Understanding Clinical Practice Guidelines: A Video Series Primer

We developed a series of videos to provide an overview of clinical practice guidelines (CPGs) in Canada through the eyes of those who design, disseminate, and use them.

CPGs are evidence-based recommendations that help health care professionals make better clinical decisions. When designed and used properly, CPGs can play an important role in the Canadian health care system.

In November 2011, we collaborated with the Canadian Medical Association on a national summit to focus attention on CPGs at the policy level and develop a shared understanding of national priorities. Governments have also been working together to bring greater attention to CPGs across Canada. The provincial and territorial premiers identified CPGs as a priority area of focus in health care and reported in July 2012 on the role of CPGs in reducing variations in clinical care.

These videos are meant to offer greater insight into what CPGs are, how they are used, how they are disseminated and implemented, and what impact they can have.

Video 1: What are CPGs

This video provides an introduction to CPGs: what they are, who can benefit from their use, and why patients and health care providers should take an interest in them.

Video 2: Challenges for CPGs
This video discusses the complexities that affect widespread usage of CPGs. National experts share their thoughts on the challenges that designers and users of CPGs face.

Video 3: Integration of CPGs at the system level
This video profiles Canadian organizations that have garnered recognition for their system-level approaches to CPGs. The groups highlighted include: 

1. The Canadian Taskforce on Preventive Health Care 
2. Canadian Stroke Strategy 
3. Cancer Care Ontario 
4. Registered Nurses’ Association of Ontario Best Practice Guidelines 

Video 4: Opportunities and future considerstaions for CPGs
This video looks at where efforts are needed to realize the benefits of CPGs on improving patient outcomes and health care system performance in Canada. We discuss the future and next steps for CPGs with national experts.

Ten years since the Romanow Report: Retrospect and prospect

On November 9, 2012, I provided closing remarks at the 10th anniversary event for the Romanow Report. The event drew key stakeholders from throughout the health care system, including up-and-coming leaders eager to learn from insights of the Honourable Roy Romanow and other invited guests.

The event was an opportunity to reflect on the issues and public expectations that brought about the final report of the Royal Commission on the Future of Health Care in Canada. We talked about the report, what had occurred in the 10 years since its release, and what is left to be done.

Romanow's vision, shaped by Canadians ten years ago, is still relevant and alive today. Conference presenters and discussion with audience members illustrated progress in every area of the report themes and pillars over the past decade. There are many examples of innovations, best practices and prototypes needing to be shared in order to continue producing positive change.

However, we have not achieved the substantial transformation in any one area of the report that Romanow and fellow Canadians originally envisioned. While many do understand the potential benefits of an integrated patient/public system, for example, this is not our current reality.

Canadians still see the health system as part of their identity, and the good news is that we seem to value the Romanow vision and have made some progress. The bad news is that our system now ranks about 30th in the world, is not leading to optimal outcomes, and is not financially sustainable.

It is time for all leaders – clinical, administrative and political – to bite the bullet, risk real change and implement integrated transformation that is true to the collective Canadian vision and to our evolving realities.  The Romanow Report was and remains a viable platform to restore the Canadian health system to the top ten in the world.

If you’d like to see some of the presentations from the event, visit CAHSPR’s youtube channel. 

 Cheryl Doiron, Councillor, Health Council of Canada

 

Learning from primary care physicians

While we often hear about surveys of the public’s views and experiences with health care, we don’t often hear from physicians. What do they think about the health system and the care their patients receive?

Primary care has been the focus of considerable policy attention across Canada and internationally. Government-led initiatives are promoting changes like greater use of electronic medical records (EMRs), interprofessional team-based care, and innovations in practice management to help primary care physicians see more patients, more effectively. How widespread are these changes and what impact are they having?

To help answer these and related questions, The Commonwealth Fund spearheaded an international survey of more than 10,000 primary care physicians in Canada and 10 other OECD countries. Today, The Commonwealth Fund published its analysis of the findings in Health Affairs.

We’ve also been busy analyzing the survey results. For some years now, we’ve been a co-funder of The Commonwealth Fund’s annual international health policy surveys. Several key organizations joined us in co-funding larger, more representative survey samples in Canada – the Alberta Health Quality Council, Health Quality Ontario, the Quebec Health and Welfare Commissioner, and Canada Health Infoway.

Today, Canada Health Infoway released some key findings from the survey on EMR adoption in particular. Have a look at their release here. We will also be expanding on both the Commonwealth Fund’s analysis in Health Affairs and Canada Health Infoway’s release. Watch for our results in January 2013 – Bulletin 7 in our Canadian Health Care Matters series. Our bulletin will focus on several key areas of health system performance – access to primary care, coordination among health care providers, and the uptake of information technology. We’ll also report on the use of incentive payments to drive improvements in primary care and on primary care physicians’ general perceptions of the system and the care their patients receive.

This year, for the first time, we are able to report on province-by-province results. We’ve identified a number of variations among the provinces in some of these areas – not surprising given that each province and territory runs its own health system based on its local priorities and policies. The purpose of our comparative analysis is to shed light on the relative impact of improvement initiatives.

We’ll also show how Canada as a whole compares to other countries in the survey. And we’ll look at trends over time by charting how key aspects of primary care have changed (or not) based on similar surveys of physicians in 2006 and 2009.

Look for our report this January at: www.healthcouncilcanada.ca.

Sukirtha Tharmalingam, Senior Policy Analyst, Health Council of Canada