Help for Your 2018 QIPs

A Quality Improvement Plan (QIP) is “a public commitment to meet quality improvement goals. By developing a QIP, an organization outlines how they will address improving the quality of care it provides to its patients, residents or clients.” Health care organizations in Ontario are required to submit a QIP to Health Quality Ontario (HQO) by April 1^st. QIPs are to be submitted online, using the QIP Navigator on HQO’s website. The resources below from HQO, AFHTO, our partners and members can help make the process easier.

Priority Issues for 2018-19

Each year, HQO identifies several priority issues – areas that urgently require improvement – for the system to work together on – in their Annual QIP Memo. For 2018-19, these issues are workplace violence prevention and the impact of opioids in Ontario.

NOTE: They are not required, but it is expected that organizations assess their performance on these indicators, and […] strongly consider these indicators for inclusion in their QIP. If organizations choose not to include a priority indicator, they should provide this rationale in the comments section only. [QIP Guidance Document, pp. 11-12]

Workplace Violence Prevention

New question in the QIP Narrative: Please describe how workplace violence prevention is a strategic priority for your organization. For example, is it included in your strategic plan or do you report on it to your board?

HQO has developed a guidance document to help you answer this question. You might also want to review their report on how teams addressed this question in last year’s QIPs. You might also consider drawing from the following resources:

• AFHTO Member Policies and Procedures on Workplace Health & Safety. These tools were developed by AFHTO member teams, who have agreed to share them with others.  Near the bottom of the page, you will find a section on Workplace Violence, Harassment, and Discrimination, with policies and guidelines from three FHTs.
• Resources from the Public Services Health & Safety Association: These posters, webinars/web tutorials,  and information sheets address a number of workplace health & safety issues, including violence & harassment.

Impact of Opioids

New question in the QIP narrative: Describe what steps your organization is taking to support the effective treatment of pain, including reviewing opioid prescribing practices and promoting alternatives to opioids. Think about access to addiction services, social services, (sub) populations, etc.

Consider using these resources to help you develop a plan to lessen the impact of opioids on your patients

• Partnered resources for management of chronic pain and addictions
• Standardized query to identify patients who use opioids

Some AFHTO members are already doing important work to reduce their patients’ need for opiates. Consider reaching out to these teams to find out if what they’re doing might work in your setting.

• Healthy Living With Pain
  • The Mount Sinai Academic FHT won a Bright Lights award for this initiative in 2016
  • An NP from the Sinai Health System shared details about the initiative at the Managing Medication as a Team workshop in November 2017.
• Low Back Pain Pilot:
  • The Belleville NPLC won a Bright Lights award in 2017 for their implementation and expansion of this provincial program.
  • IHPs from several teams in Rural Wellington shared their experience with this pilot at the Managing Medication as a Team workshop in November.

New recommended indicator for 2018-19: Diabetic foot ulcer risk assessment

Indicator Description (from the QIP Technical Specifications for 2018-19): Percentage of patients with diabetes, age 18 or over, who have had a diabetic foot ulcer risk assessment using a standard, validated tool within the past 12 months.

• Inlow’s 60-second diabetic foot-screening tool was developed by the Canadian Association of Wound Care. The assessment is comprised of 12 parameters and is divided into three categories – Look, Touch, and Assess. The assessment is usually performed by an RN or an RPN with certification in foot care.
• This screening tool is available as a custom form for TELUS PS Suite – developed by Denis Tsang, a registered dietitian at CareFirst FHT.
• The tool is also available for Accuro, from the publisher (accessible directly from within your EMR).
  • Use a different EMR? If you have an EMR tool for Diabetic Foot Assessments, consider sharing it with your peers. If you would like to help develop one or want to find out if someone else has already done so, consider joining one of our EMR Communities of Practice – contact us for more information.

More QIP Resources from HQO

HQO has many resources to help you with your QIPs.

• The QIP home page , Primary Care Sector Page, and Frequently Asked Questions are good places to start.
• The Guidance Document and Indicator Technical Specifications can help you dig deeper into the process and this year’s recommended indicators.
• Some additional tips for using the Navigator to upload your QIPS [PDF]
• HQO presented two training webinars for primary care QIPs (Beginner and Advanced) on December 18^th, 2017. If you were unable to attend and would like access to a recording, please email qip@hqontario.ca.
• Quorum is an online Quality Improvement Community managed by HQO. It’s a great way to learn from your peers across the sector, and it includes posts from provincial leaders in quality improvement, questions and answers from QI specialists across the province, and a bank of QI projects to learn from.
• The Quality Compass is a searchable tool of evidence-informed best practices, change ideas, and tools, arranged by QIP indicators.
• Query QIPs and QIP downloads let you see what other organizations have included in previous QIPs.
• Questions? Email qip@hqontario.ca for help.

Data to Decisions (D2D)

With D2D 5.1 right around the corner (submission platform will be open from January 11^th through February 8^th, 2018), there’s no better time to remind you that you can use your D2D data to help you choose areas for improvement. Remember that although teams are required to submit a QIP, the content of the QIP is up to the team. By reviewing your D2D interactive report with your team, you can work together to identify areas where there is room for improvement on indicators that matter to you and your patients.