Quality Improvement in Canadian Mental Health Care

This assignment asks you to examine and summarize a Canadian improvement. Many examples of improvement projects conducted by healthcare organizations can be found in the academic literature or on the internet.

  • Find 1 example of a Canadian healthcare quality improvement project and summarize the improvement models used (Week 1: Model for Improvement, Lean, Six Sigma, Lean Six Sigma), including diagrams and charts to demonstrate the models discussed.
  • Summarize the main principle(s) of the improvement model used and explain how the concepts and techniques worked in practice.
  • Discuss the background of the healthcare issue identified, the current state and improvement outcome goals in the real healthcare quality improvement project you found. Describe which dimensions of quality healthcare (Week 3) the project is trying to improve.
  • We discussed the basic QI process during Week 1 (slide 35). Describe how the improvement project incorporated the basic QI process steps.
  • Provide your own conclusion on the success of the initiative and any recommendations you would have in terms of other quality improvement tools that could be used, improvements to methodology and areas for further quality efforts.
  • Ensure that you provide the case study in your submission (i.e. hyperlink or download and submit of the case study document)

Introduction

The world business environment has changed due to the ever-evolving technologies leading to changing consumer needs. Such changes brought up by discoveries have not spared the health sector, and patient needs that are no longer traditional (WHO, 2018). This, therefore, calls for organizations to have embraced continuous quality improvement programs to adapt to the changing needs of clients  (Mormer & Stevens, 2019). This report introduces the quality improvement process for mental health facilities in Canada. The Canadian Mental Health Association runs the program. The report describes the quality improvement model utilized by this program and gives insights on important take-home points for organizations running similar programs.

Canadian healthcare quality improvement project and model used

The Quality Improvement of Canadian healthcare is a project by the Canadian Mental Health Association and the government. The main objective of the transformation process is to make the health systems more accountable for the outcomes of health services.  The project aimed to improve the measurability of the health outcomes for accountability and better service provisions in mental health facilities. It was aimed at efficiency in the facilities in ensuring appropriate utilization of resources for the desired results. One of the actions towards the quality improvement project was the introduction of the Excellent Care of All Act (ECFAA) which was actualized on the 8th of June in 2010. It aimed to pass a law for all healthcare executives to prioritize quality improvement for accountability, improved care, and increased patient experience.

The Model of Improvement was utilized in this project. This model is commonly used in healthcare quality improvement projects. It combines two common quality improvement models: total quality management (TQM) and rapid-cycle improvement (RCI). This combination brings about a framework that uses plan-do-study-act (PDSA) cycles in evaluating the implemented intervention on a small-scale basis (Taylor, McNicholas, Nicolay, Darzi, Bell, & Reed, 2013).

Principles of the Model of Quality Improvements

The model for improvement is a compelling framework broadly accepted in the health industry. It does not seek to substitute the existing model of change in an institution; instead, it accelerates improving the processes. This model is made up of two main parts. The first one involves three key questions: What are we trying to achieve? How will we know that change is an improvement? And what change can we make that will result in improvements? The second one is the plan-do-study-act (PDSA) cycle used to test the changes that occur during the improvement process. This cycle helps in evaluating whether the change is an improvement or not.

These principles of the model of improvement described above have been evident in the quality improvement of the Canadian healthcare project. The program’s improvement model includes answers to the three key questions: the program aims at achieving quality improvement, risk management, client safety, and management of utilities (HITRC, 2013). These aims will be achieved through policy formulation, and evaluations will be used to validate whether the changes brought about are improvements. Implementing the program involved continuous quality improvement, a risk management program, client safety, and utilization management. A process was approached through the PDSA framework (CMHA, 2018).

The Healthcare Issues Identified

The program viewed various issues that it aims at improving for better performance. The issues include the organizational structure of the health facilities, ineffective risk management systems, questionable client safety, and wasteful utilization of resources. The state of such issues is wanting because the organizational structure is not client-family focused, the risk management process is not effective and efficient, client safety standards are not to the required level for satisfaction, and utility management is inefficient due to wastage and low accountability (CMHA, 2018). The improvement outcomes of this program are a better organizational structure focused on the clients, more efficient, measurable, and accountable utility management, employment of client safety measures, and effective risk management processes.  The quality improvement program of Canadian healthcare facilities seeks to improve them through policies that legislate the facility executives and managers to prioritize achieving these outcomes. This means that the end goal of the program is achieving a client-focused organizational structure in the facilities, the ability to manage risks effectively, ensure measures are put in place to achieve client safety, and lastly to efficiently allocate and manage utilities in a way that is measurable for accountability purposes (Improvement Foundation (Australia) Ltd, 2017).

