EVALUATION & QUALITY CARE CONSORTIUM Opening REMARKS Kent - - PowerPoint PPT Presentation

EVALUATION & QUALITY

SCI IMPLEMENTATION CARE CONSORTIUM

Opening REMARKS

Kent Bassett-Spiers Stuart Howe Peter Athanasopoulos Anne Hayes Mark Bayley Cathy Craven Dalton Wolfe Jerry Mings

Welcome!

EVALUATION & QUALITY

SCI IMPLEMENTATION CARE CONSORTIUM

Ontario SCI Community Plan

Vision for Ontario

How- Best Practice Implementation

Learn from Each Other’s Experiences Measure and Evaluate our performance Plan for Success Ensure Sustainability Community Engagement (policy, service providers, researchers, and individual with lived experience)

VISION: Optimal and Equitable Health Care Services for all Ontarians regardless of where you live, to ensure functional recovery, health and wellbeing for people with SCI

https://sciontario.org/wp-content/uploads/2018/08/Amplify-Our-Community-Voice.pdf

How does this work fit in the big picture of health policy and strategy?

Anne Hayes

Director of Research Analysis and Evaluation Branch

Funding

ANNOUNCEMENT

EVALUATION & QUALITY

SCI IMPLEMENTATION CARE CONSORTIUM

How Did We Get Here?

Promoting SCI Rehab Standards (2012) – 8 Sites Accredited Data to Inform Practices Audit of Current Practice Mapping Gaps in Research, Care and Policy N= 113 Contributors Systematic Reviews of Literature Provider & Consumer Versions (27 chapters of Rehab Evidence) Best Practice Implementation Community of Practice N = 7 Sites (AB, ON, QC, NB)

How Did We Get Here?

‘All breakthrough, No follow through’

Woolf (2006) Washington Post op ed

E-Scan National REPORT CARD

Wheeled MOBILITY

afe - avoids injuries to patients from care intended to help them imely - reduces waits and delays for those who give/receive care ffective - based on scientific knowledge, extended to all likely to benefit, while avoiding underuse/overuse quitable - provides consistent quality, without regard to personal characteristics (e.g. gender, ethnicity, geographic location or socioeconomic status) fficient - avoids waste - equipment, supplies, ideas, energy atient-centered - respects and responds to individual patient preferences, needs, and values, ensuring that patient values guide all clinical decision Reference:Institute of Healthcare Improvement

What is High Quality HEALTHCARE?

Audit and Feedback** Interactive small groups Multi-disciplinary collaboration Educational outreach Mass media campaign Implementation Teams Participatory Action research Reminders Computerized decision support Financial intervention / incentive*

Stroke * SCI-High *

Proposed Strategies

1. Runciman W, Hibbert P, Thomson R, Van Der Schaaf T, Sherman H, Lewalle P. Towards an International Classification for Patient Safety: key concepts and terms. International journal for quality in health care : journal of the International Society for Quality in Health Care / ISQua. 2009;21(1):18-26. 2. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington (DC)2001. 3. Johnson MJ, May CR. Promoting professional behaviour change in healthcare: what interventions work, and why? A theory-led overview of systematic reviews. BMJ

• Open. 2015;5(9):e008592.

4. Tuti T, Nzinga J, Njoroge M, Brown B, Peek N, English M, et al. A systematic review of electronic audit and feedback: intervention effectiveness and use of behaviour change theory. Implement Sci. 2017;12(1):61. 5. Ivers NM, Grimshaw JM, Jamtvedt G, Flottorp S, O'Brien MA, French SD, et al. Growing literature, stagnant science? Systematic review, meta-regression and cumulative analysis of audit and feedback interventions in health care. Journal of general internal medicine. 2014;29(11):1534-41.

Characteristics of, or inputs to, rehab care Necessary conditions for the delivery of a given quality of rehab care but not sufficient Do not ensure that appropriate processes are carried out,

• r satisfactory outcomes are achieved

Example:

• Underwater Treadmill
• Nurse-to-Bed Ratio

Structure Indicator

Represents the closest approximation of actual rehab care offered The most clinically specific of the three types of indicators. Measure delivery of appropriate (or inappropriate) rehab care Derived from clinical evidence of the effectiveness of the process concerned & are consistent with current professional knowledge Example:

• Mobility aids delivered prior to rehabilitation discharge

(e.g. walker, wheelchair)

Process Indicator

Represent measures of health improvements (or deterioration) attributable to medical care May be influenced by other factors than the quality of care Two Types:

 Intermediary

• Mean walking distance – 10m Walk Test

 Final Outcome

• Proportion of SCI patients achieving community

mobility (walking speed of 0.8 m/s at 18 months)

Outcome Indicator

• FIM
• Length of Stay

Understanding the CARE CONTINUUM

Implementation: a set of purposeful activities designed to put into practice an activity or program of known dimensions.

Implementation Science

MAKING SURE THINGS HAPPEN!

Knowledge Generation Implementation Science

EVALUATION & QUALITY

SCI IMPLEMENTATION CARE CONSORTIUM

Goals for the Day

Goals of THE DAY

Learn about the work in organizations across the province. Review the purpose and goals of the SCI Implementation & Evaluation Quality Care Consortium. Identify issues and solutions to achieve the first network goal by April 2019. Generate a list of issues and solutions to enable working together to deliver on the April 2020 goals. Share ideas on how to build relationships and strengthen the province- wide consortium.