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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

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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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