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NEW AT HQC

Semi-transparent: New blog post by Saskatoon urologist Kishore Visvanathan

I've been feeling guilty since my last post. I hadn't shown you our 3rd NAA/wait time chart for many months, and if you've been following our adventures, you know that the 3rd NAA was the raison d'être of this project. When I finally posted the recent data, it was in anticipation of our upcoming backlog blitz that should drop the 3rd NAA to our target level of 2 weeks. Why did I keep this under wraps for so long? More…

Accelerating Excellence in Saskatchewan

The current issue of Healthcare Quarterly features an article by Jane Coutts entitled Accelerating Excellence Report: Accelerating Excellence in Saskatchewan. This is the first of a series of articles exploring the different elements of Accelerating Excellence. It explores the initiative's beginnings - with a focus on efforts to engage Saskatchewan's healthcare leaders in making a better, safer system. More…

If you missed our national webinar…

We have posted on our web site a recording of the webinar, Canada asks…and the Health Quality Council answers your questions about Releasing Time to Care (TM), held on January 13, 2010. More…

FEATURED BLOG

Progress in the ICUs

Running a Hospital, by Paul Levy, President and CEO of Beth Israel Deaconess Medical Center in Boston

Our Medical Executive Committee recently received a report from our Critical Care Committee. I cannot be more proud of our staff and the progress they have made to reduce harm and improve quality of care in our ICUs. I include two of the charts. Let me translate the implications of the reduction in Ventilator Associated Pneumonia (VAP). Preventing 744 cases over three years -- at a treatment cost of about $20,000 per case -- translates into a societal savings of $14.9 million during this period. More…

MEASUREMENT AND REPORTING IN OTHER SECTORS

Report ranks performance of Saskatchewan high schools: Final measurements not available until September

Janet French, StarPhoenix

Come September, Saskatchewan should have a glimpse at the first independently produced report card ranking the province's schools. On Monday, the Atlantic Institute for Market Studies (AIMS) and the Frontier Centre for Public Policy released its first interim report card on western Canadian high schools. More…

NEW RESOURCES AND EVENTS

CADTH's Café Scientifique at MacKenzie Art Gallery in Regina

The Canadian Agency for Drugs and Technology in Health (CADTH) is sponsoring Saskatchewan Café Scientifique sessions on March 2 and 3, 2010: "Blood Sugar Testing: Everybody's Doing It…Should They?" For more information, contact Brendalynn Enns, CADTH Liaison Officer at 306-655-6486 or brendalynne@cadth.ca. More…

Health Council of Canada announces inaugural Health Innovation Award winners

In Fall 2009, the Health Council of Canada challenged Canadian college and university students with the question: "What do you propose to help renew and sustain Canadian health care, and why?" Submissions flowed in from across the country and panelist judges from the Council executive have rendered their decision. Winners, including an entry from the University of Saskatchewan, of the inaugural Health Innovation Award were announced last week by the Health Council of Canada. More…

Helping Patients Help Themselves: Are Canadians with Chronic Conditions Getting the Support They Need to Manage Their Health?

Many Canadians with chronic health conditions don't regularly receive some of the expected types of support that could help them better manage their own health. This bulletin - Helping Patients Help Themselves: Are Canadians with chronic conditions getting the support they need to manage their health? - is based on the 2008 Canadian Survey of Experiences with Primary Health Care, which measured the quality of health care as reported by Canadian patients, including those with seven common chronic conditions. More…

Safe Surgery Saves Lives workshop

This workshop, March 8 and 9 in Vancouver, will provide a rationale and ways for you to successfully promote the "Safe Surgery Saves Lives" initiative in your institution and practice. Presented by the Canadian Patient Safety Institute, British Columbia Patient Safety & Quality Council, Western Node - Safer Healthcare Now! More…

Safer Healthcare Now! AWARDS - All Interventions

Presentation on April 12, 2010 in Toronto, ON at the Safer Healthcare Now!: Moving Forward with Vigour Preconference Day. Apply now! to receive National recognition for your work on a SHN Intervention! A simple quick on-line registration process. Funded by: Cardinal, BD and Safer Healthcare Now! Deadline for applications: February 22, 2010. More…

Getting the measure of quality: Opportunities and challenges

The quality and safety of health care is complex and challenging to measure, and the measures used are often difficult to interpret. In its discussion paper, Getting the measure of quality, the King's Fund sets out the issues that should be considered in developing and using indicators for measuring quality . More…

The Productive Ward in specialist care

The NHS Institute has created a series of case studies in collaboration with local NHS teams, to show how specialist departments have successfully implemented The Productive Ward programme. The case studies show how specialist teams have embraced tools and principles from The Productive Ward to deliver real improvements for their staff and patients. More…

