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 capability 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.
CQIP is a sister program to the internationally recognized mini-Advanced Training Program, which was developed by Intermountain Healthcare in Salt Lake City, Utah. Its content has been adapted by HQC for the Saskatchewan health care system. CQIP is accredited through both the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons.
As CQIP continues through to November 2017, HQC will share information about the participants’ projects. Here, Saskatoon Health Region physicians Dr. Henrike Rees and Dr. Rabia Shahid answer questions about their projects and about quality improvement in health care.
Dr. Henrike Rees
Q: Why did you want to get involved in CQIP?
A: I wanted to get involved because I thought this program could provide me with a unique and very timely opportunity to obtain the resources, training, and mentorship needed to become a champion for quality improvement within my department and health region and to help my project succeed. The fact that the program is provided here in Saskatchewan, and is a credible source of information, was also important to me.
Q: What is your project about?
A: I chose the development of a subspecialty specific service in anatomical pathology as my project. I have limited my project to the development of a subspecialty service model in breast pathology. I plan to develop a model that can be easily adapted to other subspecialty areas such as gynecologic pathology and cytopathology, as well as dermatopathology, genitourinary pathology, or gastrointestinal pathology.
Q: What does quality improvement mean to you?
A: Quality improvement is part of my daily work. It is an essential element in laboratory medicine and pathology and is an essential part of medicine. It is very important to pay attention to quality improvement if our goal is to provide timely and accurate patient care.
Q: Why is quality improvement important for physicians and other health care professionals?
A: There is a strong link between quality improvement and good patient care. I feel quality improvement initiatives can potentially identify areas where more resources are needed. Also, through the process of quality review, we may be able to identify areas in which we may have sufficient resources if they are simply better utilized. If all health care providers are given the opportunity to learn the basics of quality care, and understand the implication for improved patient care, I expect that they will be enthusiastic to participate in quality improvement initiatives in the future, and the cycle of action, assessment of result, and further action based on those results will be perpetuated. I believe this will lead to steady improvement not only to patient care, but also to staff ability, confidence, and morale.
Dr. Rabia Shahid, Saskatoon Health Region
Q: What is your project about?
A: My project will focus on the proper utilization of pre-operative testing in Saskatoon Health Region. I am working with a team to develop a protocol that will guide in selecting appropriate investigations based on a patient’s health status, comorbid illness, and risk of surgical procedures.
Q: Why did you choose that topic?
A: Unnecessary pre-operative testing can cause significant burden on patients and the system. Sometimes unwarranted testing can cause a series of unnecessary investigations and follow-up visits, causing psychological burden to the patients and their family. It can also delay or postpone surgeries, which could have a deleterious effect on the health of a patient. Furthermore, unnecessary pre-operative testing can cause improper utilization of resources in the pre-operative clinics and delays in the system. Routine pre-operative testing is not recommended by several medical authorities for patients undergoing low-risk non-cardiac surgeries. It is recommended to perform patient-specific testing. With this project, I would like to explore gaps that can lead to unnecessary pre-operative testing in Saskatoon hospitals and find strategies to develop an algorithm for pre-operative testing.
Q: What does quality improvement mean to you?
A: Quality improvement is working together within interdisciplinary teams to improve the system, and to provide appropriate care to the patients.