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September 26, 2017

CQIP participants discuss radiation oncology, medical imaging projects

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 capacity 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.

Until Oct. 31, applications will be accepted for the second CQIP cohort. More information, including the application package, is available on the HQC website.

As the first wave of CQIP continues through to November 2017, HQC will share information about the participants’ projects. Here, Dr. Philip Wright from the Saskatchewan Cancer Agency and Dr. Nicolette Sinclair from Saskatoon Health Region answer questions about their projects and about quality improvement in health care.


Dr. Philip Wright, Saskatchewan Cancer Agency

Q: Why did you want to get involved in CQIP?
A: I wanted to get involved in CQIP to increase my quality improvement knowledge and skills to evaluate and improve radiation oncology care delivered in Saskatchewan.
Q: What is your project about?
A: My project involves increasing the use of a single treatment of radiation therapy to relieve pain caused by cancer spread to the bones.
Q: Why did you choose that topic?
A: Choosing Wisely Canada has produced numerous recommendations to help guide physicians and patients in discussions regarding appropriate and evidence-based practices. The main premise of Choosing Wisely Canada is that more is not always better and can actually be harmful. One of the recommendations in Radiation Oncology is to use a single fraction of radiation therapy for pain relief, instead of five or 10 fractions, when appropriate. I have also been looking at this question with support from Canadian Partnership Against Cancer (CPAC).
Q: Why is quality improvement important for physicians and other health care professionals?
A: Quality improvement is important in health care to continue to provide optimal care to our patients. If we don’t evaluate the care we provide, we are unable to evaluate the effectiveness or appropriateness of the care provided. When changes are implemented, evaluations need to be performed to ensure the changes result in a sustained improvement in care and are not causing unintended harm.

Dr. Nicolette Sinclair, Saskatoon Health Region
Q: What is your project about?
A: My project is about standardizing our follow-up of patients who undergo endovascular abdominal aortic repair (EVAR) for abdominal aortic aneurysms (AAA). Specifically, I am trying to get a program going where some of these patients are followed using ultrasound instead of contrast-enhanced CT, eliminating exposure to IV contrast – which can harm kidneys – and radiation, at a lower cost to the system.
Q: Why did you choose that topic?
A: It’s a topic that seems to come up repeatedly in our department (Medical Imaging), specifically what to do with patients whose kidneys aren’t functioning well and are at high risk for worsening kidney function following the IV contrast used for CT. Patients were being cancelled or getting far more invasive tests. Many other centres use ultrasound as part of their follow-up post-EVAR, so we figured we would see if we could work it into some sort of standardized protocol.
Q: What does quality improvement mean to you?
A: I guess it just means always looking for ways to improve the care we deliver to our patients. It can be small, simple things, and often is – you just gotta keep your eyes and ears open! It also means questioning the way we do things; just because it’s the way it’s always been doesn’t mean it’s the best way going forward.
Q: Why is quality improvement important for physicians and other health care professionals?
A: It’s important because at its very centre is patient care, and striving to deliver the highest quality patient care should be everyone’s goal across the entire health care team. We all get super busy and stressed in our daily work and sometimes I don’t feel like I am making the kind of difference I wanted to make when I got into health care. With quality improvement, you get to work with other members of the health care team in a new way and come up with new ideas together, try stuff out, watch it fail, try again, watch it succeed – and, at the end, you all get to pat each other on the back and say, “Hey, look what we did. This is actually going to make a difference!” Then you move on to the next project, and the cycle continues.