CONTINUOUS QUALITY IMPROVEMENT IN HEALTHCARE

SEPTEMBER 27, 2012

8:15

Registration and Continental Breakfast

9:00

Welcoming Remarks from Insight Information

9:05

Opening Remarks from the Chair

Don Shilton
President
St. Mary's General Hospital

9:10

Assessing Appropriateness of Care in Support of CQI in Healthcare

Charles J. Wright, MD
Chair, Ontario Health Technology Advisory Committee
Consultant in Medical and Academic Affairs
Program Planning and Evaluation Councillor
Health Council of Canada

Instituting a regular review of the appropriateness of medical and healthcare services being provided must be regarded as an important component of providing high quality health care. Appropriate resource utilization is a direct quality issue and therefore services that offer no – or doubtful – benefit to patients must be examined carefully as a potentially huge opportunity cost. Several jurisdictions including Ontario are now considering or have instituted such procedures.

How should "appropriateness" of care be determined in such reviews? Who should carry out the assessment? What input should patients and patient advocacy groups have in this process? A joint committee with representation from the Ministry of Health and Long-term Care, Health Quality Ontario (HQO) and the Ontario Health Technology Advisory Committee (OHTAC) has been set up to work on this essential, but sensitive and controversial issue. The chair of the committee will discuss the background to this quality management initiative and suggest the possible options for dealing with it.

10:15

Improving Quality of Care Under Ontario's New Health System Funding Reform

Miin Alikhan 
Director, Health Quality Branch
Ministry of Health and Long-Term Care

Michael G. Stewart 
Lead, Decision Support & Knowledge Transfer
Health Quality Branch
Ministry of Health and Long-Term Care

• How has the hospital funding formula changed in Ontario?
• What does this mean for care delivery?
• How will hospital performance and funding be aligned?
• What does this mean for access to care?
• Care priorities – ramifications?

10:00

Networking Coffee Break

11:00

Connecting the Dots for Improving System Wide Performance

Carolyn Hoffman
Vice President, Clinical Performance Improvement
Alberta Health Services

• Developing a sustainable and effective infrastructure for improvement
• Mapping out the plan/trajectory
• Leadership fundamentals
• Frontline patient, physician and staff engagement
• Implementation milestones
• Lessons learned to date
• Next steps

12:00

Networking Luncheon

1:15

KEYNOTE ADDRESS

#SocialQI – Leveraging Social Learning Networks and Technologies for Quality Improvements in Healthcare

Brian S. McGowan, PhD
Author and Healthcare Innovation Consultant
Founding Chair, Committee on Emerging Technologies in Education
Alliance for Continuing Education in the Health Professions
Author of #socialQI: Simple Solutions for Improving Your Healthcare

Deficiencies in healthcare quality are generally acknowledged to be tied not the ability to provide quality care, but to the inability to provide it consistently and universally. Healthcare quality is an issue of variability - at certain times, in certain places, for certain patients the healthcare system works perfectly, and at other times it simply does not. We may address the variation in care in many ways, but most basically it is a problem with communication. As information and expertise become trapped in silos and disconnected, healthcare quality deteriorates.

Over the past decade the channels available to us for communication and collaboration have evolved significantly, but these channels have failed to gain much (if any) traction within healthcare as a vehicle to tackle variability in care and to promote greater dissemination and adoption of best practices.

This session will:

• Introduce the concept of SocialQI – leveraging social learning technologies and social networks to drive quality improvement
• Review existing data on the meaningful use of social learning technologies in healthcare
• Highlight new evidence that health professional networks can have dramatic positive impacts on healthcare quality
• Address outstanding questions that the audience may have as it relates to actionable first steps

2:00

Accountability Agreements and Better Care Delivery

Bill MacLeod
CEO
Mississauga Halton LHIN

Don Shilton
President
St. Mary's General Hospital

• Key areas of focus and framework
• Fairness and workability
• Levers for better care delivery?
• Results and evidence to date

3:00

Networking Refreshment Break

3:15

Healthcare Engineering I: Improving the System from Above

Michael W. Carter PhD
Founder and Academic Director,
Centre for Research in Healthcare Engineering
Professor, Department of Mechanical & Industrial Engineering,
University of Toronto
Adjunct Professor, School of Management, University of Ottawa
Adjunct Scientist, Institute of Clinical Evaluative Sciences (ICES)

• Planning for patients, planning for providers
• Aligning provincial and regional healthcare objectives and local care delivery
• Why consider provincial and supra-regional improvements in healthcare?
• Policy, organizational, and operational issues and obstacles
• Implementation – is there a best approach? A best level to optimize QI?
• Aligning provincial and regional healthcare objectives and local care delivery – doable?

