pqi themes in interior health - pqi summit website... · 2018-12-17 · project charter start 2019...
TRANSCRIPT
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PQI Themes in Interior Health
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Disclosures
• No disclosures• No conflict of interest
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Geographical and Clinical Diversity
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ENABLE
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Online Training Resources
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Co-Creation
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Dyads
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PQI meets MSA
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Overview of Physician QualityImprovement (PQI)at Northern Health
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Disclosure
I have no conflicts or disclosures
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Our Vision
κ Physician champions: Physicianengagement, empowerment andleadership.
κ Patient and family centeredκ QI Infrastructure/support synergizing with
existing HA framework/programκ Weaving QI at every level to create
culture of QI
“To deliver exceptional care for Northerners”
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Our Journey
First SteeringCommitteeMeeting –November
2016
Staff Hired –February
2017
Educationfirst session –
June 2017
Seed GrantProcess
launched–September
2017
May 2018 -First
physicians tocomplete
intermediateQI
Ongoing for22 months
now –
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Organization# ofReps
Perspectives Members
Patient Representative 3 Patient Partners Edwina NearhoodKD TaylorMillie Percival
Practicing Physicians &Physicians Groups
9 Rural GP or Nurse Practitioner
Operational Chief of Staff
Quality Program Lead Physician
Medical Staff Association
Division of Family Practice
Practicing GP & SP; Varying geographic/regionalperspectives
Physician Mentors
VACANT
Dr. Dawid van RensburgDr. Shyr Chui and Dr. Singh
Dr. Amin Lakhani
Dr. Bill Clifford
Dr. Denise Jaworsky NW,NE VACANTNI Dr. Shyr Chui
Dr. Jamil Akhtar, Dr. Laura Brough
Specialist ServicesCommittee
3 Physician RepresentativeSenior Staff Representative
Dr. Kathy LeeAman HundalVACANT
Northern Health 5 Medical Director or NHMAC
Executive team and/or Operational
HA PQI Sponsor
Quality & Innovation
Primary Care Clinical Quality Program Co-Lead
Dr. Anurag Singh
Penny Anguish
Candice Manahan
Tanis Hampe
Dr. Paul Murray, Pam Mulroy
Steering Committee
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StaffNH PQI Staff Photo: Summer, 2018
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We love our patient partners
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NH PQI Education Photos
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Our Achievements
κ Integration with HA Quality infrastructureleadership and program
κ Region-wide impactκ Increasing physician participation and
interest in QI education and projectsκ PQI Steering Committee and Staff
subscribe to a common visionκ Highly motivated and engaged PQI support
staff
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Our Opportunities
κ Physicians leading large scale transformativeQI projects – Physician Mentors
κ Expansion of PQI network and collaboratingwith other HA- PQI
κ Role clarity between PQI support staff andphysicians
κ Utilize patient partners in individualprojects
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What’s Next for our PQI Program?
κ Recognition: NH Research and QI Conference Nov 6-8, 2018κ 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 challengesκ Collaborate: UNBC, UBC, PHSA, Doctors of BC.κ Program Improvements: Further develop the PQI learning journey
from beginner to intermediate, to advanced training, embedmilestones for physician recognition
κ Evaluation: Embedding provincial and local evaluationrecommendations into team planning/steering committee
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Questions?
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Island Health PQI experience:Dr. Jason Wale
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I have no conflicts of interest to declare.
I receive no honorariums or finance.
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Fraser Health Set a pretty high standard…
“We’re #2!”
Island Health
Fraser HealthHAL Smechner
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Island Health PQIexperience:
3rd year and growing up fast!
2016
Now
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First challenge is weare a long and skinnygeography
In person meeting ischallenging.
