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Why Planning for Quality Improvement Matters

The newly submitted 2016/17 Quality Improvement Plans are now available for your review – each tells a story of commitment to quality.

Improving the quality of care requires a conscious effort. It is challenging work that involves individuals and teams – teams that include patients. In Ontario, we should take pride in the fact we have one of the largest efforts to improve quality in the world!

Why do I say that? Because each year in early April, health care organizations from across Ontario reflect on the quality of care they provide and submit comprehensive Quality Improvement Plans (QIPs) that detail priority areas of focus, ambitious aims, motivational targets and innovative change ideas. Open and direct, the plans also candidly describe areas in need of improvement and approaches to address them.

This year, we received 1,042 QIPs from hospitals, interprofessional primary care organizations, Community Care Access Centres (CCACs) and long-term care homes across Ontario. We want to acknowledge the effort of every organization that developed and publicly posted their QIP as a commitment to their community.

QIPs were designed to be a lever a change to help us ensure we’ve made time for the conscious effort of focusing on quality.

At their core, QIPs represent each organization’s commitment to making positive change within its own walls and beyond them. By publicly sharing these plans, we can learn from each other and discover ways to work together to better integrate care.

What I find increasingly rewarding is hearing the behind-the-scenes stories of how QIPs are developed, and the pride voiced by those who take time to make the commitment to achieve progress each year.

Since the introduction of QIPs in 2010, there has been an evolution in quality improvement efforts from organization-specific reflections into opportunities for collaboration across sectors. This evolution reveals how cross-sector endeavours to better integrate care are taking hold across Ontario. It also shows us how QIPs can serve as much more than static plans; they are living, growing and flexible designs for change. In fact, the key to the QIP is not so much the plan itself, but rather the dialogue, commitment and focus to quality it enables.

This past year, in particular, we saw an increased focus on involving patients in the development of the QIPs prior to their submission. For example, in our recent series of Insights into Quality Improvement reports, where we reviewed more than a thousand QIPs from 2015/16, we saw what could happen when a group of organizations join together to improve upon a single issue using the patient’s voice. Headwaters Health Care Centre, William Osler Health System and Central West CCAC partnered to bring more of the patient’s voice into their joint improvement efforts. Along these same lines, West Parry Sound Health Centre submitted a QIP with a narrative written by its patient advisors, dedicated to the patients and families it serves. And long-term care homes like the Village of Glendale Crossing, London told us about how they are hosting annual Conversation Cafes that empower and involve residents in shaping their care experiences.

In our review of the 2015/16 QIPs, we also observed:

  • 131 hospitals achieved improvement on at least one priority, and 51 achieved improvement on three or more areas.
  • Primary care organizations surveyed more than 70,000 patients about their experiences of care to help better understand how they can improve patient experience.
  • Long-term care homes continued to focus on improving prescribing practices – particularly the use of anti-psychotic medications – with 83% selecting this indicator. This shows a strong commitment to improving this area.
  • And all sectors showed increased levels of collaboration to improve the delivery of integrated care for patients.

On the heels of receiving the 2016/17 QIP submissions, we are excited to see what learnings we can derive from all the new observations, themes and change ideas that each organization has captured within the pages of its plan. Our specialists are currently reviewing every QIP submitted; we will share our findings in the upcoming months.

For now, you can review the newly submitted 2016/17 plans on our QIP Navigator. There you will see each plan has three components, including a progress report, narrative and work plan, that together tell a story of each organization’s commitment to quality, patient safety, transparency and accountability. Each plan can be a source for ideas, and also provide opportunities to connect with others in your region or in the province doing similar work.

Quality improvement is an ongoing effort, and one that we believe should be grounded within a framework that prioritizes six dimensions of quality: safe, effective, efficient, timely, patient-centred and equitable care. Building capacity and knowledge in QI is critical to this success, and programs like Improving & Driving Excellence Access Sectors (IDEAS) are just one example of how teams can access these supports.

There is a real need to build ongoing capacity across our health system. We hope our current work on the 2015/16 QIPs and upcoming reports on this year’s submissions will continue to stimulate cross-sector conversations and continuous improvement across our province. In a time of immense system change, maintaining a clear focus on quality is more important than ever.

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