venner, Jennifer Shepherd, Mark Belletrutti Agenda Items & Discussion Approval of Agenda Approved New Topics
Fever/Neutropenia algorithm and preprint Golda (secretary for patient care managers) is playing around with this so that it looks good. Making modifications to it. Shirley will send for everyone to review.

Codiene: I met with Kathy and Sacha today re codeine. They dont really have a plan yet, and are in the process of collecting data from other sites who have implemented, as well as within the hospital. They were keen to have us be a pilot. Sacha and I pulled some data re how much codeine the oncology patients on were using in the last 2 months. I suggested that we move forward as follows: 1. Get buy-in from the Docs (Mark?) 2. Meet and figure out how we will do this and what education will need to be delivered and how. Examples include - education/tools for docs about equivalent doses, conversions etc - info to nurses about the project and why - some general guidance for the outpatient nurses re who/how/if we will switch outpatients - Some brainstorming re: triplicates 3. Pick an implementation date and then re-measure how many patients from oncology got codeine prescriptions (at 1 month and 3months??) on 4E3 - if we were successful there will be less. (Dont worry about the measuring part - I can have somebody get that from the pharmacy computer.)

4. Committee meet with committee (ours and theirs) to share challenges and ways we overcame. Have their committee use us as a success story to move forward. 5. Have a student write it all up as a QI project and get it published. (I'm just saying - Pediatrics has a new QI section...) Action: A poster in the clinic rooms regarding phasing out codeine. Karina Marcel will figure doseing for morphine. Shirley will look at finding a locked drawer to store triplicate pads. Mary Anne will look into having to go through Extended Management for approval. May be presented as a pilot project. Report back to team March 21, 2011, next meeting. Then to present to rounds on March 23, possibly. Karina will get list for patients with information on Morphine. Fertility issues and sperm banking Possibly could be added to the New Diagnosis Conference sheet: a check box that the conversation was had with parents/patient. Someone could speak to Carol Portwine regarding how their group works with respect to these discussions. Effects on fertility as side effects of chemotherapy treatment. What do people think? Jens email Previous Action Items
See Codiene above.

2.3

2.4 3. 3.1 3.2 4. 4.1 5. 6.

Baseline Echoes Echo and MUGA in-service for outpatient nurses. Still looking into this . Additional Items Date of Next Meeting: March 21, 2011 room 4E2.24 Adjournment