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Some of our First Cohort: 2016/17
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Some of our First Cohort: 2016/17
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Balance
Physician InterestLocal cultureNovel ideas
Physician EducationHA Priorities
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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
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PQI SummitPhysician Quality Improvement VCH/PH
Vinay Dhingra MDChair PLQI VCH/PH
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Disclosure
Presenter Dr Vinay Dhingra
Relationships with commercial interests:
Grants / Research Support None
Speakers Bureau/ Honoraria None
Consulting Fees None
Other None
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Goals of Physician Led QI VCH/PH
To create the capacity andcapability for physicians toengage and lead qualityimprovement
To engage the VCH andPHC physician medicalstaff to further a culture ofquality improvement
To support the local needsof physicians withimproving the quality ofpatient care
Primary Goals
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PLQI JointSteering
Committee
MedicalAdministration
SpecialistServices
CommitteeMedical
Staff
QualityPatientSafety
PatientsAdvisors
Alignment
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VCH/PHC Physician Led Quality Improvement
• Collaboration between VCH, PHC, and the Specialist Services Committee (SSC)
1 Day QI Training
• Offered 4 times per year• 130+ VCH PHC physicians since Jun 2018• Next dates:
• Nov 27, 2018• Feb 6, 2019• Mar 6, 2019
• Funded PLQI Cohort Projects• Cohort 1 (17/18FY): 24• Cohort 2 (18/19FY): 38
Funding for projects, trainingand sessionals
QI Support and PhysicianAdvisors for mentorship &coaching
Physician-Led QI Initiative – Advanced Training
Tech support Including dataanalysis
Steering Committee providesoversight
Online Module – Intro to QI
• In development – target 2019
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1-day QI TrainingObjectives:• 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
134Total physicians trained
7One day 1-day QI training sessionsheld between Mar 2017 – Jun 2018
Spread the word! Upcoming dates:• Nov 27, 2018• Feb 6, 2019• Mar 6, 2019
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PLQI Cohort Timeline
Aug: PLQI Launch Cohort1
24 projects
2017
2018
June: Cohort 1Graduation
July/Aug:project charter start
2019
Jan: Cohort 3 intakeMay: Notification ofacceptance cohort 3
May: Cohort 2 projects chosen
(14 continuation +22 new= 36 total projects)
Sept – May 2019: Cohort 2Ongoing advanced training and project support
Apr-May: Cohort 2Project Presentations
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PLQI Project SpecialtiesGeneral Practice Critical Care Medicine
PsychiatryEmergency Medicine
Physical Medicine and Rehabilitation
Anesthesiology
Cardiology
Internal Medicine
Laboratory Medicine
Neurology
Infectious Diseases
Radiology
Palliative Medicine
Dermatology
Pediatrics
Community and Rural
Obstetrics and Gynecology Thoracic Surgery
OrthopedicsOtolaryngology
20specialties
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September October November December January February March April May June
Cohort Training – 2018/19 Training Schedule
#1Sept 12
#2Sept 19
#3Sept 26
#4Oct 30
#5Nov 29
#6Jan 16
#7Mar 5
#8Apr 3
#9May 16 Graduation
TBD
One DayTraining
Nov 29
One DayTraining
Feb 6
One DayTraining
Mar 6
One DayTraining
Aug 23
One DayTraining
Jun 12
Cohort Training
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Cohort Training - PLQI Team
PLQI SupportStaff
PLQI PhysicianCoaches
PLQI PhysicianCohort Alumni
• Model for Improvement• Overview of DMAIC• Project Charters• Ethics in QI• Project management• Considering Cause and Effect: Driver Diagrams, Ishikawa,
5Whys• Human Side of Change - Stakeholder Engagement, Patients,
Colleagues, Administration, Leadership, Public• Data planning• Testing Changes
• QI Communications• Overcoming early barriers and road-blocks• Variation – The measurement and clinical perspective• Team Work & Communication• Sustaining and Spreading Improvement• Identifying Change Ideas – moving forward post-project
Teaching Topics Covered Include:
AND MORE!!!!
