Ottawa Hospital reinforces commitment to patient safety
– The Ottawa Hospital Research Institute – the research arm of The
Ottawa Hospital and a major partner of the Faculties of Medicine and
Health Sciences at the University of Ottawa – has lured Dr. Kaveh
Shojania (pictured at left), an expert on the
topic of medical error, to the nation's capital.
After medical school in Canada, Dr. Shojania completed his training in
internal medicine at Harvard University and a subsequent fellowship at
the University of California in San Francisco, where he later took up a
faculty position. In 2003, he co-authored Internal Bleeding, a startling
book that documents and analyses the medical errors that are sometimes
made in North American practice.
Internal Bleeding recently peaked at number 11 on the Amazon.com
bestseller list and has consistently maintained a position in the top 10
selling books on health in the US since its release in February 2004.
Despite receiving offers from some of the most prominent institutions in
the United States and Canada, Dr. Shojania chose Ottawa. His decision
was influenced by the opportunity to work with world-renowned scientists
and researchers currently conducting leading research at the OHRI and
the University of Ottawa.
He was equally enthusiastic about caring for patients at The Ottawa
Hospital, where he will join a healthcare team that is committed to
taking a leadership role in patient safety. "The people doing research
and identifying patient safety issues are some of the same people
delivering bed-side care and developing ways to address those issues,"
said Dr. Shojania.
Having lived in Canada most of his life and having practiced medicine in
the United States for almost ten years, Dr. Shojania said he was also
glad to return the Canadian healthcare system. "I don't think people
realize how good we have it here," said Dr. Shojania. "I would pick the
Canadian system any day – even with the waiting times."
Dr. Shojania will be a scientist in the Clinical Epidemiology Program at
the OHRI, an Assistant Professor of Medicine at the University of Ottawa
and deliver patient care as an Internal Medicine specialist at The
Ottawa Hospital. He will work with OHRI Program Director Dr. Jeremy
Grimshaw and colleague, Dr. Alan Forster, to establish a strong patient
safety research program that will offer healthcare practitioners an easy
and quick resource to the latest and most important evidence on a number
of safety issues.
In his own research, Dr. Shojania will focus on diagnostic errors.
Though the subject of much informal discussion among physicians and
frequently the subject of malpractice suits, diagnostic errors have
received little formal study in terms of their frequency and causes.
Building on a paper he published last summer in the Journal of the
American Medical Association, Dr. Shojania plans to characterize the
type and frequency of major diagnostic errors, and also hopes to
collaborate with scientists at OHRI to identify psychological factors
and cognitive pitfalls commonly associated with major misdiagnoses.
"You start recognizing certain patterns of thought as consistently
implicated in major diagnostic errors," said Dr. Shojania. A common
example he provided is the tendency to remain committed to an initial,
seemingly obvious diagnosis and failing to take into account other
symptoms that could appear slight but taken as a whole, point to an
entirely different direction.
"It's like on detective shows – the police say it's suicide or "a
robbery gone awry," ignoring one major clue after another, until finally
Columbo or whoever proves it was a murder and solves the case. Holding
onto an initial misdiagnosis despite one contradictory piece of evidence
after another is a hallmark of many missed cancers, heart attacks, and
other diagnostic errors leading to malpractice cases. What I'd like to
do is identify some of these cognitive traps and develop tools for
making doctors more aware of them and the impact they have on their
"Dr. Shojania is a very welcome addition to our team and comes with very
impressive credentials in the field of patient safety research," said
Dr. Ron Worton, CEO and Scientific Director of the OHRI. "We expect his
research to complement that of Dr. Forster in paving the way to improved
"We have taken the series of reports suggesting problems in patient
safety throughout North America very seriously and continue to take
significant steps to address those concerns," noted Dr. Jack Kitts, the
CEO of The Ottawa Hospital. "Dr. Shojania's appointment certainly
underscores that commitment. With his arrival, The Ottawa Hospital has
taken another step to becoming one of the nation's leading authorities
on patient safety."
Dr. Peter Walker, Dean of the Faculty of Medicine at the University of
Ottawa, was equally enthused by Dr. Shojania's arrival and his
potential. "We are delighted to have Dr. Shojania join our faculty and
affirm our belief that through research, the overall quality of patient
care will be enhanced, not only in Ottawa, but throughout the world."