Quality Improvement Plan (QIP) Narrative for Health Care Organizations in Ontario
3/31/2017
This document is intended to provide health care organizations in 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 Health Quality Ontario (if required) in the format described herein.
Overview
Guelph CHC’s mission is to reduce health inequities through the provision of high quality primary care services and community programs. We believe that an individual’s health is impacted by social, economic, environmental as well as mental and physical well-being. Our staff are committed to addressing the needs of those who may experience barriers to accessing health care.
Over the last year, we have accepted over 300 new primary care clients from our priority population. Guelph CHC's priority population includes newcomers with language barriers, individuals who are homeless or at risk of homelessness, those suffering from moderate to severe mental health and/or addictions, marginalized groups and vulnerable children and families.
As we continue to take on new clients from priority groups, we expect that client access to timely primary care service will be challenged. In addition to seeing a large overall increase in the proportion of clients with mental health and addiction challenges, interpretation needs have grown significantly. Last year, the percentage of GCHC clients requiring interpretation services was nearly 9% higher than the provincial average. A number of quality improvement initiatives will be piloted in the coming year in an effort to enhance timely client access for all clients. Change ideas include the exploration of a shared roster for part-time clinicians, the delivery of consistent Nurse Practitioner-led outreach services and an analysis of the current health services reception model to identify efficiencies that improve client experience.
Guelph CHC’s 17/18 quality improvement plan closely aligns with our Sector Accountability Agreement, operational plans and new 5-year strategic plan. These strategic priorities include building capacity in priority neighbourhoods through hub development, providing hope-inspiring person centred care and a continued commitment to organizational quality improvement.
QI Achievements From the Past Year
Guelph CHC performed higher than target on nearly all priority indicators identified in last year’s quality improvement plan. Notable achievements include screening rates that are up to 30% higher than accountability agreement targets. In addition to a strong performance on indicators identified in our 16/17 QIP, we had a number of additional organizational achievements. Examples include:
>Participating as a community lead in an indigenous wellness initiative that will continue to build on and build up capacity in the community.
>Acquiring a fresh food warehouse to enhance the work of the SEED, which aims to increase food health for low income and food insecure community members.
>Working with community partners to collaborate on complex systems issues, including a multi-organizational COPD initiative that has significantly reduced COPD hospital readmission rates in Guelph.
>Developing a new performance management tool that aims to strengthen our culture of excellence through ongoing goal setting and enhanced mechanisms for feedback.
In addition, Guelph CHC staff participated in a number of organizational trainings to support in the provision of client-centered care over the last year. Examples include non-violent crisis intervention training, gender diversity training and indigenous cultural competency training. Leadership at Guelph CHC will continue to promote professional development among staff members to strengthen our quality commitments to employees and our community.
Population Health
Guelph CHC works with the following priority populations in an effort to reduce health inequities:
>Homeless or at risk of homelessness
>Low income
>Newcomers to Canada with language barriers
>Moderate to severe mental health and/or addiction issues
>Moderate to severe disabilities
>Without access to primary care
>Aboriginal communities, including First Nations, Inuit and Métis
>LGBTQ+ populations
>Other marginalized groups
>Vulnerable children and their families experiencing violence, family conflict, social isolation and attachment struggles
Over the last year, Primary Care, Community Health and Early Years teams described the need work in a more interdisciplinary manner to support the needs to vulnerable children and families. As a result, this population was re-added to Guelph CHC’s priority population. In addition, a number of quality improvement efforts are being implemented to better support this population. Initiatives include the development of a peer-to-peer program to support families in accessing interdisciplinary programs and services, as well as the development of tools and pathways to enhance early screening and referrals to appropriate services.
Guelph CHC continues to serve and take on new clients with complex mental health and addiction. Staff engagement has highlighted the need for enhanced communication with community partners to support in the delivery of high quality care for this priority group. We have been working closely with partners to address these issues, which includes enhancing role clarity and supporting non-primary care organizations in taking a lead role in care planning.
