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.”
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.
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.
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.
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.