3:45

Healthcare Engineering II: Improving the System from Within

Neil McEvoy CHE, PEng
Administrative Director
Centre for Research in Healthcare Engineering
Department of Mechanical & Industrial Engineering
University of Toronto

• Maximizing the benefits of Lean and QI initiatives
• How far can Lean/Six Sigma QI approaches take us – is there a limit?
• An integrated approach to planning, strategy and execution
• Tools and simulation applications
• Optimization techniques

4:15

IT/IM Strategies that Support Quality Improvement

Jeremy Theal MD FRCPC 
Chief Medical Information Officer
North York General Hospital

• What does IT/IM bring to the continuous improvement mandate?
• Aligning IT/IM to QI objectives
• Planning IT infrastructure and acquisitions with PI in mind
• Lean Visual management and IT/IM
• Ensuring ROI
• Case studies and lessons learned

5:00

Conference Adjourns for the Day

SEPTEMBER 28, 2012

8:30

Continental Breakfast

8:55

Chair's Opening Remarks

9:00

Physician Partners and Leaders in Achieving QI Goals

Marko Duic MD
Chief, Department of Emergency Medicine
Southlake Regional Health Centre
Staff Emergency Physician
St. Joseph's Health Centre (Toronto)

Amir Ginzburg, MD FRCPC
General Internist and Hospitalist
Physician Director, Quality and Patient Safety
The Credit Valley Hospital and Trillium Health Centre
Lecturer, Department of Medicine
Faculty of Medicine, University of Toronto

Physicians are essential partners for the success of any QI strategy in healthcare organizations. What are the key factors that will ensure there is traction and continuity in physician engagement on these initiatives?

• Value proposition for physicians
  • Better care
  • Improved standardization and efficiency
  • More patients treated
  • Work life balance
  • Workplace quality and atmosphere
• Common barriers to physician engagement and how to get around them
  • Attitude of skepticism – physician leads and mentors
  • Data – show me the evidence
  • Training and time management
  • Entropy

9:45

PANEL

Strengthening Operational Governance and Oversight for Sustained Process Improvements

Bill MacLeod
CEO
Mississauga Halton LHIN

Murray T. Martin
President and CEO
Hamilton Health Sciences

Fiona McDougall
CEO
RWS Advisory

• Facilitating organizational transformation to a continuous improvement culture
• Paradigm shift – the role of leadership and governance for successful transitions
• Embracing the philosophy and implementing the management techniques
• Macro level lean strategies
• System quality improvement – leadership role – governance role
• Alignment of Lean across the system and at all levels
• Linking strategies to operations
• Training strategies for leadership
• Leadership buy-in and mentoring
• Oversight and accountability mechanisms
• Governance and the role of the Board
• A patient-centric model
• Paying the gains forward

10:45

Networking Coffee Break

11:00

Measurement and Data Essentials for (Lean) Health Transformations – the Continuous Improvement Loop

Ladan Dadgar PhD
Manager, Performance Measurement and Decision Support
Quality, Performance & Risk Management Department
The Credit Valley Hospital

Sharon Tai-Young
Director, Health Records and Decision Support
Markham Stouffville Hospital

• Why measure the outcomes of your improvement and Lean initiatives?
  • Evaluation
  • Accountability
  • Funding model
  • Feed-back
• What are the best ways to go about doing so?
  • What information needs to be captured?
  • How to capture it with least effort
• Capturing the full picture and all the benefits
  • Process metrics
  • Outcome metrics
  • Efficiencies and cost savings
• Using the data and knowledge gathered for continued gains
  • Education
  • Buy-in
  • Next steps

11:45

CASE STUDY

Lean Strategies for Support Services in Healthcare

Rick Gowrie
Vice President, Planning, Capital Redevelopment,
Facilities and Support Services
Rouge Valley Health System

Craig Wickens
General Manager, Support Services
Rouge Valley Health System

• The performance challenges for support services
• Why consider Lean approaches?
• Planning the Lean solutions
• Implementation strategies and operations
• Obstacles and how they were addressed
• Outcomes and next steps

12:15

Networking Luncheon

1:15

KEYNOTE ADDRESS

Driving Quality Through Accountability

Fiona McDougall
CEO
RWS Advisory

John D. Whincup 
Executive Director
Optimus SBR

2:00

Ensuring a Patient Centred Focus in Healthcare Improvements

Sholom Glouberman PhD
President
The Patients' Association of Canada
Philosopher in Residence
Baycrest