Guelph CHC continues to serve priority groups using an interdisciplinary care approach. Clients from our priority population are supported by our Clinical team, as well as our Specialized Outreach Services Workers, Dieticians, Social Workers, Parent Outreach Workers, Health Guides, Health Promoters and Early Years staff.
Equity
Guelph CHC applies a health equity lens to the delivery of all programs and services. In partnership with community groups, Guelph CHC supports in the coordination and delivery of an in-house interpretation program. This program supports clients with language barriers in accessing Guelph CHC programs and services. In addition, this resource allows us to translate important communication documents in multiple languages to further promote health and wellness. Over the last few years, we have critically reviewed this program and made a number of quality improvement changes to meet our client’s growing need for interpretation support. We will continue to define the need and evaluate the program to ensure long-term sustainability.
During program planning and evaluation, Guelph CHC programs and services are reviewed using a number of health equity assessment tools. Health equity checklists are used to ensure programs are meeting priority group needs, addressing the social determinants of health and reducing barriers to health.
Integration and Continuity of Care
Guelph CHC continues to make efforts to integrate mental health and addictions services within primary care. Guelph CHC recently partnered with Homewood Health Centre to provide on site access to a Community Addictions Counsellor. This resource allows primary care clients to receive stage-matched addictions support. Furthermore, partnerships with CMHA WWD have allowed for the integration of a Support Coordination resource at the Guelph CHC.
During the coming year, Guelph CHC will be working in partnership with community partners to support in the delivery of a rapid access addictions clinic to provide clients and primary care providers with access to this specialized medical service. In addition, Guelph CHC will continue to partner with the WW LHIN CHCs to deliver an integrated Airways Clinic for client’s with upper respiratory conditions. These integration efforts will be closely monitored and evaluated to support with ongoing program planning.
Access to the Right Level of Care - Addressing ALC Issues
In partnership with the Guelph Family Health Team, Guelph CHC has been participating in the Health Links initiative for over three years. This initiative aims to provide medically and socially complex clients with the appropriate level of care. Guelph CHC continues to promote this program among primary providers to enable Allied Health team members to support in addressing client’s social needs. This allows clinicians to focus on medical stabilization. This program continues to evolve based on ongoing monitoring and staff feedback.
Engagement of Clinicians, Leadership & Staff
Guelph CHC engages leadership, clinicians and staff across departments in QIP development through a number of channels, including an interdisciplinary Quality Improvement and Information Management (QIIM) committee. Representatives from the Clinical Team include Nurse Practitioners, RPNs and Health Services Reception staff. In addition, there are representatives from the Community Health and Business Support teams, as well as members of the Management Team. The QIIM committee meets monthly to support in identifying and driving forward quality improvement change ideas. Furthermore, quality improvement updates are communicated to staff members throughout the year via monthly data reports and quarterly newsletters.
Resident, Patient, Client Engagement
Community members, clients and and board representatives sit on a number of Guelph CHC committees to inform program delivery and quality improvement work. Community members involved in the Quality Improvement Committee (QIC) ensure that change ideas are patient-centred and inclusive. In addition, community member involvement in the Brant Community Hub committee will help to ensure that new services are meeting neighbourhood-specific needs. Furthermore, a number of volunteers support Guelph CHC health promotion initiatives, including the Baby Friendly Initiative, which is on it’s way to accreditation.
Staff Safety & Workplace Violence
Guelph CHC is taking a number of steps to reduce and prevent workplace violence. Staff recently participated in workplace violence training delivered by an external Safety Coordinator. In addition, we have recently updated our workplace violence policies and will continue to work with the Health and Safety committee to review programs and procedures, as needed. Policies will continue to be posted in visible locations across our sites.
Contact Information
Navjot Thandi
Data Analytics and Quality Improvement Lead
519-821-6638 x 374
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 Chair
Quality Committee Chair or delegate
Executive Director / Administrative Lead
CEO/Executive Director/Admin. Lead______(signature)
Other leadership as appropriate______(signature)
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