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Measuring Up 2018: Complex Challenges

Anna Greenberg

Hospital overcrowding and hallway health care are realities facing today’s health care system in Ontario. The fact that they represent both a source and a symptom of the pressures that patients and frontline clinicians face underscores the complexity of the challenges to improve the situation.

This is one of the main messages to come from Measuring Up 2018, Health Quality Ontario’s yearly report on the performance of the province’s health system.

The report documents the cascading effects of hospital overcrowding such as longer wait times for admission to hospital from the emergency room; longer wait times to transfer out of hospital to other types of care – such as long-term care, home care; and insufficient access to mental health and addictions care. At a time when more and more patients have complex health needs, these stressors on the system are also contributing to rising levels of distress among unpaid caregivers.

Digital health: Transforming care and adding value

By Lee Fairclough

This week is Digital Health Week, a yearly acknowledgement of the transformative power of digital health technologies to support the delivery of health care.

That such a transformation is desired by patients and caregivers is not in doubt. Canada Health Infoway notes that 80% of patients want access to their own records and other digital health solutions. This enthusiasm was confirmed recently in a survey commissioned by the Canadian Medical Association which found:

  • Three-quarters of Canadians would like to see more technology as part of the health care system
  • 7 in 10 Canadians would take advantage of virtual physician visits and many believe that it would lead to more timely care, convenience and overall care.
  • Over half (56%) would likely wear a mobile device that monitored their health continuously.

Despite these figures, digital care has been relatively slow in coming to Ontario and the rest of Canada for a variety of reasons related to the challenges of putting the proper infrastructure in place, privacy and security concerns and some resistance from health care providers and patients.

Everything I learned about quality…

by Dr. Joshua Tepper

I am rapidly completing my five-year tenure as President and CEO of Health Quality Ontario (HQO). I am probably a bit nostalgic and reflective by nature and so this transition time has led me to think about what I have learned in the last five years about quality improvement (QI).

It is helpful for context to know that while I probably brought a certain set of useful skills and knowledge to the role of CEO, I did not have a strong background or formal training in QI. These reflections then are not about a lifetime (or decades) of thinking about QI, but rather just the last few years.

To be clear, this is not a reflection or effort at summation of the good work that HQO and its partners have done in the last five years. Rather, this is a personal look at what I see as key themes in the still emerging and rapidly evolving space of quality improvement in health care.

I acknowledge that I have written about some of these ideas in other blogs. Also a recent set of comments (not really a speech) at the graduation class of an IDEAS cohort also touched on some of these themes. However I can also safely say that I have never put all of these ideas down in one place and further that this is by far the longest blog I have ever written. In fact, Pat Rich who helped me edit this said I should call this piece “The Long Goodbye”.

As a simple literary device I will bucket these ideas as “8 P’s”.

 

Challenges and opportunities: HQT 2018

by Dr. Joshua Tepper

It is only appropriate that the biggest conference in Canada, and one of the biggest in the world focused exclusively on health quality, should look with blunt honesty at the challenges of providing quality health care in 2018.

It is equally clear from listening and talking to the frontline health care professionals, patients, family members and others who made up the 3,000 delegates attending our Health Quality Transformation conference, that those present are willing to meet these challenges and uphold the six principles upon which quality care should be based - efficiency, timeliness, safety, effectiveness, patient-centredness and equity.

Quality Care: From Good to Great

Everybody wants quality health care. Why wouldn’t they?

This belief, which underpins the work of Health Quality Ontario, was recently endorsed by no less than the World Health Organization, World Bank and Organization for Economic Co-operation and Development Countries in a major report on global health care. They stated “even with essential health coverage and financial protection, health outcomes would still be poor if services were low-quality and unsafe”.

In a recent commentary in the CMAJ, we summarized data demonstrating that the quality of health care in Canada is good but not great. We also made several suggestions for improvement. In the article, we focused not on the things that individual clinicians could do differently, but rather on decisions that managers, administrators and policy makers can make. While most quality improvement initiatives are necessarily local, we feel certain key steps could be taken across the whole country.

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