International Forum on Quality and Safety in Healthcare

Presented by the Institute for Healthcare Improvement (IHI) and the British Medical Journal (BMJ), the Forum will be held in Nice, France, April 20-23, 2010. This year's theme, Improving Quality, Reducing Costs, will address increasing challenges brought about by current global financial pressures. More…

IHI Summit on Improving Patient Care in the Office Practice and Community

Against the backdrop of an ongoing national discussion on how to achieve quality health care at an affordable cost, the Institute for Healthcare Improvement (IHI) invites you to attend the 11th Annual International Summit on Improving Patient Care in the Office Practice and the Community. This year's Summit in Washington D.C. will focus on improving patient and population health and health care across the full continuum of community care. More…

SASK NEWS LINKS

Changes proposed for medical education: U of S hopes to lead way with new training for MDs

Hannah Scissons, StarPhoenix

A focus on producing more general practitioners is at the heart of the first comprehensive report on medical education released in 100 years. All 17 of Canada's medical schools, including the University of Saskatchewan, simultaneously launched the report -- The Future of Medical Education in Canada -- on Thursday. More…

NATIONAL, INTERNATIONAL NEWS LINKS

Healthy Incentives: Paying doctors bonuses in bid to reshape medicare

Tom Blackwell, National Post

Jay Mercer's efforts to get more of his patients to undergo cancer screening are starting to pay off: Early detection resulted in one woman having her cervical cancer cured and gave another high hopes for recovering from a breast tumour. The screening push is also paying off, literally, for the Ottawa family physician. His preventive campaign is partly driven by a little-known recent trend in the Canadian health-care system: incentive payments, or bonuses, paid to doctors to encourage better health care. More…

Some incentive payments offered to Canadian doctors (on top of any regular fees)

Tom Blackwell, National Post

$40 bonus for each diabetic patient managed according to diabetes-care guidelines (Nova Scotia). - $2,000 for continuing education on adopting electronic health records (Nova Scotia). - 25% premium for treating patients evenings or weekends (Nova Scotia). - $500 bonus per year for signing up 15-49 patients on provincial diabetes registry, additional $500 for 50 or more (Ontario). More…

Medical schools looking to erase physician shortage

Pauline Tam, Canwest News Service

Faced with a shortage of physicians nationwide, Canada's medical schools are looking to produce doctors more quickly, but have stopped short of endorsing a controversial idea to reduce the time it takes for students to complete their basic training. Instead, by overhauling the undergraduate curriculum, the schools want to give students the flexibility to complete medical degrees at their own pace. More…

Nova Scotia pharmacists given permission to refill, prescribe drugs

Canwest News Service

Starting this week, pharmacists in Nova Scotia can refill and modify certain prescriptions, a responsibility normally done by doctors. "These new regulations will ensure that Nova Scotians can get the medicines they need even if they can't get to their doctor right away," said Maureen MacDonald, the province's health minister in a news release. "By more completely using the competencies of pharmacists, the regulations will improve access and create efficiencies in the health-care system." More…

ER doctors call for national care standards: Medical association points to discrepancies between urban and rural treatment

KAREN HOWLETT, Globe and Mail

The controversial closing of emergency departments in two Ontario hospitals highlights the need for trauma-care standards right across Canada, says a group representing doctors. The Canadian Association of Emergency Physicians is calling on the federal and provincial governments to set standards for treatment, including the maximum time and distance of a patient's trip to an emergency department. More…

This health-care crisis will require more than savings around the edges (opinion)

Gary Mason, Globe and Mail

Not that long ago, health care was at the top of the political agenda, federally and provincially. Any number of opinion polls showed it as top of mind for most Canadians, too. Suddenly, no one was talking about it. The environment and climate change became the hot issue. More recently, the economy has consumed the attention of the public and politicians, understandably. Meantime, however, the burgeoning crisis in health care has become more daunting. More…

All hospital patients should be assessed for risk of blood clots, NICE says

Jacqui Wise, BMJ

All patients, without exception, should be assessed on admission to hospital for their risk of developing venous thromboembolism, says new guidance from the UK National Institute for Health and Clinical Excellence (NICE). An estimated 25 000 people in the United Kingdom die from preventable hospital acquired venous thromboembolism every year. More…

JOURNAL LINKS

Lessons That Patient-Centered Medical Homes Can Learn From the Mistakes of HMOs

Ann M. Mirabito, PhD, Leonard L. Berry, PhD

Abstract: Patient-centered medical homes (PCMHs) have been endorsed by primary and specialty care medical associations, payers, and patient groups as an innovative structure for transforming health care delivery. The cornerstone principle of the PCMH is the primary care physician's coordination of a patient's use of health care services, including visits to specialists, to improve effectiveness and efficiency. This principle aligns with the vision behind the creation of HMOs, managed care organizations that were once embraced by physicians, patients, and policy analysts but have since lost much of their luster. Many patients and physicians rejected HMOs as too restrictive, objecting particularly to the concept of gatekeeping. This article reviews the HMO experience and identifies lessons applicable to PCMHs that build on the strengths of HMOs while avoiding their mistakes. More…

