Engaging Physicians to Improve Quality

Abstract

Saskatchewan’s Health Quality Council (HQC) was launched in 2003 with a mandate to not only measure and report on healthcare but also work with a range of partners to improve the province’s health system. In late 2007, HQC’s board decided it was time for Saskatchewan to reinvent its healthcare system, using the highestperforming systems in the world as its model. And in 2008, HQC launched Accelerating Excellence, a multi-level program to rethink, redesign and renew healthcare. To help maintain momentum and show other provinces whether high-performing healthcare can be achieved in Canada, HQC is documenting its journey toward high-performing healthcare. This third article in this series discusses the challenge of physician engagement. T he doctor, when he gets to sit down, perches on a bar-height chair in the corner, his laptop with the electronic records sharing space on a narrow counter with a jar of lollipops. Across the room, the big desk Dr. Mark Brown used to occupy has been given over to his medical office assistant. This unconventional arrangement saves Dr. Brown running to the back of the building every time he wants a word with his assistant, and keeps both of them just steps from the waiting and treatment rooms. It’s part of Dr. Brown’s “continuous quality improvement” efforts to run his family practice more efficiently and effectively. “My involvement in improving quality came about through my own interest in my own practice,” he says in an interview in the small, crowded office in Moose Jaw. “It wasn’t, ‘Let’s change the world.’ It was more a question of things being too busy and too chaotic … I had to use my time better and learn to work smarter.” A dawning realization that there must be better ways to practise medicine is a typical experience for the relatively few physicians already involved in Saskatchewan’s efforts to transform the quality of healthcare in the province. The program, called Accelerating Excellence, is run by the Health Quality Council (HQC). It’s a multi-level effort to rethink and renew healthcare through system-wide change, and includes Quality as a Business Strategy, a rigorous program for administrators and board members, and Releasing Time to Care TM , a new approach to hospital care that’s spreading ward by ward around the province.