1. © Health Quality Council 2007 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. © Health Quality Council 2007 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. © Health Quality Council 2007 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. © Health Quality Council 2007 Implementing Change What are the usual methods to attempt change in practice? Trial & errorDetailed prior study Chaos Too much action, not enough thinking “Something must be done, this is something, therefore we must do it…” Paralysis Too much thinking, not enough action “Trial and Learning” Approach “We can’t do anything until we know exactly what to do…” versus

5. © Health Quality Council 2007 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? Model for Improvement ActPlan StudyDo

6. © Health Quality Council 2007 How will we know that change is an improvement? Measurement Outcome measures Process measures Balancing measures

7. © Health Quality Council 2007 Research vs Improvement Science Measurement for Research Measurement for Learning and Process Improvement Purpose To discover new knowledge To bring new knowledge into daily practice Tests One large “blind” test of intervention(s) Many sequential, observable tests of change Biases Control for as many biases as possible Stabilize the biases from test to test Data Gather as much data as possible Gather “just enough” data to learn and complete another cycle Duration Can take long periods of time to obtain results “Small tests of significant changes” accelerates the rate of improvement

8. © Health Quality Council 2007 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. © Health Quality Council 2007 The vision “Saskatchewan is a Centre of Excellence in Education and Research for Quality Improvement”

10. © Health Quality Council 2007 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. © Health Quality Council 2007 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. © Health Quality Council 2007 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. © Health Quality Council 2007 Contact Information Katherine Stevenson Phone:668-8810 (Ext 1107) Email:kstevenson@hqc.sk.cakstevenson@hqc.sk.ca Sinead McGartland Phone: 668-8810 (Ext 143) Email:smcgartland@hqc.sk.casmcgartland@hqc.sk.ca

14. © Health Quality Council 2007 Comments and questions