SCI IMPLEMENTATION EVALUATION & QUALITY CARE CONSORTIUM
Opening REMARKS Kent Bassett-Spiers Stuart Howe Peter Athanasopoulos Anne Hayes Mark Bayley Cathy Craven Dalton Wolfe Jerry Mings
Welcome!
SCI IMPLEMENTATION EVALUATION & QUALITY CARE CONSORTIUM Ontario SCI Community Plan
Vision for Ontario VISION: Optimal and Equitable Health Care Services for all Ontarians regardless of where you live, to ensure functional recovery, health and wellbeing for people with SCI How- Best Practice Implementation Learn from Each Other’s Experiences Measure and Evaluate our performance Plan for Success Ensure Sustainability Community Engagement (policy, service providers, researchers, and individual with lived experience) https://sciontario.org/wp-content/uploads/2018/08/Amplify-Our-Community-Voice.pdf
Anne Hayes Director of Research Analysis and Evaluation Branch How does this work fit in the big picture of health policy and strategy?
Funding ANNOUNCEMENT
SCI IMPLEMENTATION EVALUATION & QUALITY CARE CONSORTIUM How Did We Get Here?
How Did We Get Here? Audit of Current Practice Promoting SCI Rehab Mapping Gaps in Research, Standards (2012) – 8 Sites Care and Policy Accredited N= 113 Contributors Data to Inform Practices Systematic Reviews of Literature Best Practice Implementation Provider & Consumer Versions Community of Practice (27 chapters of Rehab Evidence) N = 7 Sites (AB, ON, QC, NB)
‘ All breakthrough, No follow through ’ Woolf (2006) Washington Post op ed
E-Scan National REPORT CARD
Wheeled MOBILITY
What is High Quality HEALTHCARE? afe - avoids injuries to patients from care intended to help them imely - reduces waits and delays for those who give/receive care ffective - based on scientific knowledge, extended to all likely to benefit, while avoiding underuse/overuse quitable - provides consistent quality, without regard to personal characteristics (e.g. gender, ethnicity, geographic location or socioeconomic status) fficient - avoids waste - equipment, supplies, ideas, energy atient-centered - respects and responds to individual patient preferences, needs, and values, ensuring that patient values guide all clinical decision Reference:Institute of Healthcare Improvement
Proposed Strategies Audit and Feedback** Interactive small groups Multi-disciplinary collaboration Educational outreach Stroke * SCI-High * Mass media campaign Implementation Teams Participatory Action research Reminders Computerized decision support Financial intervention / incentive* 1. Runciman W, Hibbert P, Thomson R, Van Der Schaaf T, Sherman H, Lewalle P. Towards an International Classification for Patient Safety: key concepts and terms. International journal for quality in health care : journal of the International Society for Quality in Health Care / ISQua. 2009;21(1):18-26. 2. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington (DC)2001. 3. Johnson MJ, May CR. Promoting professional behaviour change in healthcare: what interventions work, and why? A theory-led overview of systematic reviews. BMJ Open. 2015;5(9):e008592. 4. Tuti T, Nzinga J, Njoroge M, Brown B, Peek N, English M, et al. A systematic review of electronic audit and feedback: intervention effectiveness and use of behaviour change theory. Implement Sci. 2017;12(1):61. 5. Ivers NM, Grimshaw JM, Jamtvedt G, Flottorp S, O'Brien MA, French SD, et al. Growing literature, stagnant science? Systematic review, meta-regression and cumulative analysis of audit and feedback interventions in health care. Journal of general internal medicine. 2014;29(11):1534-41.
Structure Indicator Characteristics of, or inputs to, rehab care Necessary conditions for the delivery of a given quality of rehab care but not sufficient Do not ensure that appropriate processes are carried out, or satisfactory outcomes are achieved Example: Underwater Treadmill • Nurse-to-Bed Ratio •
Process Indicator Represents the closest approximation of actual rehab care offered The most clinically specific of the three types of indicators. Measure delivery of appropriate (or inappropriate) rehab care Derived from clinical evidence of the effectiveness of the process concerned & are consistent with current professional knowledge Example: Mobility aids delivered prior to rehabilitation discharge • (e.g. walker, wheelchair)
Outcome Indicator Represent measures of health improvements (or deterioration) attributable to medical care May be influenced by other factors than the quality of care Two Types: Intermediary Mean walking distance – 10m Walk Test • Final Outcome Proportion of SCI patients achieving community • mobility (walking speed of 0.8 m/s at 18 months)
Understanding the CARE CONTINUUM • FIM • Length of Stay
Implementation Science MAKING SURE THINGS HAPPEN! Knowledge Generation Implementation Science Implementation: a set of purposeful activities designed to put into practice an activity or program of known dimensions.
SCI IMPLEMENTATION EVALUATION & QUALITY CARE CONSORTIUM Goals for the Day
Goals of THE DAY Learn about the work in organizations across the province. Review the purpose and goals of the SCI Implementation & Evaluation Quality Care Consortium. Identify issues and solutions to achieve the first network goal by April 2019. Generate a list of issues and solutions to enable working together to deliver on the April 2020 goals. Share ideas on how to build relationships and strengthen the province- wide consortium.
Recommend
More recommend
