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Combining the right “what” with the right “how”

Anthony Dale & Lee Fairclough
Spreading successful health care innovation is critical to the success of transforming health care systems.

But this is no easy task, especially in today’s complex health care environment. Funding constraints, slow-moving organizations and siloed care responsibilities can combine to create challenges to implementing new initiatives and it currently takes an average of 12 years for a health care innovation to be adopted into practice.

So, it is fitting that we should celebrate a program which over the past 5 years overcame these hurdles and helped introduce 8 proven health care initiatives to all parts of the province, in the process improving care for an estimated 300,000 patients. These interventions continue to be sustained and spread further across the province to this day.

Quality to the Core

It’s time quality science was taught as a core part of all health professional training.

No longer should quality improvement be viewed as an esoteric skill or taught as part of the “informal curriculum”, but rather it needs to become part of training for anyone embarking on a career in medicine, nursing or any other health profession.

As was pointed out more than a decade ago, the goal in quality improvement education is for everyone who works in health care to recognize that they have two jobs when they come to work every day: doing the work and improving it.

For its part, Health Quality Ontario – soon to become part of Ontario Health - has highlighted that creating a culture of quality among all involved in delivering health care is a fundamental requirement for building a better quality health care system in Ontario.

New indicators major step to bringing community pharmacists into quality fold

With health care delivery in Ontario becoming more integrated, the focus on health care teams and their role in promoting and supporting positive patient outcomes is sharpening. An important member of that team is the community pharmacy professional.

Pharmacy professionals contribute to the lives of patients every day in every part of our province. Our ability to better understand the impact of pharmacy care – like other parts of the health system – on patient outcomes and health-system performance has recently been strengthened with the introduction, for the first time in Ontario, of Quality Indicators for Community Pharmacy that are linked to the system. These indicators will ultimately be used to guide and inform quality improvement across the provincial pharmacy sector.

Here, Health Quality Ontario – soon to be part of Ontario Health – Interim President and CEO Anna Greenberg and Ontario College of Pharmacists CEO and Registrar Nancy Lum-Wilson discuss the growing interest in pharmacy as a partner in integrated care and new initiatives such as introduction of quality indicators to help community pharmacists provide quality care.

Tackling opioid use disorder on the frontlines

Evidence-based treatment can improve the lives of those living with an opioid use disorder

…so begins a report prepared by the Canadian Centre on Substance Use and Addiction (CCSA) last year documenting the many best practices in use across the country to manage a condition inexorably linked to the explosion of opioid-related deaths.

The Public Health Agency of Canada estimated 10,300 Canadians died from opioid-related causes between January 2016 and September 2018. More than 100 Ontarians are dying of an opioid overdose each month, and the crisis is not yet slowing. It is clear that we have an evidence-based consensus that more can and should be done to support those working on the front-lines of our health care system—family physician offices, nurse practitioner led clinics, and emergency departments, for example.

Counting on surgical teams

When it comes to taking opioids for the first time, it is not surprising that this frequently occurs after having surgery.

Opioids have become the go-to class of medications for controlling pain and after surgery, many patients require drugs to help deal with pain as they recover from a procedure. This has been documented in a major report by Health Quality Ontario released in 2017 – showing that surgeries are second only to dentists’ offices for the percentage of opioids prescribed to patients who had never used opioids before.

Now, 47 hospitals in Ontario who are part of the Ontario Surgical Quality Improvement Network have launched a campaign to reduce the quantity of opioids that surgical teams prescribe after surgery. These hospitals are responsible for almost 80% of the surgical operations that take place in the province annually.

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