High reliability in health care: Examples from other industries should be informative, not prescriptive (BMJ editorial)

Takehome: One solution is to look more carefully and systematically at high performance within health care, drawing on other industries for ideas and inspiration, but not as beacons of reliability that we should simply emulate. Individuals, teams, and organisations in health care that already embrace this perspective provide a means of understanding the nature of reliability and resilience, and they can be an inspiration to others. More…

NICE and new: appraising innovation

Robin E Ferner, professor of clinical pharmacology 1, Dyfrig A Hughes, reader in pharmacoeconomics 2, Jeffrey K Aronson, reader in clinical pharmacology

Takehome: What really matters to the NHS is that innovations bring benefit to patients. However, there may be wider benefits from rewarding innovation for its own sake. This can be done only if it proves possible to separate innovativeness from usefulness and if a sustainable method to finance the extra spending can be found. If it proves impossible in practice to reward innovativeness and provide incentives to develop useful medicines, we would argue strongly that NICE should keep its current methods of technology appraisal. More…

Cottage Industry to Postindustrial Care — The Revolution in Health Care Delivery (NEJM perspective)

Stephen J. Swensen, M.D., M.M.M., Gregg S. Meyer, M.D., Eugene C. Nelson, D.Sc., M.P.H., Gordon C. Hunt, Jr., M.D., M.B.A., David B. Pryor, M.D., Jed I. Weissberg, M.D., Gary S. Kaplan, M.D., Jennifer Daley, M.D., Gary R. Yates, M.D., Mark R. Chassin, M.D., M.P.P., M.P.H., Brent C. James, M.D., M.Stat., and Donald M. Berwick, M.D., M.P.P.

Takehome: Today's good doctors should see process improvement as part of their core work. Rather than undermining health care, public reporting on the performance of standardized care processes and outcomes will be the key to converting our isolated cottages into integrated, continually improving communities. More…

Increased Ambulatory Care Copayments and Hospitalizations among the Elderly

Amal N. Trivedi, M.D., M.P.H., Husein Moloo, M.P.H., and Vincent Mor, Ph.D.

Takehome: Raising cost sharing for ambulatory care among elderly patients may have adverse health consequences and may increase total spending on health care. More…

American Values and Health Care Reform (NEJM editorial)

Thomas H. Murray, Ph.D.

Excerpt: Being a good steward of health care also requires that we use the community's resources wisely and well and that we protect and sustain them so they can remain vital and productive for those who come after us. Stewardship therefore requires that we pay scrupulous attention to quality, efficiency, and cost-effectiveness — or value, to use the market's sense of the term. The evidence that we do not get good value for our money — that our health outcomes fall far short of those in many other countries, that regional variations in expenses do not track variations in quality, that our hospitals too often fail to ensure consistent adherence to practices known to enhance quality (such as hand washing) — is overwhelming. Everyone entrusted with the leadership of our health care institutions and with the allocation of our health care dollars has an obligation to be a thoughtful steward of those scarce resources. More…

Medicine's Ethical Responsibility for Health Care Reform — The Top Five List (NEJM editorial)

Howard Brody, M.D., Ph.D.

Excerpt: The best rebuttal to the antireform argument that all efforts to control medical costs amount to the "government getting between you and your doctor" is to have physicians, not "government," take the lead in identifying the waste to be eliminated. Mark Twain said, "Always do right. This will gratify some people and astonish the rest." Today, meaningful health care reform seems to be in danger of taking a back seat to special-interest pleading and partisan squabbling. If physicians seized the moral high ground, we just might astonish enough other people to change the entire reform debate for the better. More…

Improving Health by Taking It Personally

Ralph Snyderman, MD; Michaela A. Dinan, BS

Excerpt: To resolve the nation's health care dilemma and tackle exploding costs, the current sporadic and reactive focus on treating episodes of disease must be transformed into one that is coordinated to improve health and minimize the consequences of chronic diseases. Because care is more effective when services are coordinated, there are mounting efforts to spur greater integration of delivery systems. What is missing is an approach that aligns the patient's individual needs with health services tailored to meet those needs. Cordination of services will be insufficient unless they are driven by plans designed to anticipate the health needs of the patient over time. A proposal to do this is "prospective care," a strategic approach that combines personalized health planning with integrated care services to focus on individualized health promotion, disease prevention, monitoring, and early intervention.(Full text of this article available to subscribers only) More…

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Health Quality Council

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