What is a Quality Improvement Plan (QIP)?

In 2010, the Ontario government passed the Excellent Care for All Act that requires health care organizations to develop a Quality Improvement Plan (QIP) each fiscal year and make that plan available to the public.
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A QIP describes the areas that a hospital is focusing on to improve the quality of care that patients receive.  Osler, like all Ontario hospitals has developed its annual public QIP with specific targets for improvements in the areas of:

  • Safety - Ensuring patients do not experience any harm
  • Effectiveness - Ensuring hospital resources are used to the best of their ability
  • Access - Ensuring patients have timely and equitable access to care
  • Patient-centredness - Ensuring patients have the best possible experience in hospital
  • Integrated - Ensuring all parts of the system work together to enable patients to move smoothly from one area to another as their needs change
  • A QIP includes specific improvement targets that a hospital aims to achieve and ensures accountability by linking the compensation of hospital executives to the achievement of targets.

The QIP is only one small part of Osler's overall plan to improve the services we deliver for our patients.  Osler's full QIP is available on its website at www.williamoslerhs.ca.

Why is it important to have a QIP?

While we have annual internal plans to improve the quality of the services we deliver, the QIP helps to further focus our efforts and communicate our improvement goals to the public. It is one part of Osler's overall quality plan and plays an important role in ensuring we deliver innovative, patient-inspired care in a safe environment.
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The QIP helps to focus the hospital on improving things that will have the most significant impact on the quality of care.  Establishing specific indicators and targets will enable Osler to determine if the efforts of the organization are making a difference and achieving measurable improvements.

The QIP also helps to ensure accountability for the achievement of quality improvements.  The measures and targets outlined in Osler's QIP have been shared with the Central West Local Health Integration Network, approved by our Board of Directors, and submitted to the Ontario Health Quality Council.

Who selects the improvement indicators and targets in the QIP?

Nine priority indicators have been identified and are ranked as maintain or improve, as per Health Quality Ontario for all hospitals. Hospitals set their own targets for each indicator. At Osler, quality improvement is deeply rooted in our culture at every level.
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Our QIP was developed with the involvement and commitment of our:
  • Board of Directors
  • Quality Governance Committee
  • Senior Leadership and Clinical Services Leadership Team
  • Staff members, care providers, clinicians, physicians and support staff who work at the point of care
  • Patients and their families
Patients and their families are involved as true partners to drive quality and safety. Patients and our community are directly engaged to provide input on the quality of their care and their experience. They serve as members or co-chairs on various committees to contribute to and support quality improvement across the Central West, in addition to informing our QIP.

What does Osler's QIP focus on improving?

Our 2017-18 QIP marks the third year we have worked with our partners at the Central West Community Care Access Centre (CCAC) and Headwaters Health Care Centre (Headwaters) to improve the quality of care for those we serve in the Central West region. Our goal is to ensure our patients and their families have access to the care they need, when and where they need it, today and into the future. Our shared QIPs reflect that goal.
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We believe we can significantly enhance care for patients and clients in the Central West region by working together and sharing accountability to improve the following:
  • Deepen Patient and Family Involvement. We will invite patients and families to share their experiences and ideas to help improve the patient experience, from lending their voices to the design and improvement of services, to sharing insights on how and where care is delivered.
  • Improve Patient Satisfaction. We will use a variety of ways to survey patients to better understand opportunities to improve the delivery of care across our organizations.
  • Reduce Preventable Hospital Admissions. We will work to reduce hospital readmissions for patients living with Chronic Obstructive Pulmonary Disease (COPD).
  • Improve Wait Times. We will continue our work to reduce readmissions, and improve access to services, with a special emphasis on patients with complex needs.
  • Reduce Falls. We will work to reduce the risk of patient falls by identifying patients at risk for falls upon admission to hospital, upon return home, or when transferred to another health care facility or long-term care home.
  • Reduce Medication Errors. We will review a patient’s medication history both at admission to hospital and upon discharge to ensure health care providers have the right information to help make informed decisions about a patient’s care.

How do you plan to meet the QIP targets?

