The two Kims

Kim Norman, Clinical Nurse Educator, FH Renal Program, and Kim McCool, Nurse Lead & Clinical Resource Nurse, FH Medical Imaging, Abbotsford Regional Hospital and Cancer Centre

Kim Norman and Kim McCool exude a similar passion and focus for patient safety.

Sitting side-by-side you could mistake them for sisters, but they actually met while working at the Abbotsford Regional Hospital and Cancer Centre (ARHCC) a few years ago. But, their similarities don’t stop there. They also followed similar career paths, starting out as nurses in the United Kingdom (UK) before moving to Canada.

“I began my nursing career in the UK 15 years ago,” says Kim Norman in a charming British accent. “I started off in acute/chronic renal care at a facility in Oxford and then switched to general ICU nursing. When I came to Canada in 2008 I was a frontline nurse for a while, but I went back to my roots and I’ve been in Fraser Health (FH) renal services ever since.”

Laughing and joking beside her close friend is Kim McCool, who Kim Norman describes as often having an “…endless streak of energy with her! She’s always got a smile on her face and she’s always approachable, nothing is too much for her.” She also has an equally charming accent, and says she started her nursing career in Scotland where she spent 14 years as an Emergency nurse and the rest of her time setting up cardiac clinics before moving to Canada in 2006.

Since meeting each other these delightful nurses have forged a strong bond and become steadfast advocates for quality of care and patient safety in the Hemodialysis and Medical Imaging units at ARHCC. In particular, a recent patient safety problem led to collaborative frontline teamwork, new processes and quality of care improvements on both units.

Central line dislodgements – why is this happening?

When it comes to solving unexpected patient safety problems, it’s often helpful when healthcare providers have a sense of insight and curiosity. In some situations, it’s the informal conversations between healthcare colleagues (or good friends!) that lead the way to finding answers, and that’s exactly what happened…

“We would pop by each other’s areas and talk about concerns we had with our patients,” says Kim Norman. “It was really quite accidental because we would have casual but frank discussions about what we were seeing. It was our close relationship that allowed us to do that.”

Working together with their respective frontline staff, they discovered a problem with central line dislodgements – when the line inadvertently comes out of the patient’s body – resulting in patients spending additional time in hospital and experiencing unnecessary discomfort and pain due to repeat invasive procedures.

What they found was an unusual amount of central line dislodgements over a short period of time – 10 dislodgements in 3 months. “Some patients were literally coming to the hospital with the loose lines in their hands.”

In collaboration with the Medical Imaging team and a very eager Medical Imaging tech, Alyssa Dalman, the team performed a comprehensive review of patient charts to identify reasons for re-referrals to Medical Imaging. Their analysis revealed some striking similarities. All of the patients who experienced central line dislodgements had cardiac surgery combined with diabetes. This combination of comorbidities reduces the ability for the body to heal, so closer monitoring of central lines is important and sutures must stay in place longer to secure the central line.

In the end, the team’s findings led to a heightened level of awareness among all the care providers involved, and an immediate change in practice. Most of all, their collaborative team approach to patient safety now permeates throughout several departments at ARHCC.

Safety culture breakthrough – no more black holes!

The “black hole” syndrome – when safety issues are reported but there is no further communication with frontline staff – is something many healthcare providers in BC were accustomed to just a few years ago, before PSLS came into practice.

“That’s just what was expected,” says Kim Norman. “You submitted a paper incident form and never heard anything back about what was done about it. Today, leaders and managers are having conversations with frontline staff, emailing each other’s colleagues, sending “Actions“, and doing follow-up activities, all within the PSLS system.”

Both Kims say this recent experience, especially with frontline staff, has highlighted the importance of good communication and feedback in healthcare, “…that the black hole is no longer!” With open, honest and timely communication, they say patient safety awareness becomes integral to everything we do as healthcare providers.

Each also agrees that their relationship, both personally and professionally, has developed their leadership skills and instilled greater confidence within themselves and their teams. “There’s never any fear of approaching another department about patient safety. This has really opened up dialogue between all of us. The partnerships we’ve made are such a good fit in promoting a patient safety culture, it’s absolutely awesome.”

Kim Norman is Clinical Nurse Educator, FH Renal Program, and Kim McCool is Nurse Lead and Clinical Resource Nurse, FH Medical Imaging, at Abbotsford Regional Hospital & Health Centre. These two safety stars are a dynamic duo and they would love to share their views on PSLS and patient safety. You can contact them at and

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