The quality improvement (QI) processes guide the program in applying the preferred model (Radej, J., & G., 2017). The process is made up of six main steps, which are described below:

  • Establishing a quality culture in practice- This means that the organization’s culture and practices have to be aligned with the quality improvement interventions. The team’s culture, practices, attitudes, actions, and behavior greatly affect how they value the improvement initiative. The organization should, therefore, set up policies that will help them embrace the quality improvement process(Lal, 2019). This has been a significant consideration by the Canadian Mental Health Association in its program.
  • Determining and prioritizing areas that require improvement- The organization should identify specific areas and ways to improve them. For example, a hospital can identify the categories of patients requiring special attention based on statistics and find ways to improve their experience. These areas of improvement have been identified in the program, as seen in the previous section.
  • Collecting and analyzing data- Data utilization is a primary consideration in every quality improvement program. Data helps programs to work with facts and evidence in every decision made. It also helps in measuring progress. The QI program on improving mental health facilities has embraced working with data to enable the accuracy of decisions.
  • Ongoing evaluation- Improvement is a dynamic process; therefore, the organization should continuously evaluate the process and achievements using data (Tatian, 2016). The process of the program has had frequent periodical evaluations to measure the progress and confirm whether the changes being witnessed represent an improvement.
  • Spreading success- This involves sharing the lessons learned in the improvement of future programs and sharing with other organizations with similar programs. The report of the program by the Canadian Mental Health Association is an open resource for any other organization to utilize the insights (CMHA, 2018).

Recommendations

  • Program implementers working on quality improvement projects in the health sector should embrace the quality improvement model. This is because the model is simple to use and has a clear way of measuring progress in the short run, motivating the team.
  • Organizations undertaking quality improvement programs should always share their success stories and lessons to help others who run similar programs with valuable insights for success.

Conclusion

Quality improvement is a continuous process that is accustomed to the ever-changing industrial evolution. Organizations should, therefore, embrace the process of improving their processes and systems to align with the needs of the market. Quality improvement professionals must consider the best models that suit their programs for success and improved processes.

References

CMHA. (2018, September 14). Mental Health in the Balance: Ending the Healthcare Disparity in Canada. Retrieved June 22, 2020, from Canadian Mental Health Association: https://cmha.ca/ending-health-care-diparity-canada

CMHA. (2018). QUALITY IMPROVEMENT PROGRAM. Durham: Canadian Mental Health Association Durham.

HITRC. (2013). Continuous Quality Improvement (CQI) Strategies to Optimize your Practice. Washington DC: The National Learning Consortium (NLC).

Improvement Foundation (Australia) Ltd. (2017). The Model for Improvement Women’s Cancer Screening Collaborative. Rundle Mall SA 5000: Improvement Foundation (Australia) Ltd.

Lal, S. (2019). E-mental health: Promising advancements in policy, research, and practice. Healthcare Management Forum 2019, Vol. 32(2), 56-62.

Mormer, E., & Stevans, J. (2019). Clinical Quality Improvement and Quality Improvement Research. Perspectives of the ASHA Special Interest Groups, 1-11.

Radej, B., J., D., & G., B. (2017). An overview and evaluation of quality‐improvement methods from the manufacturing and supply‐chain perspective. Advances in Production Engineering & Management 12(4) 2017, 388–400.

Tatian, P. A. (2016, March). Performance Measurement to Evaluation. World Bank Group Community Outreach Program, pp. 1-21.

Taylor, M. J., McNicholas, C., Nicolay, C., Darzi, A., Bell, D., & Reed, J. E. (2013). Systematic review of the application of the plan–do–study–act method to improve quality in healthcare. Taylor MJ, et al. BMJ Qual Saf 2014;23, 290–298.

WHO. (2018). Improving the quality of health services -tools and resources. Switzerland: World Health Organization.