1. www.HQOntario.ca HQO Quality Standards Guiding evidence-based, high quality care Health Quality Ontario The provincial advisor on the quality of health care Irfan Dhalla, MD, MSc, FRCPC Vice-President, Evidence Development and Standards

4. 3 Health Quality Ontario’s role Health Quality Ontario serves as the provincial advisor on the quality of health care in Ontario. We have been entrusted to: –Monitor and report on how the health system is performing –Provide guidance on important quality issues –Assess evidence to determine what constitutes optimal care –Engage with patients and give them a voice in shaping a quality health system –Promote ongoing quality improvement aimed at substantial and sustainable positive change in health care

5. Age-standardized hysterectomy rate

6. 87 hysterectomies per 100,000 women Are we doing 6,700 more hysterectomies than women in Ontario want each year? TC LHIN rate

7. 6 “Without standards, there can be no improvement”

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9. 8 Quality Standards – why? Providing an evidence-based foundation for quality improvement Focus on high impact areas for quality improvement Tightly linked with implementation support from HQO and other partners to support uptake www.HQOntario.ca

10. 9 Concise sets of 5-15 strong (“should do”), measurable, evidence-based statements guiding care in a topic area Developed in topic areas identified as having high potential for better quality care in Ontario Each quality statement accompanied by quality indicator(s) Every quality standard will be accompanied by a plain language summary for patients and caregivers Strong emphasis on implementation through a variety of vehicles (monitoring/reporting, QBPs, Quality Improvement Plans, etc.) Strong emphasis on partnerships to support development and implementation Quality standards – what are they?

11. www.HQOntario.ca Quality Standards – what are they? (Illustrative – borrowed from NICE)

12. 11 www.HQOntario.ca What Quality Standards mean to our key audiences

13. 12 www.HQOntario.ca What Quality Standards mean to our key audiences

14. 13 www.HQOntario.ca What Quality Standards mean to our key audiences

15. 14 www.HQOntario.ca What Quality Standards mean to our key audiences

16. 15 Adoption Tools & Supports www.HQOntario.ca Baseline data Ongoing/real-time data Data support Audit & feedback Clinician/care team engagement strategy Provincial conferences/webinars Access to provincial & regional experts (clinical/data etc.) Community of practice Coaching/SWAT Team List of most important best practice recommendations Summary QBP pathway Standardized order set templates Recommendations on required local & provincial infrastructure Implementation toolkit/checklist Goal setting/benchmarking Evaluation Measurement & Reporting Support Change Management Tools Knowledge Transfer Tools Improvement Science

17. 16 Co-Chairs: Pierre Blier and Peter Voore 21 members including 3 patient/caregivers Major Depressive Disorder Co-Chairs: Ilan Fischler and Tarek Rajji 19 members including 3 patient/caregivers Dementia with agitation or aggression Co-Chairs: April Collins and Philip Klassen 23 members including 3 patient/caregivers Schizophrenia Panel composition and selection approach

18. 17 www.HQOntario.ca A few observations thus far… Huge enthusiasm for the task by all 3 panels Focusing on the ‘Q’ in QBP has helped to focus discussion on quality of care Strong multidisciplinary orientation – all participants, including patients and caregivers, have played active roles in discussion and decisions

19. www.HQOntario.ca FOLLOW@HQOntario