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Health Quality Transformation: Patients Take Centre Stage

Delivering the best care involves exchanging ideas between patient and provider as part of an ongoing dialogue about quality improvement.

We all want the highest quality of care. This requires making efforts to continuously improve. But talking about improvement and actually doing it are two very different things. We started the annual Health Quality Transformation, (HQT) conference in 2012 as a way to support quality improvement by fostering the sharing of ideas – both tested and emerging – that enable us to actually “do” quality improvement.

This year we held our biggest HQT conference yet. In fact, with more than 2,200 people registered, HQT is now Canada’s largest conference on quality in health care. This level of engagement speaks to the collective interest and commitment to improving quality shared by all involved in the health care system, including patients.

In my blogs I have often spoken about the need to design the quality agenda along with patients and caregivers. Patients and caregivers were a major part of all aspects of the conference, including our first keynote presentation by David Price from Alberta. David recounted the heartbreaking story of his son Greg Price. Two years ago, Greg died from cancer-related complications after repeatedly falling through the cracks of the health care system. He was just 31 years old. David was joined on stage by Dr. Ward Flemons, a medical examiner at the Health Quality Council of Alberta. It was a powerful presentation by a grieving father and medical expert working collaboratively to understand how system failures led to the unnecessary death of a young man. David and Dr. Flemons both made constructive suggestions for what could be done in the future to bridge gaps in the health system.

Dr. Irfan Dhalla, HQO’s Vice President of Health System Performance, continued the patient-focused theme with the unveiling of HQO’s yearly report, Measuring Up. Dr. Dhalla detailed the experience of Ilona Taylor, one of several patients who shared their stories in Measuring Up. Ilona, 70, appears on the cover of the report where she discusses her experience waiting for two hip replacements. Ilona attended HQT, and I had the pleasure of meeting her before the conference.

The 13 phenomenal breakout sessions also featured patients including sessions on putting patient engagement in action, patient experience measurement, and engaging the vulnerable in the quality agenda.

We were fortunate to have Dr. Eric Hoskins, Minister of Health and Long-Term Care, join us at lunch. Minister Hoskins also spoke from the heart, pushing aside his pre-written notes to deliver an off-the-cuff speech about his belief that Ontario can have the best health system in the world by organizing the itself around people and their families. He presented the Minister’s Medal Honouring Excellence in Health Quality & Safety, which recognizes the efforts of health care providers to put patients “in the centre of the circle of care.” The theme this year was “Quality and Value by Design,” with the medal in the team and individual champion categories going to the Toronto Central Integrated Palliative Care Program and Dr. Linda Lee at the Centre for Family Medicine Memory Clinic, respectively.

The Toronto Central Integrated Palliative Care Program provides individuals with life-limiting illnesses high-quality, round-the-clock care. Without using any extra money they were able to find better uses for their current resources to provide significantly higher quality and value, said Minister Hoskins. Dr. Lee, who has practiced in primary care in 26 years, developed a multi-disciplinary program to help patients with cognitive impairment receive better care. Her training course has since branched out from her own family health team to 56 other memory clinics in Ontario.

One of HQT’s highlights was Dr. Mike Evans, world-famous health educator and YouTube sensation, and his discussion on the value of QI science. Dr. Evans unveiled his latest video, Quality Improvement in Healthcare, to a standing-room-only audience. He delivered a simple yet powerful message to the health community that day: “Stories trump data, relationships trump stories, and individuals trump organizations.” By prioritizing the patient experience, Dr. Evans showed us what providers could learn from their patients.

Dr. Evans urged each of us to dig deeper and explore the attitudes required to make things better. It’s a mindset he says he looks for in his own patients – the desire to test small changes, like eating healthy and exercising, to see how their health might improve. When patients embrace these changes it should not only improve their lives, it should keep providers motivated to improve their own delivery of care. “If patients can change, they deserve the same from us,” said Dr. Evans. We can all learn from each other as we adapt, adopt, or discard changes on the way to improving health care.

Before I sign off, I wanted to share one last compelling quote from the afternoon keynote address by Dr. Bob Bell, Deputy Minister of Health and Long-Term Care. Dr. Bell outlined the government’s action plan and its priorities to put patients at the centre of care. He also spoke about his hopes for the future of our health system, saying “If we don’t make transformational change in the next four years, shame on us.”

I’d love to hear your thoughts on what kind of transformational changes you’d like to see. Please join this discussion by following @HQOntario on Twitter or myself @DrJoshuaTepper.

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