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Everything I learned about quality…

by Dr. Joshua Tepper

I am rapidly completing my five-year tenure as President and CEO of Health Quality Ontario (HQO). I am probably a bit nostalgic and reflective by nature and so this transition time has led me to think about what I have learned in the last five years about quality improvement (QI).

It is helpful for context to know that while I probably brought a certain set of useful skills and knowledge to the role of CEO, I did not have a strong background or formal training in QI. These reflections then are not about a lifetime (or decades) of thinking about QI, but rather just the last few years.

To be clear, this is not a reflection or effort at summation of the good work that HQO and its partners have done in the last five years. Rather, this is a personal look at what I see as key themes in the still emerging and rapidly evolving space of quality improvement in health care.

I acknowledge that I have written about some of these ideas in other blogs. Also a recent set of comments (not really a speech) at the graduation class of an IDEAS cohort also touched on some of these themes. However I can also safely say that I have never put all of these ideas down in one place and further that this is by far the longest blog I have ever written. In fact, Pat Rich who helped me edit this said I should call this piece “The Long Goodbye”.

As a simple literary device I will bucket these ideas as “8 P’s”.

 

Challenges and opportunities: HQT 2018

by Dr. Joshua Tepper

It is only appropriate that the biggest conference in Canada, and one of the biggest in the world focused exclusively on health quality, should look with blunt honesty at the challenges of providing quality health care in 2018.

It is equally clear from listening and talking to the frontline health care professionals, patients, family members and others who made up the 3,000 delegates attending our Health Quality Transformation conference, that those present are willing to meet these challenges and uphold the six principles upon which quality care should be based - efficiency, timeliness, safety, effectiveness, patient-centredness and equity.

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.

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.

 

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