 |
| Welcome to our Blog |
Did this result answer your question? Refine your search
|
| Friday April 12, 2013 | |||
| Patient engagement in health quality improvement | |||
 While most Canadian citizens are pleased with health services in this country, information from around the world tells us there is considerable room for improvement in these services. As part of these improvement efforts, Canada’s provincial and territorial Premiers have committed to an exciting new initiative to promote and share innovative approaches to delivering safer and better health care. Premier Brad Wall of Saskatchewan is a leader in this pan-Canadian process. In Saskatchewan, the Ministry of Health, all Regional Health Authorities, and the Health Quality Council are collaborating in an unprecedented improvement effort to ensure that future health services in this province are optimally safe, appropriate, and high quality. As part of this effort, these agencies are engaging many health care workers across the province in improvement work using LEAN methodologies. Another key improvement initiative under way in Saskatchewan is an effort to ensure that all citizens have access to primary care services that are patient centred, community designed and team delivered. This means, if a patient has a chronic or complex health condition, they would receive much more integrated and coordinated care from a team of health care professionals (nurses, pharmacists, social workers, family physicians, etc.). This team would collaborate in making care safer and better for the patient. Their combined expertise applied in a team approach could reduce medication errors and ensure more efficient scheduling of diagnostic tests. However the most compelling aspect of the health quality improvement work in Saskatchewan is the effort to engage many patients and citizens in the process. Many quality improvement projects include patient and family participants who are making contributions to the success of this work. On April 10 and 11, the Health Quality Council is convening a Quality Summit symposium in Regina that will bring together hundreds of participants to share knowledge about health care quality improvement from across Saskatchewan, Canada, and around the world. What is most exciting about the plans for this Quality Summit is that the Government of Saskatchewan will fund all participation costs for up to 80 patients and family members. This is another step forward for Saskatchewan, where the engagement of patients and families in health care quality improvement has moved beyond tokenism to become foundational. However, patient and family engagement in health care quality improvement should not just occur at conferences and workshops. It needs to occur every day in every setting in which health care services are delivered. Next time a patient visits their family doctor, they should ask him/her about quality improvement efforts in primary care and whether he/she is engaged in the process. As well, here’s how every citizen can play a role in improving health care services and their own personal health.
|
|||
| Health Council of Canada | Conseil Canadien de la Santé | |||
|
|||
| Quality Activities in British Columbia | |||
 The Health Council’s latest report, Which way to quality: Which way to quality? Key perspectives on quality improvement in Canadian health care systems, finds that quality in health care has been a key issue for governments and health care providers alike for more than a decade. The health literature tells us of the avoidable cost, both human and financial that burden our system because of a quality issue - medical errors. Canada is not different in this regard from other countries. Efforts at improving system quality are evidenced by the health quality councils of one sort or another in many Canadian provinces, each tasked with the job of putting quality into practice. Some limited gains are claimed by almost everyone, but measureable large scale change other than in some subspecialty areas, is not easy to find. The province of British Columbia has followed a path similar to the other provinces but with two initiatives that are worthy of special mention. The first has to do with wait list reduction and the second with reducing post-operative infections and other complications. Access to care is one of the pillars of quality and one of the most persistent complaints voiced by Canadians. Other than some easing in selected high priority areas such as hip and knee surgery, Canadians still wait on average longer for care than almost any other developed nation. This is in spite of ample international evidence that funding policies (apart from the total amount of money) are a major factor behind our wait list problem. Countries that cling to fixed global budgets in hospitals tend to have long waitlists, while those that let money follow services needed by patients do not. In 2010 BC became the first Canadian province to bring in a limited form of Activity Based Funding (ABF) in which funding follows the patients, not the hospitals, much as it does in European countries. One of the largest Vancouver hospitals recently showed how they used the inherent flexibility of ABF over a nine month period to produce a 24% overall reduction in waits and a 70% reduction in the longest wait times all with only a marginal (3%) increase in cases. In the realm of safety and reduction of complications, BC spent $12 million in the previous year to enroll 22 of their largest hospitals in the National Surgical Quality Improvement Program (NSQIP). The NSQIP is a quality improvement process developed by the American College of Surgeons that boasts over 450 member hospitals in the US, including some of the centres with the best reputations for quality. The system collects detailed data on postoperative complications from each hospital and feeds a risk-adjusted score back to each hospital. It is this risk-adjustment along with the relative standing when compared to other hospitals doing the same work that makes the NSQIP results so compelling. It is not the first time a Canadian hospital has become part of NSQIP, but the experience of one BC hospital that joined NSQIP before ABF tells the story. Their first results showed they were among the worst performing of the hospitals in the cohort and that feedback shook their confidence enough to force some serious changes. Two years later they had improved to better than the cohort average, with proven drops in post operative infections and return trips to the operating room, along with a shortened length of stay. The patient experience was clearly safer and better, but those empty beds were quickly filled with more patients and because they were still held to a fixed budget, their financial situation became worse not better. Effectively they had achieved true quality and had been punished for it. There are many examples in Canada of innovative practices, but few are sustained in the long run. Could it be because our funding system has been inadvertently punishing quality where and when it does occur? Today, the situation in BC under activity based funding should be different. NSQIP is set to help bring big improvements in real quality and ABF will at least in theory compensate for any increase in workload that results. Nobody actually makes money with hospitals in Canada nor will that change with ABF, but at least we will no longer be punishing quality. We can only wait and see if that will make a difference. |
|||
| Health Council of Canada | Conseil Canadien de la Santé | |||
|
|||
|
Blogs 5 to 6 of 121 | ||
| Health Care Themes |
| Aboriginal Health (13) |
| Access and Wait Times (9) |
| Electronic Health Records (3) |
| Health Council of Canada (20) |
| Health Indicators (14) |
| Health Promotion (13) |
| Health Status and Health Outcomes (17) |
| Home and Community Care (13) |
| Innovative Practices (34) |
| Patient Engagement (26) |
| Pharmaceuticals Management (16) |
| Primary Health Care (16) |
| Archives |
 2012 |
| 2011 |
| 2010 |
Connect & Share
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
