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Dr. Kelly Smith appointment formalizes CQuIPS and Michael Garron Hospital partnership

Dr. Kelly Smith

In the fall of 2021, Dr. Kelly Smith joined Michael Garron Hospital (MGH) as their inaugural Michael Garron Chair in Patient Oriented Research. The move was strategic for many reasons: as the hospital’s first research chair, she will pave the way for expanded research opportunities; she will support a move to spread the hospital’s quality improvement (QI) work into the community; and her arrival means the beginning of a formal relationship with the Centre for Quality Improvement and Patient Safety (CQuIPS).

“Partnering with CQuIPS was an important part of my deliberations in taking on this new role,” Dr. Smith said. “I was looking for collaborators who already spoke my language of quality and safety – people who were interested in really transforming healthcare.”

Dr. Jeff Powis, medical director, Quality, Operational Excellence, Research & Innovation at MGH, advocated for the partnership with CQuIPS.

“I have seen the benefit of working with CQuIPS for my own research journey,” he said. “I found that single-centre QI work was challenging to disseminate outside of my own organization but, working with CQuIPS, I found partners who were interested in tackling similar problems and working on issues collaboratively. This led to much higher quality QI work that had a better chance of publication. Our partnership with CQuIPS is important because we want to make sure Kelly had access to the tools and connections that allow will her research to be successful and amplified.”

A couple months into her new role, Dr. Smith is already embedded in the work of the Centre – she’s supporting work with LOFT Community Services, an organization that supports people living with mental and physical health issues, addiction and those who are experiencing homelessness.

“LOFT and Michael Garron Hospital are collaborating on a new initiative called The Path Home, which meets a big need the hospital has identified – how to improve the pathway for patients with mental health issues to get across the continuum of care,” she said. “I’m working with CQuIPS research team members to look at how we can measure the impact of this program work from the patient perspective as well as the health system perspective. We’re in the brainstorming phase but it’s exciting and I think, if it can be scaled, it could be very, very impactful.”

Dr. Smith’s work doesn’t just consider the patient perspective – she has a lot of experience in making sure patients have a valued seat at the table.

“My role is to elevate and amplify the patient voice specifically within quality improvement and patient safety activities in a way that makes sustainable change for the health system,” she said. “We need to look at pain points in the health system, where the patient voice can be leveraged to overcome some of those pain points and look at how we can co-create a future of healthcare together.”

That includes beyond the walls of the hospital. MGH is the hub for East Toronto Health Partners (ETHP), the Ontario Health Team (OHT) serving East Toronto. Smith’s work will also focus on engaging the OHT in CQuIPS-led training to build QI capacity throughout the community.

“Healthcare professionals are the most adaptive group of individuals in the world: over, under, around and through, they are figuring out how to make it work for the patient and for themselves,” Dr. Smith said. “What’s exciting about the potential of engaging our external health partners in CQuIPS training is creating a sense of community around QI and helping do more QI on scale.”

Dr. Powis agrees.

“Throughout the pandemic, we’ve been able to demonstrate the real value of partnership and integrated healthcare working with our East Toronto Health Partners,” he said. “We’ve shown that our success is based on the strength of our partnerships. If we all have the same vision of consistently improving, if we speak the same language and we all have the same set of tools to get there, it just makes our collaborative work so much easier – it’s part of what I consider vital to be an integrated healthcare system. We’re excited to work with CQuIPS and expand QI capacity across ETHP.”

Dr. Brian Wong, CQuIPS director, said the partnership between CQuIPS and Michael Garron is an important step in the Centre’s vision to grow the QI community and focus on health system resilience.

“We consistently see that when organizations work together, the impact is far greater than each of us working alone,” he said. “Dr. Smith is already a connector herself – between Michael Garron, the East Toronto Health Partners and CQuIPS – and I have no doubt that list will continue to grow. She is a world-class researcher in this area and we are fortunate to have her here in Toronto.”

Wendy Kingsburgh: Bringing a social work lens to quality improvement

Wendy Kingsburgh

After supporting patients and families as a social worker for more than two decades, Wendy Kingsburgh is excited to be starting a new career as a Performance Improvement Specialist with the Quality Improvement and Patient Safety team at Sunnybrook.

“I’m feeling rejuvenated and energized to be in this role,” the CQuIPS certificate course graduate said. “I loved my time as a social worker, but wanted to do more work with the system to improve care for patients and families.”

Kingsburgh brings a unique lens to the role as the first social worker on the quality team.

“With my background, I can help bring the patient and family perspective in,” she said. “From my two decades in general internal medicine, I have a good sense of where the system is and where the patient is and where we need to bring them closer together – that includes looking at both social determinants of health and systemic issues.”

Just one week into the role, Kingsburgh is already supporting teams across Sunnybrook to make improvements for their patients and staff through an initiative called quality conversations.

“These are 15-minute huddles that happen weekly. They’re interprofessional, so everybody comes together to brainstorm what we can do to improve things on the unit,” she said. “Then out of that, the team chooses one project to work on over the next week and they start PDSA cycles. They’re not big projects – these are quick win initiatives. And I’m there as a coach to help guide and get them excited about this.”

Kingsburgh said that if you asked her five years ago whether she would be working in quality improvement (QI), the answer would be absolutely not. But a couple of key opportunities led her here. The first was being part of the Toronto Academic Health Sciences Network (TAHSN) Innovative Fellowship Program that sparked a realization for Kingsburgh that she could use her experience to work on system-level improvements. Her work through the fellowship on advanced care planning for general internal medicine patients and families became a leading practice with Accreditation Canada.

Inspired by that experience, Kingsburgh went on to enroll in the CQuIPS certificate course where she gained more in-depth knowledge on quality improvement and patient safety (QIPS) skills and tools, and in 2020, she graduated from the Institute of Health Policy, Management and Evaluation MSc in Quality Improvement and Patient Safety.

“The quality conversations are a great door opener for a lot of people who don’t know a ton about QI,” she said. “We’re all often quick to jump to conclusions and look for a quick fix. But there’s a scientific methodology behind fixing the problem, so this is about diving a little bit deeper to do a root cause analysis and find out if there really is a problem and then identify what we’re trying to do.”

Kingsburgh highlighted several mentors she’s had over the years who have supported her journey into QI, including: Brian Wong, CQuIPS director; Kaveh Shojania, CQuIPS senior scholar and former CQuIPS director; Marie Pinard, CQuIPS associate director at Women’s College Hospital; Brigette Hales, director, quality and patient safety at Sunnybrook; Lisa Di Prospero, director, practice-based research and innovation at Sunnybrook; and Sonia Dyal, her former patient care manager.

Pinard said she is not surprised to see Kingsburgh pivoting to QI.

“It was clear in Wendy’s time in the certificate course that she felt empowered by what QI could do for her colleagues, patients and families,” Pinard said. “Having her in this new role means amazing things for the Toronto QI community – her background in social work will bring such a rich addition to the projects she works on. She is in a great position to help make significant and important changes to our practice to benefit the entire health system.”

Kingsburgh said she’s looking forward to seeing what she can do in this position.

“Quality improvement is so important because it tells us we can come in every day and do a little bit better than the day before,” she said. “There’s always room for improvement. Even if it’s to be a little bit quicker, a little more seamless or communicate a little better, there are so many different ways we can make things better for patients and for those of us providing care.”