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www.HQOntario.ca
HQO Quality StandardsGuiding evidence-based, high quality care
Health Quality OntarioThe provincial advisor on the quality of health care
Irfan Dhalla, MD, MSc, FRCPCVice-President, Evidence Development and Standards
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Health Quality Ontario’s role
• Health Quality Ontario serves as the provincial advisor on the quality of health care in Ontario. We have been entrusted to:
– Monitor and report on how the health system is performing– Provide guidance on important quality issues– Assess evidence to determine what constitutes optimal care– Engage with patients and give them a voice in shaping a
quality health system– Promote ongoing quality improvement aimed at substantial
and sustainable positive change in health care
North E
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South E
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North S
imco
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uskoka
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Haldim
and B
rant
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Centra
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siss
auga
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Toronto
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Age-standardized hysterectomy rate
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87 hysterectomies per 100,000 women
Are we doing 6,700 more hysterectomies than women in Ontario want each year?
TC LHIN rate
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“Without standards, there can be no improvement”
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Quality Standards – why?
• Providing an evidence-based foundation for quality improvement
• Focus on high impact areas for quality improvement
• Tightly linked with implementation support from HQO and other partners to support uptake
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• Concise sets of 5-15 strong (“should do”), measurable, evidence-based statements guiding care in a topic area
• Developed in topic areas identified as having high potential for better quality care in Ontario
• Each quality statement accompanied by quality indicator(s)
• Every quality standard will be accompanied by a plain language summary for patients and caregivers
• Strong emphasis on implementation through a variety of vehicles (monitoring/reporting, QBPs, Quality Improvement Plans, etc.)
• Strong emphasis on partnerships to support development and implementation
Quality standards – what are they?
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Quality Standards – what are they?(Illustrative – borrowed from NICE)
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What Quality Standards mean to our key audiences
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What Quality Standards mean to our key audiences
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What Quality Standards mean to our key audiences
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What Quality Standards mean to our key audiences
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Adoption Tools & Supports
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• Baseline data• Ongoing/real-time data• Data support• Audit & feedback
• Clinician/care team engagement strategy
• Provincial conferences/webinars
• Access to provincial & regional experts (clinical/data etc.)
• Community of practice• Coaching/SWAT Team
• List of most important best practice recommendations
• Summary QBP pathway• Standardized order set
templates• Recommendations on
required local & provincial infrastructure
• Implementation toolkit/checklist
• Goal setting/benchmarking• Evaluation
Measurement & Reporting Support
Change Management Tools
Knowledge Transfer Tools
Improvement Science
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• Co-Chairs: Pierre Blier and Peter Voore• 21 members including 3 patient/caregivers
Major Depressive
Disorder
• Co-Chairs: Ilan Fischler and Tarek Rajji• 19 members including 3 patient/caregivers
Dementia with agitation or aggression
• Co-Chairs: April Collins and Philip Klassen• 23 members including 3 patient/caregiversSchizophrenia
Panel composition and selection approach
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A few observations thus far…
• Huge enthusiasm for the task by all 3 panels
• Focusing on the ‘Q’ in QBP has helped to focus discussion on quality of care
• Strong multidisciplinary orientation – all participants, including patients and caregivers, have played active roles in discussion and decisions
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