• Putting the patient first – what does this mean in real terms?
• What do patients want in their care?
• Patient participation in healthcare planning and process
• Mechanisms for patient participation in decision making

2:30

Using Lean to Support Regional Collaboration

Michele Jordan
Vice President, Women's and Children's Program,
Quality Improvement and Transformation
Rouge Valley Health System

• Recognizing the opportunity – Lean to further collaboration
• Leveraging the opportunity
• Using Lean at the system level and with multiple organizations
• Examples and lessons learned

3:00

Networking Refreshment Break

3:15

Building Capacity for Sustainable and Continuous Excellence – Lessons Learned and Dangers to Avoid

Susan Randell, MLT (ASQ- CQIA, CQM)
Quality and Patient Safety Manager
Ross Memorial Hospital

With a number of successful QI implementations already concluded, what are the key lessons that have been learned to date? How can you build your organizational capacity for getting QI initiatives right from the get go and avoiding costly errors? Here are some essential factors to consider:

• Goal setting and alignment
• What to measure and how
• Visual reporting
• Dealing with competing priorities
• Eye on the process and the results
• Where does the real work happen?
• Transparency and information sharing
• Align the incentives to the goals
• Retaining the commitment and the excitement
• Putting "improvement" into continuous
• Building the improvement culture

4:00

EMERGENCY DEPARTMENT CASE STUDY

Questioning the Use of Reservoirs in Health Care – Do They Really Improve the Quality of Care Delivered?

Marko Duic MD
Chief, Department of Emergency Medicine
Southlake Regional Health Centre
Staff Emergency Physician
St. Joseph's Health Centre (Toronto)

Dr. Shawn Whatley
Medical Director, Emergency Program
Southlake Regional Health Centre

• The function of reservoirs in health care – a review
• The ED waiting room as a reservoir
• Closing the waiting room and impact on patient flow
• Staff reactions to this major change
• Physician reactions to this major change
• Patient reactions to major change
• Impact on the quality of care
• General lessons and takeaways

4:30

MAINTENANCE OF CERTIFICATION

Attendance at this program entitles certified Canadian College of Health Leaders members (CHE / Fellow) to 6 Category II credits for the conference and 1.5 Category II credits for each workshop toward their maintenance of certification requirement.

CEOs, Senior Administrators, Medical Directors, Chiefs of Staff, Directors and Managers of:

• Performance Improvement, Safety and Quality, Operations, Corporate Services, Clinical Care, Laboratory Services, Emergency Departments, Decision Support

And:

• Consultants, Educators and Trainers, Researchers, Ministers, Deputy Ministers, Public Policy Analysts and Advisers

From:

• Health Regions, Hospitals, Long Term Care and Rehabilitation Centres, Regional and Community Health Centres, Private and Public Laboratories, Diagnostic Imaging Services, Provincial Health Ministries, Health Canada, Professional Associations and Colleges

Dear colleague,

Delivering lasting improvements in the quality of healthcare services in the face of declining budgets has become the number one priority for most healthcare organizations. In the context of budget constraints, new funding models, and ballooning demand, how can health ministries, LHINS, healthcare organizations and front line managers, as well as healthcare professionals, ensure these primary objectives of healthcare systems are met? How can we improve quality while also ensuring safety and service satisfaction for patients and staff in an era of deficits and belt tightening?

Now, more than ever before, healthcare leaders will need to ensure that more gets done with less. This Insight Information healthcare event will focus on key strategies for achieving planning, process and outcome improvements in healthcare on limited budgets. Using practical case studies and reporting on a range of strategies that include Lean and Six Sigma, the conference will support the efforts of provincial, regional and organization healthcare leaders, as they institute comprehensive strategies for improving the quality of healthcare in the face of reduced resources.

Topics you have told us are important to you and that will be addressed in this conference include:

• Physician partners and leaders in achieving QI goals
• Building a culture of continuous improvement
• Measurement and data essentials for (Lean) health transformations – the continuous improvement loop
• Questioning the use of Emergency Department reservoirs
• Maximizing the benefits of Lean and QI initiatives
• Aligning provincial and regional healthcare objectives and local care delivery
• Oversight and accountability mechanisms
• Sustaining the gains of QI throughout the organization

Don't miss this opportunity to benefit from the hard won lessons of leading improvement experts in Canadian healthcare and beyond.

I look forward to seeing you there!

Don Shilton 
President
St. Mary's General Hospital

Bronze Sponsor

Please note: Full payment is required in advance of conference dates. Please make all cheques payable to Insight Information.