Let's get together

Hugh B. MacLeod is CEO of the Canadian Patient Safety Institute. His interests lie in the areas of system/integrative thinking, sustainability, and organizational cultures that create high performance.

While we may have differences in how we move forward the quality agenda, we have common challenges and with them common opportunities to be leveraged, shaped, and enabled. Now is the time for strong, courageous and committed collaborative leadership from funders, policy makers, direct delivery operations and supporting national and provincial organizations. While good policy direction and alignment of effort are important, the patient voice is a huge system quality and patient safety lever and enabler…a valuable game changer. 

Which way to Quality, challenges us to meet and work together. A common thread throughout the report is a call for an aligned quality agenda that links federal, provincial and local efforts.  A smooth operating system is not the product of a series of isolated actions. We need the orchestration of interactions at the right time, for the right patients, in the right places. The following quote from the report sums up for me where we must go… “all of us can benefit from learning more about each other’s quality improvement efforts, sharing what works, and discussing ways to overcome common challenges. Sharing information and innovation among provinces and territories is absolutely the way to go”.If we collectively want to accelerate change and improve performance on a larger scale as discussed in this report, we have to do things differently. “We” means the actors (many were interviewed for this report) – governments, regulatory agencies, organizations, leaders, etc. All have either legal or moral authority to demand and compel a different path forward.

On the Patient Safety front, CPSI through its new business plan is committed to providing leadership through a consortium of partners to establish a National Integrated Patient Safety Strategy. In keeping with the spirit of this report, CPSI has identified three complimentary goals: knowledge mobilization and innovation; building capability (patient safety knowledge and skills) and expanding reach by engaging audiences across the health system.

Which way to Quality? Let’s answer the question by coming together and working together!

Sharing is Growing

Dr. John W. Cowell is the Chief Executive Officer of the Health Quality Council of Alberta

What a long way our nation has come in regards to quality improvement in health care since Alberta first put its toes in the water in 2003. Our own organization has evolved significantly in that time, and there is great value for us to see what approaches other provinces are taking as this important field of work progresses and adapts to the needs of the various health care systems.

In 2004 the Health Quality Council of Alberta (HQCA) helped initiate regular meetings with the other quality councils in Western Canada to explore how we could learn from each other. It was a very productive exercise and early on included the Canadian Patient Safety Institute. These quarterly meetings were a starting point for the collaboration that continues across our country today, and when reading the Which way to quality, report it reinforces the value of sharing these perspectives.

I’m very proud to have been with the HQCA since our inception. It’s tremendously rewarding to have been a part of something that began as a philosophy and has evolved to offer very tangible benefits to the health care system in our province. For example, I encourage anyone interested in defining and measuring quality in health care to learn how our Alberta Quality Matrix for Health provides a lens through which to focus quality improvement efforts.

Another example of a very real benefit we offer is one of the first measurement tools that we introduced and continue to provide today - our patient satisfaction and experience survey. We have completed six province-wide surveys since 2003. These survey results offer health care providers a valuable glimpse into how Albertans’ experiences have changed over time and by location for a variety of health care services and settings.

The Health Council of Canada’s report has inspired our team at the HQCA to continue to expand our collaborative efforts with our partners across Canada. As wisely said by Oliver Wendell Holmes, “Many ideas grow better when transplanted into another mind than the one where they sprang up.”

Moving from conversations to action…quality health care across Canada

Bonnie Brossart, Chief Executive Officer, Health Quality Council (Saskatchewan)

There’s a sobering statement in the Health Council of Canada’s, Which way to quality, report on the collective efforts of governments and agencies at both the provincial and federal level:

“…it was clear there is no common vision for quality improvement in Canada.”

Why is that? There’s the conventional answer: because health care is a provincial jurisdiction, not a federal one.  But what could we learn by digging a little deeper? What’s stopping us from exploring how we, as provinces, territories and national organizations, could become more intentional in creating the will for change, and building the networks and structures to meaningfully grow improvement capability among Canada’s tens of thousands of health care workers and leaders? We’re short-changing the people we serve when we say it’s because we’re different, or because it couldn’t work here, or because it’s just too hard.

It’s heartening to see the similarities in the hopes and challenges expressed by health system leaders from across the country.  Maybe we’re not as different as we think.  It’s promising to see the different quality improvement strategies that are being tested around Canada, as these will serve as rich opportunities to learn from each other. Maybe creating a common vision for quality improvement in Canada is not so far out of reach. Good ideas abound across our great country.

Yes, it’s daunting to think about building and nurturing a pan-Canadian approach to achieving better health, better care, and lower costs.  But what if we started by asking “why?” five times, to unearth the real issues standing in our way?  It just might help us move from simply talking about our lack of a common vision for quality improvement, to developing and acting on one.

CIHI reports on wait times for priority procedures

In the 2004 10-Year Plan to Strengthen Health Care, first ministers identified wait times reduction as a top priority for the Canadian health system. 

