PQI Themes in Interior Health
Disclosures • No disclosures • No conflict of interest
Geographical and Clinical Diversity
ENABLE
Online Training Resources
Co-Creation
Dyads
PQI meets MSA
Overview of Physician Quality Improvement (PQI) at Northern Health
Disclosure I have no conflicts or disclosures
Our Vision “To deliver exceptional care for Northerners” κ Physician champions: Physician engagement, empowerment and leadership. κ Patient and family centered κ QI Infrastructure/support synergizing with existing HA framework/program κ Weaving QI at every level to create culture of QI
Our Journey May 2018 - First Steering Seed Grant First Committee Staff Hired – Education Process Ongoing for physicians to Meeting – February first session – launched– 22 months complete November 2017 June 2017 September now – intermediate 2016 2017 QI
Steering Committee # of Organization Perspectives Members Reps Patient Representative 3 Patient Partners Edwina Nearhood KD Taylor Millie Percival Practicing Physicians & 9 Rural GP or Nurse Practitioner VACANT Physicians Groups Operational Chief of Staff Dr. Dawid van Rensburg Dr. Shyr Chui and Dr. Singh Quality Program Lead Physician Dr. Amin Lakhani Medical Staff Association Dr. Bill Clifford Division of Family Practice Dr. Denise Jaworsky NW, Practicing GP & SP; Varying geographic/regional NE VACANT perspectives NI Dr. Shyr Chui Dr. Jamil Akhtar, Dr. Laura Brough Physician Mentors Specialist Services 3 Physician Representative Dr. Kathy Lee Committee Senior Staff Representative Aman Hundal VACANT Northern Health 5 Medical Director or NHMAC Dr. Anurag Singh Executive team and/or Operational Penny Anguish HA PQI Sponsor Candice Manahan Quality & Innovation Tanis Hampe Primary Care Clinical Quality Program Co-Lead Dr. Paul Murray, Pam Mulroy
NH PQI Staff Photo: Summer, 2018 Staff
We love our patient partners
NH PQI Education Photos
Our Achievements κ Integration with HA Quality infrastructure leadership and program κ Region-wide impact κ Increasing physician participation and interest in QI education and projects κ PQI Steering Committee and Staff subscribe to a common vision κ Highly motivated and engaged PQI support staff
Our Opportunities κ Physicians leading large scale transformative QI projects – Physician Mentors κ Expansion of PQI network and collaborating with other HA- PQI κ Role clarity between PQI support staff and physicians κ Utilize patient partners in individual projects
What’s Next for our PQI Program? κ Recognition: NH Research and QI Conference Nov 6-8, 2018 κ Education: Implement this year’s PQI education workshop series (including new brief skill building workshops) κ Staff: Continue our staff learning plan; Monitor staff resource capacity challenges κ Collaborate: UNBC, UBC, PHSA, Doctors of BC. κ Program Improvements: Further develop the PQI learning journey from beginner to intermediate, to advanced training, embed milestones for physician recognition κ Evaluation: Embedding provincial and local evaluation recommendations into team planning/steering committee
Questions?
Island Health PQI experience: Dr. Jason Wale
I have no conflicts of interest to declare. I receive no honorariums or finance.
Fraser Health Set a pretty high standard… HAL Smechner Fraser Health “We’re #2!” Island Health
Island Health PQI experience: 3 rd year and growing up fast! 2016 Now
First challenge is we are a long and skinny geography In person meeting is challenging.
