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Equipping clinicians for academic success in quality improvement

Any clinician can tell you that a knowledge of basic quality improvement (QI) principles does not guarantee successful QI projects; many QI attempts result in learnings rather than lasting change. Graduates of the Centre for Quality Improvement and Patient Safety (C-QuIPS) Excellence in Quality Improvement Certificate Program (EQUIP), however, will tell you that the year-long mentorship and education program will significantly increase the likelihood of those projects succeeding – and results being published.

“In the program, we learned how to write a good QI paper, what QI editors are looking for and how to structure a project so it can be written about and shared,” said Dr. Anne Smeraglio, a 2020 EQUIP graduate and hospitalist at the Portland Oregon VA Health Care System. “And since graduating, those lessons have helped me get published.”

Knowledge gained in the program also helped Dr. Smeraglio advance to more senior roles – she’s now the Director of Quality Improvement in the Oregon Health & Science University’s internal medicine residency program​ and was invited to teach as part of the Accreditation Council for Graduate Medical Education’s Program Director Patient Safety and Quality (PDPQ) Educators Network.

Dr. Smeraglio is not unique in this sense – many of the program’s more than 60 graduates to date from all across North America have found success in leading, teaching and publishing their QI work. Dr. Adina Weinerman, now one of EQUIP’s core faculty members, was in the program’s first cohort and said the program has had a significant impact on her career.

“EQUIP strengthened my quality improvement knowledge and made me more confident to lead and mentor quality improvement projects in an academic environment,” she said. “As a direct result of EQUIP, I am now the Medical Director, Quality and Patient Safety at my academic institution, and couldn’t be happier.”

EQUIP is delivered through six full days of virtual training (July 7-9, 2021 and May 9-11, 2022) and monthly webinars between. Over the course of the program, learners benefit from one-on-one coaching and mentorship from EQUIP faculty who are internationally recognized QI clinicians and experts. In addition to track records successfully executing QI projects in academic settings, faculty members have published their work in high-impact journals such as JAMA Internal Medicine¸ Academic Medicine and BMJ Quality & Safety.

“EQUIP is meant to provide a deeper dive into QI methodologies and help clinicians take their QI skills to the next level,” said Dr. Brian Wong, C-QuIPS Director and EQUIP Co-Director along with Dr. Kaveh Shojania. “We’ve been amazed in every cohort at the calibre of our learners – they all bring a lot of energy and enthusiasm for QI and we know they make an impact in the QI field after they leave.”

Dr. Benjamin Leis, a newly-appointed staff physician and assistant professor at the University of Saskatchewan College of Medicine, was a cardiology trainee when he took the EQUIP course.

“Through EQUIP, I was taught a systematic approach to quality improvement which is invaluable and has already led to two publications in the last year and a half,” he said. “You are more likely to be successful in QI with the foundations taught in the EQUIP program. You will also meet wonderful people and mentors who will share your enthusiasm and be very useful professional connections for the rest of your career.”

Spots are open for the program’s fifth cohort. Learn more and apply here.

Dr. Patricia Trbovich joins C-QuIPS as Research and Scholarship Lead

Patricia Trbovich has no interest in going backwards after the COVID-19 pandemic.

“As a quality improvement and patient safety community, we have a societal responsibility to craft what a ‘new normal’ will look like,” she said. “We don’t want to go back to the old normal which was to normalize inequity, exhaustion and burnout.”

Dr. Trbovich is uniquely positioned to help create a better system – with a background in cognitive psychology, her career has focused on understanding the motives behind people’s actions. Partnered with her research experience – including as current Badeau Family Research Chair in Patient Safety and Quality Improvement at North York General Hospital – she is able to make recommendations about how systemic changes can better shape workflows and, ultimately, healthcare.

And now, through her new role as Research and Scholarship Lead with the Centre for Quality Improvement and Patient Safety (C-QuIPS), she will have a platform to help share best practices – across professions, provinces and countries.

“I really focus on the word ‘across’ here because, as QIPS professionals, we do a lot of great work but sometimes it’s in silos,” she said. “I see one of my roles as ensuring there is cross learning and sharing and ensuring that we help people put the proper research lens on some of the great practical work they’re doing so they can bring it to the next level and we can either scale or spread the innovation if that’s the right thing to do.”

Dr. Trbovich’s path has crossed the Centre many times – in addition to formerly teaching in the C-QuIPS certificate course and VAQS program, she is an associate professor in the MSc Quality Improvement and Patient Safety program at the Institute of Health Policy, Management and Evaluation at the University of Toronto and has been mentored by senior Centre members Drs. Edward Etchells and Kaveh Shojania.

“Her history with C-QuIPS made her a perfect fit for this role,” said Dr. Brian Wong, C-QuIPS director. “We’re excited to have her expertise on board. She is a pre-eminent researcher in our field and the incredible amount of knowledge she brings with her in human factors and QIPS research will benefit everyone in the QIPS community.”

