PQI Themes in Interior - PQI Summit Website...¢  2018-12-17¢  project charter...

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Transcript of PQI Themes in Interior - PQI Summit Website...¢  2018-12-17¢  project charter...

  • PQI Themes in Interior Health

  • Disclosures

    • No disclosures • No conflict of interest

  • Geographical and Clinical Diversity


  • Online Training Resources

  • Co-Creation

  • Dyads

  • PQI meets MSA

  • Overview of Physician Quality Improvement (PQI) at Northern Health

  • Disclosure

    I have no conflicts or disclosures

  • Our Vision

    κ Physician champions: Physician engagement, empowerment and leadership.

    κ Patient and family centered κ QI Infrastructure/support synergizing with

    existing HA framework/program κ Weaving QI at every level to create

    culture of QI

    “To deliver exceptional care for Northerners”

  • Our Journey

    First Steering Committee Meeting – November


    Staff Hired – February


    Education first session –

    June 2017

    Seed Grant Process

    launched– September


    May 2018 - First

    physicians to complete

    intermediate QI

    Ongoing for 22 months

    now –

  • Organization # of Reps

    Perspectives Members

    Patient Representative 3 Patient Partners Edwina Nearhood KD Taylor Millie 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/regional perspectives

    Physician Mentors


    Dr. Dawid van Rensburg Dr. Shyr Chui and Dr. Singh

    Dr. Amin Lakhani

    Dr. Bill Clifford

    Dr. Denise Jaworsky NW, NE VACANT NI Dr. Shyr Chui

    Dr. Jamil Akhtar, Dr. Laura Brough

    Specialist Services Committee

    3 Physician Representative Senior Staff Representative

    Dr. Kathy Lee Aman Hundal VACANT

    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

  • Staff NH PQI Staff Photo: Summer, 2018

  • We love our patient partners

  • NH PQI Education Photos

  • Our Achievements

    κ Integration with HA Quality infrastructure leadership and program

    κ Region-wide impact κ Increasing physician participation and

    interest in QI education and projects κ PQI Steering Committee and Staff

    subscribe to a common vision κ Highly motivated and engaged PQI support


  • Our Opportunities

    κ Physicians leading large scale transformative QI projects – Physician Mentors

    κ Expansion of PQI network and collaborating with other HA- PQI

    κ Role clarity between PQI support staff and physicians

    κ Utilize patient partners in individual projects

  • What’s Next for our PQI Program?

    κ Recognition: NH Research and QI Conference Nov 6-8, 2018 κ 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 challenges κ Collaborate: UNBC, UBC, PHSA, Doctors of BC. κ Program Improvements: Further develop the PQI learning journey

    from beginner to intermediate, to advanced training, embed milestones for physician recognition

    κ Evaluation: Embedding provincial and local evaluation recommendations into team planning/steering committee

  • Questions?

  • Island Health PQI experience: Dr. Jason Wale

  • I have no conflicts of interest to declare.

    I receive no honorariums or finance.

  • Fraser Health Set a pretty high standard…

    “We’re #2!”

    Island Health

    Fraser Health HAL Smechner

  • Island Health PQI experience:

    3rd year and growing up fast!



  • First challenge is we are a long and skinny geography

    In person meeting is challenging.

  • Some of our First Cohort: 2016/17

  • Some of our First Cohort: 2016/17

  • Balance

    Physician Interest Local culture Novel ideas

    Physician Education HA Priorities

  • 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

  • PQI Summit Physician Quality Improvement VCH/PH

    Vinay Dhingra MD Chair PLQI VCH/PH

  • Disclosure

    Presenter Dr Vinay Dhingra

    Relationships with commercial interests:

    Grants / Research Support None

    Speakers Bureau/ Honoraria None

    Consulting Fees None

    Other None

  • Goals of Physician Led QI VCH/PH

    To create the capacity and capability for physicians to engage and lead quality improvement

    To engage the VCH and PHC physician medical staff to further a culture of quality improvement

    To support the local needs of physicians with improving the quality of patient care

    Primary Goals

  • PLQI Joint Steering


    Medical Administration

    Specialist Services

    Committee Medical


    Quality Patient Safety

    Patients Advisors


  • 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, training and sessionals

    QI Support and Physician Advisors for mentorship & coaching

    Physician-Led QI Initiative – Advanced Training

    Tech support Including data analysis

    Steering Committee provides oversight

    Online Module – Intro to QI

    • In development – target 2019

  • 1-day QI Training Objectives: • 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

    134 Total physicians trained

    7 One day 1-day QI training sessions held between Mar 2017 – Jun 2018

    Spread the word! Upcoming dates: • Nov 27, 2018 • Feb 6, 2019 • Mar 6, 2019

  • PLQI Cohort Timeline

    Aug: PLQI Launch Cohort 1

    24 projects



    June: Cohort 1 Graduation

    July/Aug: project charter start


    Jan: Cohort 3 intake May: Notification of acceptance cohort 3

    May: Cohort 2 projects chosen

    (14 continuation +22 new = 36 total projects)

    Sept – May 2019: Cohort 2 Ongoing advanced training and project support

    Apr-May: Cohort 2 Project Presentations

  • PLQI Project Specialties General Practice Critical Care Medicine

    Psychiatry Emergency Medicine

    Physical Medicine and Rehabilitation



    Internal Medicine

    Laboratory Medicine


    Infectious Diseases


    Palliative Medicine



    Community and Rural

    Obstetrics and Gynecology Thoracic Surgery

    Orthopedics Otolaryngology

    20 specialties

  • September October November December January February March April May June

    Cohort Training – 2018/19 Training Schedule

    #1 Sept 12

    #2 Sept 19

    #3 Sept 26

    #4 Oct 30

    #5 Nov 29

    #6 Jan 16

    #7 Mar 5

    #8 Apr 3

    #9 May 16 Graduation


    One Day Training

    Nov 29

    One Day Training

    Feb 6

    One Day Training

    Mar 6

    One Day Training

    Aug 23

    One Day Training

    Jun 12

    Cohort Training

  • Cohort Training - PLQI Team

    PLQI Support Staff

    PLQI Physician Coaches

    PLQI Physician Cohort 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!!!!

    PLQI Chairs

  • Cohort Training – Additional Facilitators