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March 15, 2017

CQIP participant discusses clinical pathway project

In January 2017, 16 Saskatchewan doctors became the first participants in the new Clinical Quality Improvement Program (CQIP), which was launched by the Health Quality Council (HQC) in collaboration with the Saskatchewan Medical Association (SMA) and the provincial Ministry of Health. CQIP is an 11-month course designed to build capability for facilitating and leading successful health care improvement work in Saskatchewan. The program includes a mix of theory and experiential learning, along with individual coaching and a community of practice for physicians actively working in a clinical context.

CQIP is a sister program to the internationally recognized mini-Advanced Training Program, which was developed by Intermountain Healthcare in Salt Lake City, Utah. Its content has been adapted by HQC for the Saskatchewan health care system. CQIP is accredited through both the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons.

As CQIP continues through to November 2017, HQC will share information about the participants’ projects. Here, pediatrician Dr. Shamsuddin Fakhir answers questions about his project and about quality improvement in health care.

Dr. Shamsuddin Fakhir, Cypress Health Region

Q: Why did you want to get involved in CQIP?

A: In today’s fast-changing health care scenario, the prime focus is on improving quality of health services. Physicians’ engagement and leadership in health system performance and improvement can improve overall quality of care and safety. A significant part of physicians’ practice as of today is the paucity of important data regarding their own practices. Clinical quality improvement projects will help to identify and understand the ways in which the practice may improve. This will reduce practice variation and thus make the services safe.

Q: What is your project about?

A:My project is about developing clinical pathways in pediatric practice. Clinical pathways standardize care for common clinical conditions. Despite the available evidence, there is considerable variation in the management of common pediatric problems. Availability and judicious use of evidence-based standardized clinical pathways will reduce the variation, provide safe care, decrease the resource utilization, improve the safety aspect, and “level up” the care, so that the patient receives the best available standardized care.

Q: Why did you choose that topic?

A: I have selected the clinical pathway for the management of acute bronchiolitis in children. There was a revision of 2006 American Academy of Pediatrics (AAP) guidelines for the management of acute bronchiolitis in 2014. These guidelines place an increasing emphasis on using clinical judgement in the diagnosis of acute bronchiolitis. Proper and effective use of the clinical pathway will reduce unnecessary diagnostic tests, respiratory treatments, rate of admission, and length of hospital stay. With this, the overall cost of treatment will be significantly reduced. This will also encourage and promote evidence-based management of other common pediatric problems.

Q: What does quality improvement mean to you?

A: Clinical quality improvement is an interdisciplinary process designed to raise the standard of delivery of preventive, diagnostic, therapeutic, and rehabilitative measures in order to maintain, restore, or improve the health outcomes of individuals and the population. The basic philosophy is that health care should be safe, effective, patient-centred, timely, efficient, and equitable. The most important challenge in quality improvement is to identify improvement priorities and form a clinical team with consensus about the aims and a commitment towards achievement.

Q: Why is quality improvement important for physicians and other health care professionals?

A: Physicians’ engagement and participation in quality improvement will improve safety and quality of care. This will help in developing physicians’ other professional skills, knowledge, and competencies, which will support and sustain the improvement within their area of expertise and the system. This way they will be able to address the increasing expectations for improved services and higher standard of care by patients, the public, and policy-makers.