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Lee Fairclough

Quality Improvement Plans Having an Impact

We would like to congratulate the more than 1000 healthcare organizations who submitted their Quality Improvement Plans (QIPs) for 2017/18.

These plans and the recently published reports documenting work over the previous year are not only tangible evidence of the growing quality care culture in Ontario, they also deserve careful review because they show how specific organizations in the various sectors are translating the principles of quality care to make real change at the community level. The lessons and successes from these organizations can benefit others.

The scale and spread of quality improvement (QI) ideas is one of the great opportunities of the QIP.

This year also saw the achievement of a significant milestone. It’s the first time Collaborative Quality Improvement Plans have been submitted.

A Collaborative QIP is a formal, documented set of quality commitments made by health care organizations in a sub-region to improve quality through focused targets and actions that specifically address agreed upon issues.

This year, Collaborative QIPs were submitted by organizations within the sub-regions of the Waterloo Wellington Local Health Integration Network (LHIN) as a pilot to trial this approach.

This joint commitment by the staff and boards of these organizations to improving the care that patients experience as they transition services and care across the Waterloo Wellington LHIN is commendable. It represents the first time that groups other than those in primary care, long-term care and home care and the hospital sector have been involved in submitting a QIP.

At the same time as organizations submitted their plans for the coming year, Health Quality Ontario released its annual sector-based reports on last year’s QIPs, including the addition of a first cross-sector report on equity.

Reports documenting continued improvements from primary care teams, hospitals, the long-term care sector and home care have been prepared based on feedback on how initiatives have been implemented to improve quality.

We recently reported highlights from the equity and primary care QIPs earlier this year. Here are some noteworthy findings from the other reports:

  • Hospitals have made significant progress in engaging patients in their quality improvement initiatives: the percent of hospitals that indicated that their Patient and Family Advisory Council were involved in the development of their QIP rose from 45% in 2015/16 to 66% in 2016/17.
  • A strong majority of long-term care homes (87%) continue to focus on the appropriate prescribing of antipsychotics indicator, which has been identified as an area of focus in the province.
  • Home care organizations are using more participatory methods to engage home care clients in the design of quality improvement initiatives. Notably, use of client and family advisory councils increased from 21% of CCACs in the 2015/16 QIPs to 64% in the 2016/17 QIPs.
  • Many primary care organizations have undertaken initiatives in population health by improving colorectal and cervical cancer screening and by starting to use the same techniques to measure hemoglobin AIC monitoring among patients with diabetes.

Of course, there are also areas in every sector where organizations can strive to do better, especially in setting more ambitious targets for improvement.

We now have evidence that the development of these plans is helping build a culture for quality care in Ontario as well as supporting health care organizations to improve their performance.

Results of a recent survey show those who are intimately involved in guiding preparation of QIPS see the value of the quality planning process.

More than a third of CEOs or board chairs in the province’s primary care teams, long-term care institutions, community care access centres (CCACs) and hospitals completed the poll designed to assess the value of the QIP process implemented four years ago and coordinated by Health Quality Ontario.

The majority of respondents across all sectors felt that QIPs supported their organization in both discussing quality and quality improvement, as well as actually supporting the organization to improve performance. Also important is the majority of respondents who felt that developing quality improvement plans helps them build a quality-driven culture within their organization.

Results of the survey seem to clearly indicate that quality has become a top-of-mind issue for those delivering care in communities throughout Ontario.

As reflected in the title of Health Quality Ontario’s Strategic Plan for 2016-2019, Better has no limit – no matter which sector of the health care system you may work in or experience.

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