Quality Improvement Plan (QIP) Narrative for Health Care Organizations in Ontario
4/15/2014
This document is intended to provide health care organizationsin Ontario with guidance as to how they can develop a quality improvement plan. While much effort and care has gone into preparing this document, this document should not be relied on as legal advice and organizations should consult with their legal, governance and other relevant advisors as appropriate in preparing their quality improvement plans. Furthermore, organizations are free to design their own public quality improvement plans using alternative formats and contents, provided that they submit a version of their quality improvement plan to HQO (if required) in the format described herein.
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Overview
Themission of De dwa da dehs nye>s Aboriginal Health Centreis to improve the wellness of Aboriginal individuals and of the Aboriginal Community by providing services which respect people as individuals with a distinctive cultural identity and distinctive values and beliefs.
"De dwa da dehs nye>s" embodies the concept of "we're taking care of each other amongst ourselves."
Our organization offers: Primary Care, Traditional Healing, Mental Health and Addictions, Health Promotions, Advocacy and Patient Navigation, and Transportation Services. All services and supports are providedin both the cities of Hamilton and Brantford, and Patient Navigation andmarginal mental health services are provided in the Niagara Region. Services and Supports are available to First Nations, Inuit, Metis, and self-identified Aboriginal Peoples.
Integration & Continuity of Care
Our Quality Improvement Plan promotes integration of service/support and facilitates continuity of care of all patients within the Primary Health Care Clinic. To facilitate the continuity of care, De dwa da dehs nye>s works with external health service providers as necessitated for patient care on a case by case basis.
The 2014 - 2015 Quality Improvement plan includes an internal referral process across the organization through our newly implemented EMR. This new referral process will support staff as they can better track their patients through our system.
In addition, the EMR will track the number of no-showswhich will help to track the improvement made within the no show rate.
Lastly, the Health Promotions Department is also enrolling and tracking its participants through the EMR. This is a practice that was never in place, but is now possible with the implementation of the new EMR.
Challenges, Risks & Mitigation Strategies
One of the greatest challenges is the lack of funding to monitor and support the data collection process. As we have recently changed our Electronic Medical Record (EMR), we have overcome some hurdles in the learning curve, but also recognize that we aren't yet documenting to the best of what the EMR's capabilities are. Staff/Practitioners are routinely training on the new EMR and are troubleshooting and learning as each new hurdle arises. The data is becoming more refined, but with few dollars available to support the process and the data mining, we are behind the curve of being able to collect data in a meaningful way, and are far from Best Practice.
The risk is that without the ability to appropriatelyrecord data, or the ability to mine data in a timely manner,the data gathered is incomplete, outdatedand often flawed.
To mitigate the data collection risks, we are streamlining our Staff/Practitioners recording process, and are working to our best capabilities.
Information Management Systems
Since we have recently introduced a new Electronic Medical Record (EMR), one that is being utilized across the sector, we have not yet overcome a number of the challenges of implementation.
There have been a number of issues with the new EMR, and additionally, we do not have a Data Management Coordinator to mine the data. We have one day a week support for all Internet Technology issues from North Hamilton Community Health Centre, but that simply isn't enough to support the IT infrastructure, support all staff, and mine data.
Engagement of Clinical Staff & Broader Leadership
The Board of Directors has a Standing Quality Committee. This committee meets quarterly and reports to the Board of Directors. The Quality Committee includes: Two Board Members, Executive Director, Two Managers,a Community Member with expertise in Quality, and two patients (one from each of our sites - Brantford and Hamilton).
The Management Team discusses Quality Improvement within Departments and across the organization, and that work flows through to the Quality Committee where priorities are made in terms of what our Quality Improvement Plan will include.
Accountability Management
It is an expectation that the leadership will meet all Quality Improvement Plans. Quality Improvement is tied to Executive Director compensation.
Moreover, Quality Improvement is viewed as a team exercise, which includes, the Board, Quality Committee, Management and Staff. It is demoralizing to not meet or exceed Quality Improvement targets. Together, we identify what is needed, manageable, and leads to quality process/service to our community. Our organization was built on Quality Improvement, it was simply never documented as such.
Other
De dwa da dehs nye>s Aboriginal Health Centre is growing and improving at a rapid pace. The new EMR, will, in time, prove to be one of the best investments in quality improvement that the organization and Ministry of Health and Long Term Care could make, in terms of improving the quality ofcare of the people we serve.
Internal QI note
The training of staff on the new EMR continues to be on-going.
Sign-off
It is recommended that the following individuals review and sign-off on your organization’s Quality Improvement Plan (where applicable):
I have reviewed and approved our organization’s Quality Improvement Plan
Board ChairPat Mandy
Clinician LeadNot Applicable
Executive Director / Administrative LeadConstance McKnight
Instructions: Enter the person’s name. Once the QIP is complete, please export the QIP from Navigator, and have each participant sign on the line. Organizations are not required to submit the signed QIP to HQO. Upon submission of the QIP, organizations will be asked to confirm that they have signed their QIP.
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