One of Dr. Trbovich’s first priorities will be to focus on C-QuIPS’ two key themes: health equity and health system resilience – and specifically how they connect.

“If you’re able to improve health equity and diversity, then you will in turn build a more resilient health care system – I see them as two sides of the same coin,” she said. “These two themes aren’t topics du jour that we’re going to work on for two years and then let them go and move on to something else; I see these as important areas of priority we have to include in the way we do our research so it just becomes part of our work.”

Announcing C-QuIPS Improvement Fellows

The fastest way to spread quality improvement initiatives, successes and learnings from failures is through a strong network. That’s why one of our 2020-24 strategic plan goals is to grow our community – to create more opportunities for shared learning and the pursuit of joint research and improvement initiatives. It is through this lens that we are thrilled to announce our eight inaugural C-QuIPS Improvement Fellows:

  • Mo Alhaj, Department of Family and Community Medicine, St. Michael’s Hospital, Unity Health Toronto
  • Genevieve Bouchard-Fortier, Gynaecologic Oncology, University Health Network – joint C-QuIPS-Choosing Wisely Canada Fellow
  • Allison Brown, Department of Medicine, University of Calgary
  • Natasha Gakhal, Rheumatology, Women’s College Hospital
  • Beth Gamulka, Pediatric Medicine/Paediatric Emergency Medicine, Hospital for Sick Children
  • Ashraf Kharrat, Neonatology, Mount Sinai Hospital
  • Samuel Vaillancourt, Emergency Medicine, St. Michael’s Hospital, Unity Health Toronto
  • Jennifer Wong, Speech-Language Pathology, Sunnybrook Veteran’s

These individuals all have advanced QI training and bring diversity in terms of their clinical and professional backgrounds, organizational workplaces and QI interests and experiences. For the next 12-18 months, they will be integrated with our team, supporting quality and patient safety activities that are priorities for both C-QuIPS and our partner organizations as they further develop their QI experience and leadership.

“We were overwhelmed by the quality of candidates who applied,” said Joanne Goldman, C-QuIPS Fellowship Director. “We hope with this fellowship to foster a community of improvement – our Fellows will regularly be connecting with one another, working together and learning from one another. We are positive they will continue to make incredible contributions to the QIPS field.”

As a further example of connection and collaboration, one of the Fellows, Genevieve Bouchard-Fortier, has been selected as a joint C-QuIPS-Choosing Wisely Canada (CWC) Fellow. C-QuIPS staff have actively been engaged in CWC priorities and we are happy to support Bouchard-Fortier as she is embedded within the national CWC campaign and aligns her initiative with campaign priorities/national implementation activities.

Stay tuned for more information on our Fellows and their work!

Meet Marie Pinard, C-QuIPS associate director for Women’s College Hospital

One of Marie Pinard’s top goals as the new associate director with the Centre for Quality Improvement and Patient Safety (C-QuIPS) for Women’s College Hospital is no secret: she wants to get more interprofessional health care leaders involved in quality improvement (QI) and patient safety. As a nurse by background, Pinard has spent her career engaged in quality improvement at SickKids and Women’s College Hospital, and now she’s helping inspire others.

“Quality and safety need leadership in both the academic and operational worlds so part of our work is helping create a bridge between the two,” she said. “When you have more interprofessional providers trained in QI, you get more of those critical QI skills into the front lines of the health system which leads to meaningful changes and safer care.”

Pinard has been affiliated with C-QuIPS for almost a decade, providing support as a mentor to students and an instructor for the Centre’s certificate course. When Women’s College became part of C-QuIPS earlier this year – joining established partners Sunnybrook Health Sciences Centre, The Hospital for Sick Children (‘SickKids’) and the University of Toronto’s Faculty of Medicine – it was a natural fit for Pinard to take on the associate director role, said Dr. Brian Wong, C-QuIPS director.

“C-QuIPS is focused on accelerating and deepening the work of people and organizations that are passionate about enhancing quality and patient safety,” he said. “And Marie has been involved with this work for years – initially as a front-line nurse and then in a variety of hospital-based leadership roles. And it’s the wealth of experience that Marie has accrued over the years that we are so excited to draw upon as we attempt to better align the work we do with the organizations we partner with.”

Working at Women’s College where a significant focus is on ambulatory care, one of Pinard’s other goals is to expand the quality lens to capture areas beyond inpatient practice.

“C-QuIPS provides access to so much knowledge and expertise that we can leverage, and education programs that can help develop more health leaders,” she said. “I drank the Kool-Aid; QI has been my whole career and I’m so passionate about getting more people involved – I’m excited to help build our QI community by getting more of my colleagues at Women’s College involved in this important work.”

