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Doing it right – quality standards to improve care

Dr. Irfan Dhalla and Dr. Chris Simpson / January 29, 2019

Patients across Ontario should expect to receive excellent care from our health system. And it usually delivers. But in too many instances, the quality of care people receive can vary depending on where they live.

For example, people with a diagnosis of heavy menstrual bleeding living in the northeast are more than ten times as likely to receive a hysterectomy as people living in Toronto. Similarly, people hospitalized with a hip fracture have a likelihood of dying within 30 days of admission that varies from 3% to 16% across the 50 highest volume hospitals in the province.

Some variation in care is always to be expected because of differences in patients’ underlying health conditions or in their treatment preferences. However, wide unwarranted regional variations in practices and outcomes are often a symptom of a system that lacks focus. Several decades ago, renowned health services researcher Dr. John E. Wennberg and colleagues at the Dartmouth Institute of Health Policy and Clinical Practice in the US determined that such regional variations point to a lack of “evidence-based standards of practice”.

Quality at the coalface: How front-line providers are upping their game

Dr. David Kaplan / January 22, 2019

Providing quality care should be the aim of all who work in the Ontario health care system.

However, in today’s high-pressure environment, physicians and other health care professionals practising primary care in the community or in hospitals are often challenged to find time to engage in quality improvement initiatives on top of providing the necessary care for their patients.

As Dr. Jeremy Grimshaw, Professor of Medicine at the University of Ottawa said in a recent commentary for physicians: “You want to provide the best care for your patients but often don’t have the time or energy to scan a dense and convoluted report that tells you how to do this, even if it is based on data from your own practice.”

Quality Improvement Plans: Meaningful change and more value

Lee Fairclough / January 10, 2019

As we begin a new year and look towards further enhancing quality care in Ontario, it’s a good time to reflect on the annual public commitment that health care organizations make to their communities through their Quality Improvement Plans (QIPs). These plans share what was achieved to improve care in the previous year and set out how they will improve health care quality within their organizations in the coming year.

On April 1, 2019, more than 1000 QIPs will be submitted to Health Quality Ontario by hospitals, long-term care homes, home-care organizations and primary care teams and simultaneously shared with their local communities.

It is worth remembering that QIPs have only been required in Ontario for the past eight years, starting with Ontario’s 142 public hospitals. The original QIP stated “they should be seen as a tool, providing a structured format and common language that focuses an organization on change.” This was a major shift from the prevailing, more ad hoc approach to quality most Canadian health care organizations took, where there was limited support for local improvement efforts and as a result, change was diffused.

Doing it right – quality standards to improve care

Quality at the coalface: How front-line providers are upping their game

Quality Improvement Plans: Meaningful change and more value

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