Advancing Clinical Quality Improvement

I firmly believe as health care professionals, we have the ability to bring about positive and meaningful change to the health care system. It all begins with the work we do in our very own healthcare settings.

Clinical Quality Improvement is about empowering physicians and health care providers with the tools and skills to make that positive change happen.

Given the health system transformations Saskatchewan is currently undergoing, there is a growing recognition of the importance for clinicians and healthcare providers to be actively engaged in driving positive, and effective change that raises the quality of care for patients in this province.

In this capacity I have focused on Quality Improvement Capacity Building (most notably, the creation of the province’s first ever Clinical Quality Improvement Training Program, which I helped to develop and the development and implementation of a more condensed version that residency training programs are welcome to use) as well as spearheading efforts to create a province-wide QI Support Unit housed in the College of Medicine for clinicians who need help conceptualizing, developing and carrying out QI initiatives

I have been actively involved in efforts to develop Quality Improvement Curriculum provincially. This includes:

●     Collaborating with Dr. Paul Babyn to develop the Quality Improvement and Patient Safety Curriculum for a training program for residents and new physicians (in conjunction with the Health Quality Council)

●     Worked with the Health Quality Council and the Postgraduate Medical Education Program (PGME) to develop the University of Saskatchewan College of Medicine Resident Quality Improvement Program

Designing an “Integrated Learning System” with the Health Quality Council.

●     Developing a Quality Improvement Course and training module for the proposed Health Sciences Network and

●     Developing the Quality Improvement components for the College of Medicine curriculum

What’s it like to be a clinician in the CQIP Program? Click here for more information.

Learn more about the Health Quality Council’s CQIP Program here.

Improving Quality of Care for Patients Requiring Colonoscopy

DOPS is a Quality Improvement Project which I support that is being led by the Saskatchewan Cancer Agency (SCA) with support from the provincial Appropriateness of Care (AC )Program Team in applying the AC framework.

• The quality of colonoscopies in SK as measured by adenoma detection rate (ADR) is excellent, exceeding the national standard of 50% as set by Canadian Partnership Against Cancer (CPAC). However, there are a number of physicians who do not meet this standard.

• A key strategy to improve quality is through a Direct Observation of Procedural Skills (DOPS) program, developed initially in the U.K. Bowel Screen Program and later adopted by the Royal College of Physicians in the United Kingdom for training and credentialing of endoscopists. This program has been adopted in various provincial programs in Canada, including the British Columbia Colon Screening Program. Not only does this program assess procedural skills it also reviews the whole process, from procedure indication to communication, diagnostic and therapeutic ability and safety.

• The DOPS Assessors are practicing endoscopists interested in colonoscopy quality improvement. Eight DOPS Program assessors, from both urban and rural health regions, are being trained at Saskatoon City Hospital on November 23, 2017.

• The DOPS process involves two assessors simultaneously and independently observing an endoscopist perform two consecutive colonoscopies resulting in four separate assessments for each endoscopist. The assessments typically are conducted in the endoscopists’ hospital during their regular endoscopy slate. The assessors will provide feedback during the colonoscopy and then following the two procedures.

• DOPS results will only be shared with the endoscopist and the Screening Program for Colorectal Cancer. The endoscopist may choose to share their results with their Health Region SMO or endoscopy committee.

  (source: Saskatchewan Health Authority Improving Appropriateness of Care Update, 2017)