1. familymedicine.uottawa.ca The Resident QI Project: What is it & what is my role as faculty? Lunch time Webinar – October 22, 2015 NEED TECHNICAL SUPPORT? Call 613-854-0949

2. familymedicine.uottawa.ca MAINPRO-M1 This event is an Accredited Group Learning Activity (Section 1) as defined by the Maintenance of Certification program of the Royal College of Physicians and Surgeons of Canada for.5 credits.. This program has also been accredited by the College of Family Physicians of Canada for up to.5 Mainpro-M1 credits. This program has been reviewed and approved by the University of Ottawa, Office of Continuing Professional Development.

3. familymedicine.uottawa.ca Disclosures Commercial Support: Elizabeth Muggah, Ruth Dimopoulos, Tamara Fortin and Liz Jackson have nothing to disclose Potential for conflict(s) of interest: Elizabeth Muggah, Ruth Dimopoulos, Tamara Fortin and Liz Jackson have no conflicts to declare

4. familymedicine.uottawa.ca Introduction FACILITATORS: Liz Muggah, Director of QI for the DFM Liz Jackson, Ruth Dimopoulos & Tamara Fortin Primary Care Quality Practice Facilitators for Champlain LHIN SUPPORT FROM: Dr Paul Hendry and Mr Bob Parsons from the Faculty Development office at the Faculty of Medicine 4

5. med.uOttawa.ca TECH HELP 613-854-0949

6. familymedicine.uottawa.ca IPAD Dashboard

7. familymedicine.uottawa.ca Who is on the call?

8. familymedicine.uottawa.ca Learning Objectives 1.Review what is (& isn’t) Quality Improvement. 2.Outline the expectations for the resident for the Quality Improvement Project (QIP). 3.Clarify the faculty role for the QIP. 4.Explore how you can coach your resident in the first part of the QIP. 5.Share key QI resources

9. familymedicine.uottawa.ca QI – what it is and isn’t

10. familymedicine.uottawa.ca What is Quality Improvement? Quality Improvement Quality Assurance Research PURPOSETo improveTo judgeTo discover TESTSSmall tests of change No testsOne large blinded test DATA“just enough”All relevant dataAs much as possible “just in case” BIASStabilize bias from tests to test Adjust to reduce bias Control for bias HOW TO KNOW IF CHANGE WORKED? Repeated tests of change No focus on change Hypothesis testing (t-test, chi square), p- value

11. familymedicine.uottawa.ca QI Project Goals Resident expectations Faculty Role

12. familymedicine.uottawa.ca QI Project: Resident Goals and Expectations Select a topic/Ask a question Collect information - review data & survey team members Identify the root problem Make recommendations Select a topic/Ask a question Collect information - review data & survey team members Identify the root problem Make recommendations Select a topic/Ask a question Collect information - review data & survey team members Identify the root problem Make recommendations Practice Audit (alone) Goal: Ask is there a “problem” in the clinic? (15-20 charts). What is the standard of care? Formerly “epearls” Written report due: Dec 18, 2015 Practice Improvement: (groups) Goal: Explore root cause of gap, engage clinic team to understand gap, identify & plan improvement idea Written report due: April 1, 2016 FMRSP Goal: Could implement improvement Due: March 1,2017 Practice Audit (alone) Goal: Ask is there a “problem” in the clinic? (15-20 charts). What is the standard of care? Formerly “epearls” Written report due: Dec 18, 2015

13. familymedicine.uottawa.ca QI Project: Faculty Role is to help resident to….. Select a topic/Ask a question Collect information - review data & survey team members Identify the root problem Make recommendations Select a topic/Ask a question Collect information - review data & survey team members Identify the root problem Make recommendations Select a topic/Ask a question Collect information - review data & survey team members Identify the root problem Make recommendations Practice Audit Identify a question about how your clinic is doing Think about how to assess practice Link to their FMRSP Read and give feedback on report Practice Improvement: Explore why there is a gap Connect with clinic team No evaluation (this is done by Unit QI lead) FMRSP : Scholarly Project in QI Supervise their FMRSP

14. familymedicine.uottawa.ca Practice Audit report Due Dec 18, 2015

15. med.uOttawa.ca Supervisor Feedback Form Due Dec 18, 2015

16. familymedicine.uottawa.ca Questions?