We have established innovative strategies and stretch targets for ourselves, which will require the combined efforts of our staff, physicians and volunteers. We have set a high bar in the targets we are striving to achieve in five key areas: access, effectiveness, integration, patient-centred and safety.
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Osler has outlined a series of initiatives that will help us to achieve our improvement targets. These initiatives include things like streamlining processes, strengthening community partnerships, educating staff, improving communication, and implementing evidence-based strategies.

Our plan highlights our commitment to continuous improvement and the achievement of these goals puts a portion of the salaries of our senior executives at risk as a demonstration of our commitment to quality services for the community. Aside from ensuring that we reach our targets, we are committed to making sure the people in our organization can develop the skills, knowledge, and ability to support continuous improvement and sustain ongoing enhancements to the hospital.

What happens if you are unable to reach the targets identified in the QIP?

We will be measuring and monitoring our performance on a regular basis to assess if the changes we are making are having an impact on the quality of our services. This will help the teams that are directly involved in our improvement initiatives to know if they are successful, or if they need to make further adjustments.
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Our targets are set high, but we take continuous quality improvement seriously. Our Senior Leadership Team has put its salary on the line in relation to achieving our targets.

How much of compensation is tied to the achievement of the QIP targets for Osler's Executives?

Members of the Executive Team have their compensation linked to achieving specific QIP targets as well as achieving other individual performance targets. The amount of compensation that is performance-based for each Executive Team member is determined as a percentage of that member’s base salary. The performance-based compensation percentages at risk for the 2017-18 fiscal year are set out below.
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  • President & Chief Executive Officer: 2%
  • Chief of Staff: 2%
  • Executive Vice President, Clinical Services & Chief Nursing Executive: 2%
  • Vice President, Medical Affairs: 2%
  • Vice President, Human Resources & Organizational Design: 2%
  • Vice President, Facilities, Redevelopment & Information Technology: 2%
  • Chief Financial Officer: 2%
  • Vice President, Service Quality and Community Relations: 2%
Application of Improvement Targets to Individual Executives
To enhance our accountability and ability to achieve success, the targets identified in the QIP form the basis for several performance goals for the leadership team, staff and physicians. Each member of the Executive Team will have his/her performance-based compensation tied to the achievement of six key targets contained within the QIP. Specifically, performance on the following indicators will be the focus:
  • Alternate Level of Care (ALC)
  • Readmission for COPD patients
  • Home support for discharged palliative patients
  • Leaving hospital – did you have enough information?
  • Medication Reconciliation on admission
  • Medication Reconciliation on discharge.

Why didn't Osler meet all of the targets set in the 2016-17 QIP?

At Osler, we are constantly striving to grow and improve our organization and services in order to provide patient-inspired health care without boundaries. At this point we do not have all of the data for Q4. Once we have calculated all of the data we will update our progress for the full year. Though the 2016-17 QIP period has ended, we will continue to work with our partners, staff and physicians to improve on indicators in the future.
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That being said, the final results for the indicators in the 2016-2017 QIP cannot be calculated until all of the data from the fiscal year have been finalized. In addition, the Ministry of Health and Long-Term Care is determining the final timeframes to be captured for each indicator. When the final results are available they will be posted on Osler’s website.

In the interim, Osler has posted its progress against the targets with timeframes set by the Ministry for the progress report and have also included our most recent data for reference.

What has changed from last year’s QIP to the 2017-2018 QIP?

This year marks the third year in a row that we have worked with our partners at the Central West CCAC and Headwaters to create our joint QIPs. Our 2017-18 QIP builds on last year’s successes and achievements, particularly in the new and innovative ways our three organizations provide care for patients who no longer need hospital care but who still require some additional support outside of the hospital, also known as alternate level of care (ALC) patients.

By focusing on the same improvement activities and working together, our three organizations are able to provide more patients in our region with the care they need in the most appropriate setting, which improves the quality and safety of patient care and helps to ensure hospital care is available for patients needing to be admitted to hospital. Building on our collaborative, regional approach to setting improvement targets and developing change initiatives will allow us to better support the delivery of quality, timely health care services to those we serve.

When will Osler's final results for the 2016-17 QIP be reported?

The sources for the reporting data on the QIP indicators comes from a variety of sources. We anticipate that all the results will be available by the end of June. While this final data is being compiled, a progress report for our 2016-17 QIP is available on our website .
 

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