Capacity Building for Excellence in Health Care Quality Improvement

1. Capacity Building for Excellence in Health Care Quality Improvement Marlene Smadu, Vice Chair, Board of Directors Katherine Stevenson, Senior Knowledge Exchange Consultant Sinead McGartland, Knowledge Exchange Consultant Health Quality Council June 2007

2. Objectives • Present an overview of Quality Improvement and Implementation Science • Why, what, how • Discuss a vision for Saskatchewan as a Centre of Excellence in Quality Improvement • Discuss strengths, opportunities, challenges and priorities for realization of the vision, including best approaches to enable and embed QI training in pre-professional healthcare curricula

3. Lag times to Best Practice • The lag between publication of landmark clinical trials and application in practice (to 50% use) is unnecessarily long, in the range of about 15 to 20 years. Balas and Boren, 2000

4. What are the usual methods to attempt change in practice? Trial & error Detailed prior study Chaos Paralysis Too much action, not enough thinking Too much thinking, not enough action “Something must be done, this is something, therefore we must do it…” “We can’t do anything until we know exactly what to do…” “Trial and Learning” Approach Implementing Change versus

5. Act Plan Study Do Model for Improvement What are we trying to accomplish? How will we know that a change is an improvement? What change can we make that will result in improvement?

6. How will we know that change is an improvement? Measurement • Outcome measures • Process measures • Balancing measures

7. Research vs Improvement Science

8. Quality Improvement is: • Competency based • Interprofessional • Patient-centred • Systems focus • The health care system is people and processes working together for a common purpose • The vast majority of improvements in the system can be gained through improved processes and improved linkages between processes around a common purpose: the patient’s perspective on quality

9. The vision “Saskatchewan is a Centre of Excellence in Education and Research for Quality Improvement”

10. Strengths and Opportunities • Saskatchewan’s innovative history • Saskatchewan’s Health Quality Council • Opportunity exists to promote SK educational programs as Centres of Excellence in QI training • Potential for impact on: • Recruitment • Retention • Quality as a business case: • Savings through improved care, outcomes, systems and processes • The time is right • QI movement is gaining prominence with world-wide success • Interprofessional Education

11. Strategies: Building Capacity Continuing Education Training Programs • TLQITs, Coach Approach, Workshops, Collaboratives, formal CE Faculty Development Summer Faculty Institute In-person training (year round) Health Professional Education Collaborative (HPEC) On-line modules Case development work Student Development Classroom training Clinical Placements On-line QI modules Case competition/Simulated QI project with IT Research Applied chair program application: CIHR Emerging team grant program application: CIHR

12. Next Steps • Ongoing consultation and partnering with provincial stakeholders • HQC sponsoring faculty member attendance at HPEC (April) • PCITE funding to run 2 undergraduate courses 2007/08 • Two Faculty Summer Institutes • Saskatoon: August 16 & 17 • Regina: August 23 & 24 • HQC Strategic Plan • Workplan and budget developed by fall, 2007

13. Contact Information Katherine Stevenson Phone: 668-8810 (Ext 1107) Email: kstevenson@hqc.sk.ca Sinead McGartland Phone: 668-8810 (Ext 143) Email: smcgartland@hqc.sk.ca

14. Comments and questions