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Quality Matters: A Playbook for Health System Improvement

Health Quality Ontario issues a call-to-action for health system quality improvement in Ontario.

Almost exactly two years ago I had the privilege of joining Health Quality Ontario.

In my first week, I remember attending a lunch presentation with a number of health system leaders. In speaking with people over the course of the lunch, individuals expressed to me their strong commitment to quality but also their uncertainty about whether there was a broadly accepted definition for quality. They said they were seeking greater clarity about what a “big picture” agenda for quality might look like.

It was an appeal for a common playbook for quality.

As the provincial advisor on quality, Health Quality Ontario has an obligation to answer this appeal. Today we are pleased to share the start of our answer to that call, a playbook of sorts, bundled into an initiative called Quality Matters.

This is just the start. For now, Quality Matters has two distinct parts that involve listening and learning from the perspectives of others (patients, providers and the like) on quality care.

First, we believe that defining quality needs to start with the voice of the patient. To that end, we’ve created Quality Is... with the help of documentary filmmaker and internal medicine physician Dr. Seema Marwaha.

Quality Is... captures the patient engagement element behind Quality Matters. In this video, patients from across the province express what quality care means to them. Capturing the voice of patients ensures that quality in health care is being designed inclusive of the voice and experience of those who use it.

Second, Health Quality Ontario has established the System Quality Advisory Committee (SQAC) to articulate a common language on quality, to be used by professional and administrative groups, patients and the public. SQAC is composed of three working groups that will work to define and support quality care across the province. Based on these efforts, Health Quality Ontario will put forward recommendations and a plan of action.

SQAC is led by the talented Dr. Adalsteinn Brown, director of the Institute of Health Policy Management at the University of Toronto. He has created a strong team of experts with a demonstrated commitment to quality. Click here to see the people behind SQAC.

One of SQAC’s first works is Realizing Excellent Care For All. This report builds the case for a provincial quality framework and shares a set of principles, domains of quality (borrowed from the Institute of Medicine), and key factors that must be considered to focus quality within the core of the health system.

At the heart of the report is a definition of a high-quality health system:

“A health system that delivers world-leading safe, effective, patient-centred services, efficiently and in a timely fashion, resulting in optimal health status for all communities.”

One sentence holds a world of potential. It’s the basis of our playbook.

We want to make Ontario’s health system a world leader in delivering the best outcomes across all six dimensions of quality, in engaging patients and families, and in its commitment to continuous improvement.

Realizing Excellent Care For All argues that it’s not acceptable to simply acknowledge the importance of a quality health care system or identify gaps that need to be closed. We have to find a way to learn from our successes and our failure. We need to and put them into motion across Ontario.

We are well on our way, and I am more than a little excited to see what Quality Matters will achieve and what will happen when we start putting our playbook into action.

Our new Quality Matters initiative is just beginning. We need to hear your views, so I encourage you to watch Quality Is…, download a copy of Realizing Excellent Care For All and also download and post our “Embrace System Quality Poster” and let us know what resonates for you and where we can improve. Email us at with your thoughts.

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Previous Article Introducing Health Quality Ontario’s Patient, Family and Public Advisors Council
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