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Quality Care: From Good to Great

Everybody wants quality health care. Why wouldn’t they?

This belief, which underpins the work of Health Quality Ontario, was recently endorsed by no less than the World Health Organization, World Bank and Organization for Economic Co-operation and Development Countries in a major report on global health care. They stated “even with essential health coverage and financial protection, health outcomes would still be poor if services were low-quality and unsafe”.

In a recent commentary in the CMAJ, we summarized data demonstrating that the quality of health care in Canada is good but not great. We also made several suggestions for improvement. In the article, we focused not on the things that individual clinicians could do differently, but rather on decisions that managers, administrators and policy makers can make. While most quality improvement initiatives are necessarily local, we feel certain key steps could be taken across the whole country.

Osteoarthritis: Be aware of a better care option

by Dr. Joshua Tepper

Osteoarthritis (OA) is the most common form of arthritis and a leading cause of disability.

With an estimated 5.6 million Canadians suffering from osteoarthritis and that number expected to increase significantly as the population ages, the condition still has no cure and can be difficult to manage effectively. In Ontario, people with osteoarthritis report a quality of life 10% to 25% lower than those without osteoarthritis, and they incur health care costs two to three times higher. Despite the seriousness of this situation, osteoarthritis is often underdiagnosed and undertreated.

Osteoarthritis is just one of several musculoskeletal conditions that affects one in three Ontario adults. Recently released wait-time data that can be found on the Health Quality Ontario website shows that patients with these conditions spend the most time waiting to access health-care services, like magnetic resonance imaging (MRI) even though that may not be the best treatment option. In addition, uncontrolled knee, hip and back pain has been associated with inappropriate use of opioids.

To address this, an approach to redesign and innovate the current model of care in Ontario will help people access the right treatment faster, starting with osteoarthritis and other conditions causing hip, knee and low-back pain.

Seven Competencies for Quality Leadership

by Dr. Joshua Tepper

Improving the quality of health care involves many factors.

Probably the most commonly discussed enabler of quality is data and the associated issues about quantity, type, accuracy, etc.  The role of standards and guidelines are also often referenced. And let’s not forget patient and public partnering as a critical element in quality improvement.

One element that has not had as much attention is the role of leadership. From local quality improvement (QI) efforts to broad system efforts, leadership is a key element needed to enable and sustain quality improvement.  To this end QI training programs like IDEAS includes leadership as a component of the curriculum and in the United States, the Institute of Health Care Improvement has a CEO leadership alliance focused on health care.

 

 

Change Day 2018 – Building on a Good Thing

Dr. Joshua Tepper and Gail Paech

Change is not a one-time event. It is not a box you can check off and then move on.

Health care systems can be changed and made better, but the prospect can be overwhelming. However, as individuals we can all commit to changing something we do for the better and making a difference at the local level.

Which is why the Change Day Ontario campaign will take place for the second consecutive year from Sept. 13 to Nov. 22 with the sponsorship of Health Quality Ontario and AMS Healthcare.

Last year’s Change Day campaign was a tremendous success, demonstrating the commitment of those working in Ontario’s health care system to make individual or group commitments to improve the compassionate care they provide.

 

Choosing Wisely: Wise Choices for Quality Care

Dr. Joshua Tepper

As one of the largest quality improvement initiatives in Canada, Choosing Wisely Canada has made impressive progress over the 3.5 years of its existence.

Physicians and patients working together to avoid treatments, procedures or tests that may not be necessary, or may even be harmful to patients is an important part of a quality health care system. It is also the driving force behind Choosing Wisely Canada, with whom Health Quality Ontario has partnered in this province.

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