Quality Dimensions

Costs of Cardiovascular Care - US Mozaffarian Circ 2015;131:e29-

Sustainable? 34.2 M people 23.4M people CIHI website 1975 to 2010 Expenditure increases = 3.5 fold Population increases = 1.5 fold 23.4M people 34.2 M people CIHI website

Sustainable? Alberta Health Clinical Area Inpatient Costs ED + UC Physician Services Total Addictions and Mental Health $194,898,187 $11,499,681 $219,134,001 $425,531,869 Bone and Joint $149,284,168 $21,615,954 $161,930,594 $332,830,715 Cancer $116,225,723 $9,655,216 $68,344,711 $194,225,649 Cardiac and Stroke $202,145,065 $21,811,328 $149,068,838 $373,025,231 Diabetes Nutrition Obesity $37,766,695 $2,559,936 $63,247,102 $103,573,733 Seniors Health TBD Alberta Health

Currently everyone in our system is working hard, and doing their individual parts. But we won’t achieve full integration until we can correctly align all of the pieces of the puzzle for the patients. We are proposing recommendations that will accelerate the path to a fully integrated and highly functioning health care system. This patient centered system will minimize gaps in the patient journey allowing clinical information to flow along the patient journey resulting in high patient satisfaction and greater value. Utilization of clinical pathways will allow clinicians to practice using flexible evidenced based protocols supporting the highest level of patient care. Now I would like to invite Sandra to walk us through the methodology and learnings from our research. “The current care systems cannot do the job. Trying harder will not work. Changing systems of care will.” IOM, Crossing the Quality Chasm: A new Health System for the 21st Century 2001

What is the Future State? Priority must be on quality and not cost Quadruple aim is a balance of competing factors Appropriateness is the responsibility of all Standardized pathways decrease practice variation and waste Choosing Wisely must become part of the culture Costing knowledge needs to start during training Innovation is a reality and also needs to be embraced