The Ministère de la Santé et des Services sociaux (MSSS) has mandated the Unité de soutien au système de santé apprenant (SSA) Québec to structure and deploy continuous quality improvement (CQI) in the province. The objective is to implement activities for reflexivity, skills development and support for practice changes in community-based services.
What is Continuous Quality Improvement?
Continuous Quality Improvement (CQI) is the ongoing, combined effort of all stakeholders in an organization to make changes that will lead to better results at the quintuple aim.
This approach is characterized by the development of a culture that leads all the actors involved to take a systemic and reflective approach to identifying opportunities for improvement. These opportunities for action may concern one or more dimensions of the quality of care and services:
- Effectiveness
- Efficiency
- Access
- Security
- Equity
- Continuity
- Responsiveness
- Sustainability
In Québec, CQI projects are coordinated by Continuous Quality Improvement Agents in academic family medicine groups (GMF-Us in French). As of April 1, 2023, they will also be coordinated by regional continuous quality improvement agents in family medicine groups (GMFs in French).
What is the benefit of CQI?
Continuous quality improvement projects benefit everyone involved in the health and social services network:
- Patients
- Receive continuously improved care and services based on best practices
- Contribute their experiential knowledge to CQI projects
- Clinicians
- Contribute their professional skills and experiential knowledge to CQI projects
- Act as leaders in teamwork and interprofessional collaboration
- Benefit from the expertise of practice facilitators who support them in the human dimension of change and the sustainability of the solutions put in place
- Decision makers
- Act as leaders in identifying and prioritizing CQI opportunities
- Have a greater capacity to carry out CQI projects
- Benefit from the support of the Continuous Quality Improvement Agents in the consolidation of the CQI culture within their teams
- Learners
- Benefit from clinical teaching environments
- Research staff
- Are supported in research projects that have a strong patient focus and are directly related to a CQI priority
- The integrated health and social services centers (CISSS) and the integrated university health and social services centers (CIUSSS)
- Benefit from the support of the Continuous Quality Improvement Agents in the consolidation of the CQI culture within their teams
How?
- CQI is an approach that involves the use of tools based on improvement science
- These tools allow for proper planning and execution of projects aimed at optimizing results by improving processes and workflows
- Continuous Quality Improvement Agents must have the skills required to use these tools
- The actors concerned by the changes must adhere to them and participate in the realization of the projects
- Large improvements in quality can be achieved by introducing small, fundamental changes
- Identify opportunities for improvement
- Identify and measure relevant indicators
- Experiment with solutions
- Successfully implement solutions gradually
- Sustain the changes
- Ensure the dissemination of the improvements noted
- Working in partnership is key to integrating CQI projects and optimizing the impact of their care and services on patients. For example,
- A GMF-U with the directions of the CISSS or CIUSSS in its territory
- Continuous Quality Improvement Agents with the Quality, Evaluation, Performance and Ethics directions (DQEPE in french) and their institutions
- Continuous Quality Improvement Agents with the academic and research community
- The family medicine groups, academic or not, act as flagship primary care environments in the Québec health and social services network
- Organization of front-line services
- Clinical training for learners
- Research focused on patient needs
History
Creation of four regional continuous quality improvement agent positions by the Unité de soutien SSA Québec. These people will work in the family medicine groups while the continuous quality improvement agents are deployed in the academic family medicine groups.
Appointment of a facilitator of clinical and organizational practices in outreach services, particularly in the context of the COMPAS+ initiative, and integration of this person into the Unité de soutien SSA Québec team Read the article
- The Ministère de la Santé et des Services sociaux du Québec mandates the Unité de soutien au système de santé apprenant (SSA) Québec to structure and deploy continuous quality improvement (hereinafter referred to as CQI) in order to contribute to the emergence of a learning health system in which the scientific expertise recognized in CQI in Québec allows for the improvement of practices in the network
- Appointment of a new CQI provincial coordinator (CPACQ, formerly CCACQ in French) and integration of this person into the Unité de soutien SSA Québec team Read the article
Dissemination of the Framework for CQI in Québec’s GMF-Us (in French), a document from which the CQI culture and practices can be consolidated in the academic family medicine groups. It aims to lay the conceptual foundations necessary to allow a common understanding of what CQI is and to give precise indications as to the roles and responsibilities expected of those involved in this type of activity
- Implementation of the MSSS’s Management Framework for Academic Family Medicine Groups (GMF-Us)
- Integration of new professionals such as Continuous Quality Improvement Agents. Given their activities, these agents will be able to consolidate the adequacy of practices in these settings with the successful model for the organization of primary care and services advocated by the College of Family Physicians of Canada
- Appointment of an executive advisor for continuous quality improvement (CCACQ in French) who is attached to the Direction de la qualité, l’évaluation, la performance et l’éthique (DQEPE) at the CIUSSS de la Capitale-Nationale. The CCACQ is called upon to coordinate the action of the continuous quality improvement agents in all academic family medicine groups (GMF-Us) located in Québec and to exercise functional authority over these agents. In collaboration with the integrated health and social services centers (CISSS) and the integrated university health and social services centers (CIUSSS) of Québec, it is responsible for implementing a culture of continuous improvement of quality and safety within the GMF-Us, as well as supporting strategic thinking, action and decision-making with concrete impacts in the environments
- Establishment of an advisory committee composed of network representatives, clinicians, researchers and user partners. Its mission is to determine the priorities of the executive advisor for continuous quality improvement and to participate in the consolidation of a CQI culture in the GMF-U network
New provincial leadership for continuous quality improvement in the health and social services network
The Ministère de la santé et des services sociaux du Québec mandates the Unité de soutien au système de santé apprenant (SSA) Québec to structure and deploy continuous quality improvement (hereinafter referred to as CQI) in order to contribute to the emergence of a learning health system in which the scientific expertise recognized in CQI in Québec allows for the improvement of practices in the network.
Nomination of a Provincial Continuous Quality Improvement Coordinator
Under the direction of the Unit, in close collaboration with the Ministère de la Santé et des Services sociaux (MSSS) and the health and social services network, Ms. Plouffe-Malette will coordinate and guide the activities of the Continuous Quality Improvement agents of Québec (hereinafter referred to AACQ, the French acronym).
A practice facilitator for continuous quality improvement initiatives including COMPAS+
The Unité de soutien au système de santé apprenant (SSA) Québec is pleased to welcome Johannie Laliberté-Gagné to its team as a facilitator of clinical and organizational practices in outreach services, particularly in the context of the COMPAS+ initiative.
