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.
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.
CQI in healthcare is a fundamental approach to quality primary care. It rigorously combines reflective practice, the application of best practices, data analysis and teamwork. The approach is also characterized by the development of a culture that leads all players involved to adopt a systemic and reflective approach to identify opportunities for improvement.
CQI is one of the driving forces behind the development of a learning health system, i.e. a health system in which health data from care delivery and research are analyzed to advance knowledge, which is then integrated into practices for the purpose of continuous improvement.
Healthcare professionals, working alone or as part of a team, are already involved in CQI in a more or less formal way. These individuals and teams can improve the performance of their approach by relying on a structured and documented methodology with the aim of improving the quality dimensions of health and social services (MSSS, 2012) :
- Effectiveness
- Efficiency
- Accessibility
- Safety
- Equal access
- Continuity
- Responsiveness
- Viability
Some CQI approaches meet the continuing professional development requirements of the Collège des Médecins du Québec (CMQ), and engaging in them can contribute to the 10 hours of professional practice evaluation activities required per reference period.
There are several methodologies available for CQI, including the Model for Improvement and the Lean-Six Sigma model. The Unité de soutien SSA Québec is a partner of the Académie qualité santé (AQS), which has chosen the Model for Improvement, a proven approach created and adapted for healthcare systems by the Institute for healthcare improvement (IHI). This model enables us to engage in the CQI process in a step-by-step fashion. Once a problem or an opportunity for improvement has been defined, an improvement team is formed, an objective is developed, indicators are chosen, ideas for change are generated, and these are tested using PDSA cycles (P: plan; D: do; S: study and A: act). The change ideas fine-tuned in the pilot project are then rolled out to the entire team and made permanent. A further step is to scale up the ideas for change in other environments.
Une soixantaine de facilitatrices et facilitateurs de pratique coordonnent des démarches d’ACQ dans les milieux cliniques de première ligne :
- 2017: Continuous quality improvement agents (AACQs in French) act as practice facilitators in university family medicine groups (FMG-U).
- 2020: AACQs in support of clinical transformation (AACQ-STCs in French) have been added as practice facilitators in family medicine groups (FMGs) in the Chaudière-Appalaches region, with one agent per local service network.
- 2022: one practice facilitator dedicated to CoMPAS+ initiatives
- 2023: regional continuous quality improvement agents (ARACQs in French) dedicated to FMGs, with one agent per RUISSS territory. Consult their service offer
Continuous quality improvement services for family medicine clinics and family medicine groups
The Unité de soutien SSA Québec offers Continuous Quality Improvement (CQI) support to family medicine clinics and Family Medicine Groups (GMFs). How do we do it? Thanks to the expertise of regional CQI agents.
History
Publication of a model designed by and for family medicine groups (FMGs): supportive, concrete and evidence-based. English version of the Learning FMG model and orientations coming soon.
Publication of a Position statement on continuous quality improvement (CQI) by the Unité de soutien SSA Québec. English version coming soon.
Launch of the continuous quality improvement service offer for family medicine clinics and family medicine groups See the offer
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
Mandate and nomination
- 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
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.
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).
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.
