Celebrating Leaders in Quality
Recognizing leaders in quality and safety across Ontario.
Quality improvement (QI) is critically important for our health care system, but it is also hard work. Many pieces need to fall into place for a QI initiative to succeed. Behind great QI initiatives are good data, QI skills, team work and, crucially, leadership.
Sometimes we fail to recognize the importance of leadership and to celebrate the people who are at the forefront of leading quality in Ontario’s health system. Their leadership success is a testament to both skill and passion. While people may exercise leadership skills differently, they usually all work to combine vision with execution, to lead and follow, and to help motivate others to participate on the journey of change.
There are many great leaders in QI in Ontario. I had a chance to learn about a few of these individuals during the selection process for Ontario’s Minister’s Medal Honouring Excellence in Health Quality and Safety. As applications for the 2015 Minister’s Medal will be available this spring, I wanted to take a moment to highlight some of the remarkable Individual Champions and honourees since the establishment of the awards in 2013.
These individuals were often nominated by their patients, peers and community.
- Linda Lee, Director, Centre for Family Medicine Memory Clinic, Kitchener (Minister’s Medal Winner, 2014)
- Eleanor Rivoire, Executive Vice President & Chief Nursing Executive, Kingston General Hospital (2014 Honour Roll )
- Pauline Pariser, Primary Care Lead, Seamless Care Optimizing the Patient Experience, Toronto (2014 Honour Roll)
- Karen Hall Barber, Physician Lead, Queen’s Family Health Team, Kingston (2014 Honour Roll)
- Chandrakant Shah, Staff Physician, Anishnawbe Health Toronto (2014 Honour Roll)
- Nathalie Fleming, Head of Pediatric and Adolescent Gynecology Division, Children’s Hospital of Eastern Ontario, Ottawa (Minister’s Medal Winner, 2013)
- Frank Martino, Chief of Family Medicine, William Osler Health System, Etobicoke (2013 Honour Roll)
- Garry Laws, Executive Director, Mental Health Support Network South East Ontario, Belleville (2013 Honour Roll)
When Dr. Lee noticed that especially vulnerable patients with cognitive impairment were not receiving care in the timeliest fashion, she developed a multi-disciplinary program as part of the Centre for Family Medicine Clinic’s memory initiative to provide earlier diagnoses. She intuitively knew that earlier diagnosis delays decline, improves quality of life, and eases caregiver burden. She worked to ensure her program would provide holistic care using evidence-based tools and best practices for cognitive dysfunction. As a result of her efforts, there has been significant improvement in referral rates to geriatricians. Since 2008, Dr. Lee has trained 64 other teams across Toronto; her training course has led to the creation of 56 other memory clinics throughout Ontario.
Patient Engagement should be a key element of a successful QI initiative. Described as the “heart and soul” behind Kingston General Hospital’s (KGH) Patient and Family-Centred Care program (PFCC), Rivoire has used her leadership skills to help involve patients in all the key elements of their care. Introduced in 2010, the program has recruited over 90 patient and family members to partner with staff on committees and councils. Just last year, patient advisors volunteered 4,875 hours and the strength of their individual voices is can be heard throughout KGH. Rivoire has been an anchor throughout the process.
Dr. Pariser is a passionate advocate for improving the patient experience, especially for those with complex health issues. The success of SCOPE (Seamless Care Optimizing the Patient Experience), a QI initiative involving the University Health Network, Women’s College Hospital, and the Toronto Central Community Care Access Centre, is owed in no small part to her direction. SCOPE has helped relieve emergency departments from the stress of high users with multiple chronic conditions by supplying primary care physicians (PCPs) with a single access point. This hub can tap into a range of interdisciplinary supports, like a resource navigation network, on-call hospital internists and diagnostic imaging, and an electronic database with real-time hospital records and lab results. PCPs who use SCOPE now report 15 percent fewer avoidable emergency department visits.
Karen Hall Barber
Dr. Hall Barber has helped bring collaboration to the forefront of her QI and patient safety efforts since she joined the Department of Family Medicine and the Queen’s Family Health Team (FHT) in 2007. For Dr. Hall Barber, collaboration meant developing partnerships outside Queen’s FHT. Championing the spirit of team work, she has co-chaired a committee of local primary care leaders to better address QI issues and supported shared projects with local hospital partners and the local Public Health Unit. Dr. Hall Barber’s work drives home the power of working together to strengthen our system for the better.
Dr. Shah developed the Aboriginal Cultural Safety Initiative through Anishnawbe Health Toronto in 2011 to address the lack of cultural training in health professions courses in Ontario’s colleges and universities. He had discovered in 2008 that most of the 57,000 students in Ontario set to become front-line health care workers lacked training related to Aboriginal people and culture. Dr. Shah helped initiate a three-hour cultural competency training module for health sciences students with financial support from the Ontario Trillium Foundation and the Ontario Ministry of Training, Colleges and Universities. Inspired by the Indigenous Physicians Association of Canada’s curriculum framework, the training addresses gaps in mainstream health services. Dr. Shah also recruited 35 volunteer Aboriginal instructors across Ontario to deliver the training and shared their lived experience.
Equity is a key domain of quality. A champion of equitable health care, Dr. Fleming, created the Adolescent Obstetrics Outreach Program, a one-of-a-kind multidisciplinary Canadian program, in partnership with The Ottawa Hospital and St. Mary’s Home. Crucially, the outreach clinic is based in an inner-city refuge (instead of a hospital), allowing the program to provide care to at-risk teens during the first months of pregnancy, as well as parenting classes, a satellite high school, and a shelter. It was because of Dr. Fleming’s leadership that she was able to recruit so many talented health care professionals and partners to work together. She is now working to spread her model of care provincially and nationally.
Serving as the Chief of Family Medicine at William Osler Health System, President of the Ontario College of Family Physicians, Primary Care Lead at the Central West Local Hospital Integrated Network, and a board member of the Health Quality Innovation Collaborative, Dr. Martino is an example of someone who is as tireless as he is talented. The Health Quality Innovation Collaborative strives to bridge gaps within the health system related to lack of communication, access, and teamwork between sectors and providers. With the help and guidance of Dr. Martino, the initiative has helped improve access to health information, more clinical performance feedback to clinicians, and increased accountability for transfer of care between providers. Dr. Martino is helping make the Central West region (and indeed the whole province) a healthier system for us all.
You may have seen a blue elephant on display at various places of work or school in the South East Ontario region – and it’s a reflection of the efforts of Garry Laws, the executive director of the Mental Health Support Network South East Ontario. Laws created the “Elephant in the Room” Anti-Stigma campaign, which supports people with mental health and addictions challenges throughout the South East who are part of the Peer Support Network. The program zeroes in on how stigma is a significant contributing factor to the recovery progress.
These individuals represent a diverse range of projects spanning geography and the health care system, but they all share one thing in common – the untiring pursuit of improving quality in health care.
Quality improvement is hard but the people listed here and many others are leaders and difference makers. They find innovative approaches and connect with others in alternative ways.
Awards like this are important because they support the development of new difference makers. If you know someone whose exemplary leadership inspires collaboration and real change I would love to hear about them. Please e-mail me at email@example.com. Also be sure to visit the Ministry of Health and Long-Term Care’s website and nominate them for this year’s Minister’s Medal Honouring Excellence in Health Quality and Safety. Applications are open to all health services providers, and those who have applied in previous years are encouraged to do so again this year. An application template will be available soon.
I’d love to hear your thoughts on difference makers in your lives. Please Tweet me @DrJoshuaTepper and or email firstname.lastname@example.org.