Last updated on April 21, 2014 at 5:21 EDT

CFHI: Leading the Way to Healthcare Improvement in Quebec

March 14, 2013

Three CFHI-Funded Healthcare Transformation and Coordination Approaches
Realize Results

OTTAWA, March 14, 2013 /CNW/ – Three Quebec-led teams are accelerating
the transformation of healthcare and seeing positive change, as a
result of having applied innovative healthcare improvement and
change-management processes to the healthcare challenges in their

The findings are revealed in three reports funded by the Canadian
Foundation for Healthcare Improvement (CFHI) released today. They

        --  Strategic Community
            (SC): An Approach for Developing Interorganizational
             Collaboration by the members of the Work Organization
            Studies Chair, Université de Sherbrooke, led by Dr. Mario Roy
            and Madeleine Audet

        --  An Innovative Strategy in Organizational Transformation: Creating and
             Implementing a Transition Support Office within a University Health
             Centre led by Mélanie Lavoie-Tremblay,Associate Professor,
            Ingram School of Nursing, McGill University and Marie Claire
            Richer, Director, Transition Support Office (TSO)

        --  Knowledge in Action: Healthcare Management and Governance Innovation Lab,ledby
            Dr. Denis A. Roy, Vice-president of Scientific Affairs,
            National Institute of Public Health, Quebec

Strategic Community (SC): An Approach for Developing Interorganizational Collaboration

Improving the accessibility of healthcare services within the Estrie
region of Quebec, with a population of more than 315,000 and
characterized by scarce human and financial resources, was the catalyst
for pursuing the “Strategic Community” (SC) approach.   “The SC came
from a need to end gridlock and to be innovative very fast,” says Mario
Roy, one of the lead authors.  The first SC trial took place in the
field of telecommunications in Japan where the primary goal was to
promote innovation and bring together key players from various partner
organizations.  It is the first time the concept has been applied to
healthcare improvement.

Dr. Roy and his team used SC to transform the organization of work among
three institutions in Estrie, to maintain and improve the quality of
services for cancer and mental health patients with complex care needs.
SC made it possible to implement, relatively quickly, initiatives for
improving the organization of work, the accessibility of services for
clients and the degree of trust between the partners involved.

“It was unusual for a Centre de santé et de services sociaux (CSSS)
nurse to go to the university hospital to interact with a patient care
team, so there was a bit of a learning curve before her participation
was fully accepted,” says Roy. “When vulnerable patients have to move
back and forth several times between organizations, people on the
frontlines of care have to know each other.  Because the health
situation of these patients is always changing, and changing so
rapidly, we really need collaboration at the operational level rather
than rely on standardized processes,” adds Dr.  Roy.  “The care team
must be interorganizational.”

Dr. Mario Roy and his team demonstrate that through SC, it is possible
to challenge the status quo and to break down barriers in institutions
in order to implement simultaneous change. The SC process began by
understanding what each group (psychologists, social workers,
physicians and other frontline care workers) was doing. “A willingness
to collaborate is key, but the thing to remember with collaboration is
that it involves people, not roles. People change positions, and that
will impact the collaboration,” says Dr. Roy.

At the conclusion of the study, several organizations decided to
continue, including the Centre hospitalier universitaire de Sherbrooke
(CHUS), the fourth largest hospital in Quebec. “We are continuing this
approach for our clients,” says Patricia Gauthier, General Director,
CHUS. “SC showed us where we must improve the continuum of care and
services between institutions in our network.”

Innovative Strategy in Organizational Transformation: Creating and
Implementing a Transition Support Office within a University Health

In 2008, the McGill University Health Centre (MUHC) set up the
Transition Support Office (TSO) to guide the implementation of its
large scale redevelopment project which is still underway.  Once
complete in 2015, the care and services now provided at six hospital
sites will be absorbed into three. More than 10,000 staff and thousands
of clients will be impacted by the redevelopment.  The TSO’s goal is to
ensure consistency around the harmonization of clinical practices, team
consolidation and process optimization.

“Since being introduced, TSO experts have made it possible to improve
practices and patient care, making them safer and of better quality,”
says lead researcher Melanie Lavoie-Tremblay.   “Our participants
stress that they would be unable to execute change without the TSO’s
support.” One example involves harmonizing the use of central catheters
to reduce levels of bacteremias (BACC). Since April 2011, the MUHC has
harmonized central line practices across its critical care sectors and
avoided 45 cases of BACCs while client reinsertions have dropped to 11%
from 24%. TSO has supported more than 35 clinical teams in projects to
improve health and healthcare.

The creation of the TSO has facilitated and supported a culture of
optimization for the MUHC.  “By promoting the positive outcomes through
a clearly defined process and specific objectives, change is not only
supported, but enhanced,” says Lavoie-Tremblay.

Knowledge in Action: Healthcare Management and Governance Innovation Lab

The will to encourage improvement at the local level, to transform
regional governance and to build greater synergy among all players was
the impetus for creating the Healthcare and Social Services Management
and Governance Innovation Lab (LEGG) in the Montérégie region of

The LEGG brought together decision-makers and researchers to actively
support teams from different organizations and program areas who wished
to experiment with ideas that have a potential to transform service
delivery. Three key ingredients were conducive to its success:
improvement-focused leadership, project management and active knowledge

The researchers note that all innovation projects supported by the LEGG
have led to sustained changes in local practices and many have received
recognition from external bodies and peers. According to lead author
Denis Roy, “The LEGG approach is now embedded into regional governance
in the Montérégie region.  It should be considered as a promising
practice and has implications for the modernization of health system
governance in Quebec and elsewhere.”

“The Montérégie region has worked very hard to transform governance over
the past 10 years, and today, it is leading in this area.  One of the
most significant outcomes of the project has been to secure ongoing
regional funding that’s co-managed with the local institutions.
Regional and local actors both recognize the benefits of investing in
healthcare improvement,” adds Dr. Roy.

To read all three research reports, visit: www.cfhi-fcass.ca

The Canadian Foundation for Healthcare Improvement (cfhi-fcass.ca) is a not-for-profit organization dedicated to healthcare improvement
and transformation for Canadians. CFHI collaborates with governments,
policy-makers, and health system leaders to convert evidence and
innovative practices into actionable policies, programs, tools and
leadership development. CFHI is funded through an agreement with the
Government of Canada.

SOURCE Canadian Foundation for Healthcare Improvement

Source: PR Newswire