Some of our First Cohort: 2016/17
Some of our First Cohort: 2016/17
Balance Physician Interest Physician Education Local culture HA Priorities Novel ideas
Challenges: • Role clarity • Education versus commitment ( especially surgeons) • Balance HA needs with physician interests • New admin structures • What admin endorsement means • What to do with grads after cohort
PQI Summit Physician Quality Improvement VCH/PH Vinay Dhingra MD Chair PLQI VCH/PH
Disclosure Presenter Dr Vinay Dhingra Relationships with commercial interests: Grants / Research Support None Speakers Bureau/ Honoraria None Consulting Fees None Other None
Goals of Physician Led QI VCH/PH To engage the VCH and To create the capacity and To support the local needs PHC physician medical Primary Goals capability for physicians to of physicians with staff to further a culture of engage and lead quality improving the quality of quality improvement improvement patient care
Alignment Quality Medical Patient Administration Safety PLQI Joint Steering Committee Specialist Services Medical Committee Staff Patients Advisors
VCH/PHC Physician Led Quality Improvement • Collaboration between VCH, PHC, and the Specialist Services Committee (SSC) 1 Day QI Training Physician-Led QI Initiative – Advanced Training • • Funded PLQI Cohort Projects Offered 4 times per year • • Cohort 1 (17/18FY): 24 130+ VCH PHC physicians since Jun 2018 • • Cohort 2 (18/19FY): 38 Next dates: • Nov 27, 2018 • Feb 6, 2019 • Mar 6, 2019 Funding for projects, training Tech support Including data and sessionals analysis Online Module – Intro to QI • Steering Committee provides In development – target 2019 QI Support and Physician oversight Advisors for mentorship & coaching
1-day QI Training Objectives: • Develop a culture of engagement in QI among physicians in PHC/VCH • Enhance QI understanding for physicians in PHC/VCH • To provide fundamental skills, tools and resources for QI 7 134 One day 1-day QI training sessions Total physicians trained held between Mar 2017 – Jun 2018 Spread the word! Upcoming dates: • Nov 27, 2018 • Feb 6, 2019 • Mar 6, 2019
PLQI Cohort Timeline May: Cohort 2 projects chosen 2017 (14 continuation +22 new = 36 total projects) Aug: PLQI Launch Cohort 1 2018 24 projects June: Cohort 1 Graduation May: Notification of July/Aug: acceptance cohort 3 Jan: Cohort 3 intake project charter start 2019 Apr-May: Cohort 2 Project Presentations Sept – May 2019: Cohort 2 Ongoing advanced training and project support
PLQI Project Specialties Neurology General Practice Critical Care Medicine Anesthesiology Psychiatry Emergency Medicine Internal Medicine Physical Medicine and Rehabilitation 20 Laboratory Medicine Obstetrics and Gynecology Thoracic Surgery Pediatrics specialties Cardiology Community and Rural Infectious Diseases Radiology Dermatology Otolaryngology Orthopedics Palliative Medicine
Cohort Training – 2018/19 Training Schedule Cohort Training #5 #6 #7 #8 Sept 12 #2 #1 Sept 19 #3 #4 #9 Nov 29 Jan 16 Mar 5 Sept 26 Oct 30 Apr 3 May 16 Graduation TBD September October November December January February March April May June One Day One Day One Day One Day One Day Training Training Training Training Training Jun 12 Aug 23 Feb 6 Nov 29 Mar 6
Cohort Training - PLQI Team PLQI PLQI Support PLQI Physician PLQI Physician Chairs Staff Coaches Cohort Alumni Teaching Topics Covered Include: • • Model for Improvement QI Communications • • Overview of DMAIC Overcoming early barriers and road-blocks • • Project Charters Variation – The measurement and clinical perspective • • Ethics in QI Team Work & Communication • • Project management Sustaining and Spreading Improvement • • Considering Cause and Effect: Driver Diagrams, Ishikawa, Identifying Change Ideas – moving forward post-project 5Whys • Human Side of Change - Stakeholder Engagement, Patients, AND MORE!!!! Colleagues, Administration, Leadership, Public • Data planning • Testing Changes
Cohort Training – Additional Facilitators PLQI Physician PLQI Physician PLQI Support Staff Chair Coaches PLQI Physician Capturing and Cohort Alumni Understanding the Patient voice Patient Advisor Communicating Change (Knowledge Translation) How to be an Director, Health Services and Clinical research and Knowledge effective change Translation agent PHC Change Specialist PHC – Leadership and Organizational Change Patient-Centred Measurement in BC Teamwork and What Matters to You (PROMs/PREMs) Communication Engagement Leader VCH QI, Patient Centred Leader, Health System BCPSQC Measurement Working Group Improvement BCPSQC
Cohort 1 Graduation & Awards 2018 BC Health Care Hero Award PLQI Project: • to provide early access to food and water in the ED at St. Paul's Hospital in an effort to reduce aggressive behaviour. Dr. David Agulnik, Emergency Physician, St. Paul’s Hospital
Steering Committee Members VCH/PHC SSC Dr. Brenda Wagner Dr. Ken Hughes Dr. Janet Kow Aman Hundal (SSC Sponsor) Allison Muniak Camille Ciarniello Vivian Chan (HA Sponsor) Clinically Active Physicians Patient Partners Dr. Vinay Dhingra (Chair) Lori Pederson Dr. Kelly Mayson Hamid Ghanbari Dr. Julie Baxter Dr. Karen Dallas
PQI Summit Session: PHSA Rapid Fire Dr. Montgomery Martin Ms. Georgene Miller, VP Quality PHSA Ms. Bethina Abrahams, Dr. Celine Kim November 19, 2018
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