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October 12, 2017

Physicians reflect on Clinical Quality Improvement Program

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, 2017, 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. Patricia Campbell from Prairie North Health Region and Dr. Mark James and Dr. Maurice Ogaick from Saskatoon Health Region answer questions about their CQIP experiences and about quality improvement in health care.

Dr. Patricia Campbell, Prairie North Health Region

Q: How would you describe your experience as a CQIP participant?
A: My experience as a CQIP participant has been very rewarding. From an academic point of view, I have been given a structured, methodical approach to designing, planning, and implementing change. The course supplies the framework for evaluating the effects of changes made within the clinical setting. It also touches on organizational psychology, which is invaluable in any workplace environment.
Q: What has been your biggest learning as a result of your involvement in the program?
A: I have enjoyed the exposure to new ideas and to the dynamism and optimism of the mentors, lecturers, and participants. It has reinforced my personal commitment to strive for excellence in primary health care delivery.
Q: Why do you think it is important to learn about quality improvement in health care?
A: Medicine is an environment which demands constant continuing education and constant broad-based improvement. . . . Quality improvement is a fundamental pillar of best possible medical care.

Dr. Mark James, Saskatoon Health Region

Q: What is your project about?
A: My project stemmed from initial work done around sepsis diagnosis and timely, appropriate intervention at SPH (St. Paul’s Hospital). As a comparator, I chose the RUH (Royal University Hospital) 5000 ward as a pre/post-intervention observational study. Why 5000? This ward already had established process around defining and managing the deteriorating patient, and I was curious to see if any change would occur once the Sepsis Bundle became a region imperative.
Q: Why did you choose that topic?
A: (It) seemed a natural progression: an area of interest, a population at risk, and a desire to enhance our patient experience. In addition, this was an opportunity to use this novel RUH environment, with engaged staff, as a test bed.
Q: What does quality improvement mean to you?
A: Quality improvement speaks to that confluence of care where we, with appropriate resources, are able to positively affect the well-being of patients entrusted to our care. In order to affect this change, we need to appreciate the current state and have the authority to enable and empower the front-line caregiver to implement serial improvement initiatives. In order to understand the effects of our manipulations, we need robust data collection and thoughtful interrogation of that data.

Dr. Maurice Ogaick, Saskatoon Health Region

Q: Why did you want to get involved in CQIP?
A: My interest in CQIP stems from my involvement with quality assurance within the Division of General Surgery. As the person charged with running our divisional morbidity and mortality rounds, I see many areas of possible improvement on a daily basis. The CQIP program provided an excellent opportunity for me to improve my understanding of quality improvement tools and methods as well as a framework to develop a small project of my own.
Q: What is your project about?
A: I chose to review how patients with clinically apparent inguinal hernias were referred to general surgeons. Specifically, I was interested in which ones were referred with an ultrasound to confirm the hernia despite the fact that often these are not needed and do not impact clinical management. If I could find a way to reduce the number of referrals with unnecessary ultrasounds, I could reduce both resource utilization and the additional time and effort required of patients to complete the investigation.
Q: What does quality improvement mean to you?
A: In my mind, health care is a dynamic and complex system that requires constant revision and modification. Quality improvement is the framework that allows that modification to progress in a systematic and effective way.  Since physicians and other health care professionals have unique insights into the overall system, their involvement in QI is both valuable and essential.