DEVELOPMENT OF AN ECHOCARDIOGRAPHIC QUALITY IMPROVEMENT AND ACCREDITATION PROCESS THROUGH A SUCCESSFUL GOVERNMENT-MEDICAL COLLABORATION

Abstract

Echocardiography (echo) is a frequently used diagnostic test in Ontario with significant implications for clinical care, patient outcomes, and health system costs. To help ensure quality echo services, the Ontario Ministry of Health and Long Term Care (MOHLTC) and Ontario Medical Association (OMA) convened the Hospital Outpatient and Community-based Echocardiography Working Group, whose recommendations subsequently resulted in CorHealth Ontario releasing the Standards for Provision of Echocardiography in Ontario. Along with the Standards, and in collaboration with the MOHLTC and the Ontario Association of Cardiologists (OAC), CorHealth launched the Echo Quality Improvement Program (EQIP), a process designed to ensure that echo facilities practice according to the Standards. The core elements of the EQIP include an echo facility site visit along with process and case reviews. To facilitate quality improvement in alignment with the Standards, detailed and meaningful feedback is provided in a consistent and structured format. In April 2016 participation in the EQIP became a requirement for physician payment from the Ontario Health Insurance Program. Working with the Ontario Association of Cardiologists (OAC) and the MOHLTC, the EQI Program developed consistent, objective, and transparent processes and reporting requirements to address the shared desire for accountability and quality. As of April 26, 2018, 432 out of 766 operational echo facilities have been reviewed. 175 of the reviewed echo facilities have completed quality improvements and achieved accreditation. The success of the EQIP to date demonstrates the value of government-medical collaboration to improve the quality of echo services across both publicly funded hospitals and independent physician practices in Ontario. The benefits arising from the collaborative effort is positively impacting clinical decision making and patient care and could serve as a foundation for similar diagnostic quality improvement initiatives.