Dr. Amanda Mayo is C-QuIPS’ new associate director for Sunnybrook

Dr. Amanda Mayo recognizes that COVID-19 has brought countless challenges to the health system. At the same time, she also sees hope – that the pandemic will lead to more innovative care models for better person-centred and equitable care. This year, health care has adapted and evolved much faster than ever before and magnified disparities in outcomes.

“Virtual care innovations have accelerated in the pandemic, enabling access to care for patients sheltering at home and creating collaborative care models between providers,” she said, “ We have had virtual care technologies for years – there was just no urgency to do high quantity and quality virtual care until now. At the same time, it’s become clear that these resources don’t work for everyone – there are patients without access to technology, so we still have work to do.”

Dr. Mayo has been involved in making necessary changes – she’s currently working on creating a virtual orthopaedic consult care pathway for long-term care residents with fractures, preventing elderly patients from having to wait long hours in Emergency Departments and having to quarantine after acute care hospital visits. And now, as the new Centre for Quality Improvement and Patient Safety (C-QuIPS) associate director for Sunnybrook, she’ll be able to get more people involved in quality improvement work to shape better, safer care.

C-QuIPS – a joint partnership between the University of Toronto’s Faculty of Medicine and three of its major teaching hospitals, Sunnybrook Health Sciences Centre, the Hospital for Sick Children (‘SickKids’) and Women’s College Hospital – focuses on research and education to accelerate and deepen the work of people and organizations that are passionate about enhancing quality and patient safety.

“Amanda brings a unique perspective to the Centre with her background in clinical engineering and human factors,” said Dr. Brain Wong, director of C-QuIPS. “She has been deeply involved in our two major certificate courses and has been instrumental in training the next generation of quality leaders. We’re thrilled she’s coming on board in this role to continue supporting this important work.”

Dr. Mayo first became involved with C-QuIPS five years ago as an instructor in the Excellence in Quality Improvement Certificate Program (EQUIP).

“I’m excited to be taking on the associate director role because quality improvement work is close to my heart,” she said. “One of the things we’re trying to is build a community of QI practice within the health care community – both physicians and interprofessional providers. We’re blessed in Toronto and at Sunnybrook to have a strong QI background, so I see my work as supporting the Centre to bring these individuals together to collaborate on bigger projects that lead to significant system improvements.

Introducing Dr. Olivia Ostrow, new C-QuIPS associate director for SickKids

Dr. Olivia Ostrow is here to break down silos in health care. As a staff physician in the Division of Pediatric Emergency Medicine, a medical safety leader at the Hospital for Sick Children and an assistant professor in the Department of Pediatrics at the University of Toronto, her focus is on bringing people together to find innovative ways to keep patients safe, and use resources more wisely to provide high quality care.

And as a newly appointed associate director with the Centre for Quality Improvement and Patient Safety (C-QuIPS), she has a bigger platform to do exactly that.

“In this role, I hope to continue building quality improvement capacity at SickKids while also creating a bridge between the hospital and C-QuIPS to help tackle our quality and safety priorities,” she said. “The pandemic has made quality and safety even more relevant and there’s plenty of opportunity to grow these spaces, especially for pediatrics.”

C-QuIPS, a joint partnership between the University of Toronto’s Faculty of Medicine and three of its major teaching hospitals, Sunnybrook Health Sciences Centre, the Hospital for Sick Children (‘SickKids’), and Women’s College Hospital, focuses on research and education to accelerate and deepen the work of people and organizations that are passionate about enhancing quality and patient safety.

Dr. Brian Wong, C-QuIPS director, said Dr. Ostrow’s experience fits in perfectly with C-QuIPS’ mission.

“Dr. Ostrow is a well-established quality improvement and patient safety leader whose work has had an impact at institutional, regional and national levels,” he said. “Prior to taking on the role of associate director, she served as our C-QUIPS certificate course co-director and was instrumental in building capacity amongst clinicians and fellows to lead quality improvement work at SickKids. We are thrilled to welcome her in her new role, and certain that her expertise in health system improvement and focus on patient safety and resource stewardship will elevate the Centre’s ability to impact even more change in the years to come.”

Dr. Ostrow’s work as a course director for C-QuIPS’ co-learning curriculum in quality improvement program has already led her to help create unlikely teams focused on improving the health system – in the program, faculty members and trainees from eleven divisions in the Department of Paediatrics learn about quality improvement and work on real projects together.

“What I really like about quality improvement work is that you can have a pediatric emergency doctor and a urologist in the same room and, when you’re talking about quality and safety, it often doesn’t matter that we practice in very different fields of medicine,” she said. “We all share the same goal of striving to see change and a willingness to tackle complex problems to develop sustainable improvements so we can support better outcomes for patients.”

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