This week, CIHI released a report outlining progress on wait times in five out of eight priority procedures, namely:

• Radiation therapy for cancer 
• Cardiac bypass surgery 
• Hip and knee replacements 
• Hip fracture repair 
• Cataract surgery 

The report offers both good news and bad. For example, more joint replacement procedures are being performed, but the proportion of Canadians receiving surgery within the recommended timeframes has not improved. Patients waiting for knee replacement are least likely to have their surgery within the benchmarked time.

Wait times for Priority Procedures in Canada, 2013, CIHI

We report on wait times, most recently in our Progress Report 2011; this Spring, we’ll update you through Progress Report 2013. In the summer we’ll have more, as we release a video series on wait times challenges and innovative practices in Canada through our Health Innovation Portal and online.

Health Council reveals shortlist for fourth annual Health Innovation Challenge

Today, we announced the shortlist for the fourth annual Health Innovation Challenge. In September, we challenged college and university students to find innovative practices in Canadian health care, tell us why the innovations were working, and how they could be applied to the rest of the country.

Over 100 students across Canada participated, submitting a total of 74 essays explaining which innovative practices they think could change the future of health care in Canada. Entries came from students in many disciplines, including nursing, medicine, kinesiology, arts, engineering, indigenous studies, political science, and environmental science. The entry topics were just as diverse, including innovations in aboriginal health, emergency room wait times, rural health care, primary care, and chronic disease.

The Health Council of Canada identifies and shares hundreds of innovative practices from across the country on the Health Innovation Portal. Winning Challenge entries will be featured on the Portal and the Council’s digital properties when they are announced on April 2, 2013.

Winners will also receive a cash prize and the chance to apply for a summer internship at the Health Council of Canada office in Toronto, Ontario.

Congrats to all the amazing students who entered!

Full Shortlist: 

Category: Individual 

Dorothy Wang
Dalhousie University
Collaborative Emergency Centres Improve Access to Primary and Emergency Care in Rural Nova Scotia

Randi Jackson
Grande Prairie Regional College
Emergency to Home: Improving Health Outcomes for Seniors Across the Continuum

Mary Qiu
University of Toronto
Preventing Acute Care Hospital Readmissions Through the Use of a Virtual Ward

Jake Yorke
Dalhousie University
Collaborative Emergency Centres: Improving Access to Primary and Emergency Care in Rural Nova Scotia

Sophia Harrison
University of Northern British Columbia
A New Way Forward: Improving the Health Status of British Columbian First Nations with the Tripartite First Nations Health Plan

Category: Group

Farell Archibald, Nahanni Hasselfield, Crystal Goosney
Grande Prairie Regional College
The Hamilton-Wentworth HSO Mental Health Program

Haley Augustine & Rakesh Gupta
Dalhousie University
Chronic Disease Management Strategy: Diabetes Quality Collaborative

Kenisha Constable, Tannis Donaldson, Lindsey Jones
Grand Prairie Regional College
Saskatoon Health Bus

Aaron Lau, Alexandre Tran, Yvonne Tse
McMaster University
The McMaster PIPER Project: A Novel Approach to Interprofessional Education through Simulation-Based Learning

Kathryn Reid & Joshua Plante
University of Alberta
Changing Practice Paradigm through Innovative Policy

Showcasing the Health Innovation Portal in Vancouver

Last week, we demonstrated the Health Innovation Portal for the first time at Pharmacare 2020 (February 26-27) and the BC Quality Forum (February 28-March 1).

Pharmacare 2020 hosted 225 participants from academia, the pharmaceutical industry and government. The keynote speakers were Dr. Steve Morgan and Dr. Michael Law.

The BC Quality Forum hosted 640 people with participants ranging from managers of regional health authorities, providers, researchers, government analysts and consultants. Keynote speakers included Jim Easton and Steven Lewis.

We decided to demonstrate the Health Innovation Portal to attendees at these conferences using our new iPad kiosks. People seemed eager to give it a try, searching for practices that might interest them and learning how to navigate the portal.

Participants had lots of questions for us, so we thought we’d answer a few of the most common ones here:

How does the Health Council identify innovative practices? We’ve developed an Innovative Practices Evaluation Framework™ to support the identification of practices. The Framework categorizes innovative practices as “emerging,” “promising,” or “leading” based on four evaluation criteria: quality of evidence, impact, applicability and transferability.

How can I submit a practice to be included on the Portal? To submit a practice, download and complete the Innovative Practice Submission Form and send it to us at: innovation@healthcouncilcanada.ca. Based on the information you provide, we’ll evaluate the practice using our Innovative Practices Evaluation Framework™, then categorize the practice as emerging, promising or leading and get back to you with the results.
We will use the information you submit to prepare a description of the practice in the HIP’s designated format.

Is there an evaluation planned for the Portal? A formal evaluation of the Health Innovation Portal is currently being planned and will include a user survey and interviews to measure whether the Portal is adding value to our audience and providing high quality, contextual information on Canadian health innovative practices. You can provide feedback by completing our online survey in April.

Thanks again to everyone who came to visit! Next up, we’ll be attending the Saskatchewan Health Care Quality Summit 2013 conference on April 10-11, so please do drop by and give the portal a try.