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Tweeting about quality: How social media can help improve care

Pat Rich

Informing and connecting: If social media is supporting the development of quality care in Ontario and elsewhere, it is through effectively performing these two key tasks.

While social media may still only be used by a portion of health care providers, policy-makers and patients in the province, the platforms we have come to associate with social media – Twitter, Facebook, LinkedIn etc. – can be influential in supporting quality care initiatives.

In developing a system that we wish to be patient-centred, social media has emerged as an important platform for allowing patients and members of the public to engage with health care providers and policy-makers to make their views clear. The degree of interaction between those with lived experience with a disease or illness with those providing their care is unprecedented thanks to online communities and social media like Twitter.

The Twitter hashtag #metoomedicine, galvanized women physicians and their supporters through Twitter to demand more equity and gender equality within the medical profession and has helped bring a much higher profile to this issue. It is an example of how social media has emerged as a powerful tool for helping health care providers share their experiences and insights. It can also help providers deal with their challenges to support the fourth pillar of the Quadruple Aim in quality care – that of enhancing provider wellbeing (although to be fair, social media can also impede this by adding more time pressures to already stressed providers or exposing practitioners to frankly hostile or upsetting views or individuals).

Doing it right – quality standards to improve care

Patients across Ontario should expect to receive excellent care from our health system. And it usually delivers. But in too many instances, the quality of care people receive can vary depending on where they live.

For example, people with a diagnosis of heavy menstrual bleeding living in the northeast are more than ten times as likely to receive a hysterectomy as people living in Toronto. Similarly, people hospitalized with a hip fracture have a likelihood of dying within 30 days of admission that varies from 3% to 16% across the 50 highest volume hospitals in the province.

Some variation in care is always to be expected because of differences in patients’ underlying health conditions or in their treatment preferences. However, wide unwarranted regional variations in practices and outcomes are often a symptom of a system that lacks focus. Several decades ago, renowned health services researcher Dr. John E. Wennberg and colleagues at the Dartmouth Institute of Health Policy and Clinical Practice in the US determined that such regional variations point to a lack of “evidence-based standards of practice”.

Quality at the coalface: How front-line providers are upping their game

Dr. David Kaplan

Providing quality care should be the aim of all who work in the Ontario health care system.

However, in today’s high-pressure environment, physicians and other health care professionals practising primary care in the community or in hospitals are often challenged to find time to engage in quality improvement initiatives on top of providing the necessary care for their patients.

As Dr. Jeremy Grimshaw, Professor of Medicine at the University of Ottawa said in a recent commentary for physicians: “You want to provide the best care for your patients but often don’t have the time or energy to scan a dense and convoluted report that tells you how to do this, even if it is based on data from your own practice.”

Quality Improvement Plans: Meaningful change and more value

Lee Fairclough


As we begin a new year and look towards further enhancing quality care in Ontario, it’s a good time to reflect on the annual public commitment that health care organizations make to their communities through their Quality Improvement Plans (QIPs). These plans share what was achieved to improve care in the previous year and set out how they will improve health care quality within their organizations in the coming year.

On April 1, 2019, more than 1000 QIPs will be submitted to Health Quality Ontario by hospitals, long-term care homes, home-care organizations and primary care teams and simultaneously shared with their local communities.

It is worth remembering that QIPs have only been required in Ontario for the past eight years, starting with Ontario’s 142 public hospitals. The original QIP stated “they should be seen as a tool, providing a structured format and common language that focuses an organization on change.” This was a major shift from the prevailing, more ad hoc approach to quality most Canadian health care organizations took, where there was limited support for local improvement efforts and as a result, change was diffused.

Patient partnering: A blossoming movement


A Conversation with patient advisor Diane McKenzie and Chief of Communications and Patient Partnering, Jennifer Schipper

Diane McKenzie: Patient partnering means building deeper, long-term relationships with health care professionals that lead to improved health care quality. This work is about challenges that need to be overcome. By working through those challenges – together – patients and organizations can make dramatic changes. It’s not easy. But together we are better when we are done.

Jennifer Schipper: When I first started at Health Quality Ontario more than four years ago, I was keen to “engage” patients and find out how we could work together.

One of my first meetings was with the founding president of Patient’s Canada, Sholom Glouberman, who told me: “Jennifer, patients don’t want to be engaged when it comes to health care improvement, they want to be married.”

Sholom’s phrase and sentiment has stayed with me ever since and has helped guide how Health Quality Ontario is working to help patients, health care professionals and organizations truly partner to effectively improve the quality of health care.

The speed at which this is occurring and the associated changes in language about this trend can be overwhelming to those who are not directly involved. For example, the concept of ‘patient engagement’ which was so dominant so recently, has largely been replaced by the more proactive concept of partnership.

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