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.
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.
“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.
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.
Moving away from a fragmented and siloed health care system to one that seamlessly connects patients to the services that they need is currently driving health care reform in Ontario.
How will this look for patients?
If you’re a patient with chronic knee pain, in most cases you will be seen and assessed by a family physician. However, in some cases you may be assessed at a rapid access clinic and, if you need surgery, seeing an orthopedic surgeon in a timely manner and having knee replacement surgery. After the operation, it means that you and your family work with health care professionals, so your needs and wishes are met when being discharged from hospital. When discharged you will have a transition plan that has been developed in collaboration with you and shared with your primary care provider. You will receive post-operative rehabilitation, education and training about self-care, and you will have a clear sense of the steps needed to ensure your recovery.