PLQIChairs
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Cohort Training – Additional Facilitators
Capturing andUnderstanding the
Patient voicePatient Advisor
How to be aneffective change
agentChange Specialist
PHC – Leadership andOrganizational Change
What Matters to YouEngagement Leader
BCPSQC
Patient-CentredMeasurement in BC
(PROMs/PREMs)VCH QI, Patient Centred
Measurement Working Group
Communicating Change(Knowledge Translation)
Director, Health Services andClinical research and Knowledge
TranslationPHC
PLQI Support StaffPLQI Physician
ChairPLQI PhysicianCohort Alumni
Teamwork andCommunication
Leader, Health SystemImprovement
BCPSQC
PLQI PhysicianCoaches
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Cohort 1 Graduation & Awards
PLQI Project:• to provide early access to food
and water in the ED at St.Paul's Hospital in an effort toreduce aggressive behaviour.
Dr. David Agulnik, Emergency Physician, St. Paul’s Hospital
2018 BC Health Care Hero Award
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Steering Committee MembersVCH/PHCDr. Brenda WagnerDr. Janet KowAllison MuniakCamille CiarnielloVivian Chan (HA Sponsor)
SSCDr. Ken HughesAman Hundal (SSC Sponsor)
Clinically Active PhysiciansDr. Vinay Dhingra (Chair)Dr. Kelly MaysonDr. Julie BaxterDr. Karen Dallas
Patient PartnersLori PedersonHamid Ghanbari
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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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Disclosure
2
Presenter / Faculty Dr. Montgomery Martin
Relationships with commercial interests:
Grants / Research Support
Speakers Bureau/ Honoraria
Consulting Fees
Other
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PHSA PQI Journey:
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Lessons Learned:
3
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Impact:
3
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Cohort #2; 2018-2019:
3
20 PhysiciansIN
Five Programs /Agencies:
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3Collaboration Education
Future Plans:
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Thank You
3
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PQI Across the ProvinceFraser Health
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Dr Chris BozekChairman Fraser Health PQI Steering Committee
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Conflicts
• I have no commercial conflicts in the presenting of this talk
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FH PQI Journey
• had 2 “champions” in Fraser Health
• the late Dr Jan Kornder, had initial job of QA/QI 2013
• Dr Curt Smecher, QI since 80’s before medicine, did IHI training in Boston in2013
• May 2014, meeting of SSC and FH, decided Curt would lead the change tostart PQI in FH
• Apr 2015 first cohort of FH Physicians, trained entirely by Curt, 9 docs
• “ on the run” setting of terms of reference and steering committee
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FH PQI Journey
• the budget of 1 million 2015 grew to 2 million 2016
• forged multiple partnerships with privacy office, IT, QA early on
• setting up of formal Steering Committee after cohort 1 underDayan Muthayan, EMD at FH
• 2016, cohort 2 had 13 docs, hiring of Crystal Sun and AngelaTecson to assist Curt and the cohort
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FH PQI Journey
• we've grown!
• currently cohort 4 has 26 students
• we've accepted community docs,medical administrators
• our support staff has grown to 24,teaching is increasingly being doneby cohort graduates
• we have 2 patient representatives
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FH PQI Journey
• and we've had results!
• over 100 projects are being managed
• several workshops have been done to promote spread of QI
• a QI network has been established to support ongoing work, collaborationand spread of successful projects
• through FE, a growing engagement with site administrators already focusedon QI is clearly occurring, with trained QI doctors sharing the lead
• over 50 percent of our graduates are assuming leadership roles in FH
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FH PQI Journey
• but theres more to be done…
• we are reaching a “tipping point” where a culture of QI is getting embedded
• we are increasingly moving to a project management focus
• change from a cohort training model which is based in one site, to bringing thetraining to hospitals in modules, easier access
• steering committee to work mainly on steering our PQI, not operations
• and this is all physician led!
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STAY TUNED!