17. familymedicine.uottawa.ca QI Project and Faculty Coaching…

18. familymedicine.uottawa.ca Task 1: Coach your Resident to Identify the QI Problem Faculty: Let’s talk about your QI project. Resident: Ok…I’ve got a great idea!

19. med.uOttawa.ca Resident: I would like to implement a patient “HIV toolkit” in your practice. Faculty: How might that might work?

20. familymedicine.uottawa.ca WAIT!!! DOES THIS SOUND FAMILIAR? What would you do next? Type your answer into the CHAT BOX A.Congratulate resident on an excellent idea and tell them to get started on implementation. B.Ask for more details to see if this matches with the QI project goal. C.Think that the resident may be off track but you are not sure what to do next. D.Do something else (type in what you would do)

21. med.uOttawa.ca Faculty: Let’s try the 5W 2H tool. Resident: Well I haven’t really got that far...

22. familymedicine.uottawa.ca Let’s Investigate a Bit…

23. familymedicine.uottawa.ca Stay tuned for the next episode: What the practice audit told us..... Faculty: Maybe we need to audit my practice to find out more.

24. familymedicine.uottawa.ca Now let’s reflect…

25. familymedicine.uottawa.ca WANT TO KNOW MORE about the QIP and your role as faculty? Resident webpage, DFM Curriculum page Liz Muggah – QI Director for DFM QI UNIT LEADS Bruyere – Courtney Maskerine Primrose – Sharon Johnston Civic/Riverside – Vanessa Murley Community – Ed/David or associated Academic Unit lead Pembroke – Todd Gauthier Montfort – Manon Denis-Leblanc Winchester – all faculty

26. familymedicine.uottawa.ca WANT TO KNOW MORE About QI Tools & Ideas? Health Quality Ontario Institute for Healthcare Improvement (IHI) Mike Evans’ IHI video on QI (8 minutes)

27. familymedicine.uottawa.ca “A significant impact on how I view workplace issues. Practice Facilitators bring a wealth of background QI knowledge.” ~ Dr. A.F. Program Alumni www.PracticeExcellence.ca 613-820-4922 ext 3395 Support for primary care practices to improve : o practice processes o patient experience o provider and staff experience o patient outcomes WANT TO KNOW MORE about supporting QI in your practice?

28. familymedicine.uottawa.ca Feedback – what did you think? Would you recommend the webinar to a colleague? With your “pen” indicate from 0 (no) to 10 (absolutely!)

29. familymedicine.uottawa.ca Feedback – please help us help you! Did this work for you? Should we do it again? What are your learning needs in QI? A short survey will be sent to you by email after this webinar or click the link in chat now https://www.surveymonkey.com/r/QI_Resident_Webinar2015

30. familymedicine.uottawa.ca References Health Quality Ontario – Primary Care resources: http://qualitycompass.hqontario.ca/ Institute for Health Care Improvement: http://www.ihi.org/education/ihiopenschool/Pages/default.aspx Mike Evans QI Video: http://www.ihi.org/resources/pages/audioandvideo/mikeevansvid eoqihealthcare.aspx http://www.ihi.org/resources/pages/audioandvideo/mikeevansvid eoqihealthcare.aspx 5W2H: www.hqontario.ca/Portals/0/documents/qi/.../pc-5w2h-method- en.docx Practice Facilitation in Primary Care: Baskerville BN, Liddy C, Hogg W. Systematic review and meta analysis of practice facilitation within primary care settings. Ann Fam Med 2012;10(1):63-74. Available at: www.annfammed.org/content/10/1/63.full www.annfammed.org/content/10/1/63.full

31. How to find the QI resources Click anywhere on the wheel

32. familymedicine.uottawa.ca Click the “Other” folder

33. familymedicine.uottawa.ca FMRSP resources in this folder QI resources in this folder

34. familymedicine.uottawa.ca Thank-you!