HQCA STRATEGIC FRAMEWORK AND BUSINESS PLAN 2016 17
Message from the Board Chair and CEO We are pleased to share the HQCA s Strategic Framework and 2016-17 Business Plan. Now in our second year with a renewed strategic framework, our organization is committed to fulfilling the vision, mission, and values it sets forth. Our strategic areas of focus remain: build capacity, measure to improve, monitor the health system, and partner with the public. The 2016-17 Business Plan describes how we will achieve our legislated mandate to promote and improve patient safety and health service quality across the province. The HQCA s Strategic Framework provided the direction needed for how to best allocate the resources of the HQCA in achieving this mandate. The business plan outlines new projects for the HQCA for this fiscal year, as well as those projects carried forward from the previous year. The plan demonstrates the many approaches our team is taking to deliver on our mandate, and to support our patient and health system partners. We have worked hard to ensure each project we undertake meets several criteria: they align with our strategic framework, deliver on a need expressed by our stakeholders; engage patients; will have a demonstrated impact on our healthcare system; are appropriate for the HQCA s mandate; and, are feasible for our small but nimble organization to accomplish. Using these criteria as a guide, and with the support and collaboration of our healthcare partners, we can be confident our work will make real improvements to patient safety and quality healthcare services in Alberta. In 2015-16 the economic climate in Alberta shifted significantly, posing a strain on public resources which the Ministry of Health and our healthcare partners will continue to navigate in 2016-17. Recognizing this ever-changing and dynamic environment in which our stakeholders operate, we are prepared to adapt our work when needed and welcome new challenges as they arise. It is because of our confidence in the skills and capabilities of each employee, and their demonstrated commitment to working together as a high performing team, that we are able to present this comprehensive plan for the year. Our entire HQCA team, including our Board of Directors, shares a collective passion for healthcare improvement. Together, we look forward to accomplishing the work we have set out for the upcoming year and making a meaningful contribution to improvements in healthcare for the benefit of each Albertan. Andrew Neuner Chief Executive Officer Tony Fields Board Chair 1
Who We Are The Health Quality Council of Alberta (HQCA) has a legislated mandate to promote and improve patient safety and health service quality on a province wide basis. Our mandate spans the spectrum of publicly funded healthcare in Alberta as well as the geography of the entire province. We do this by measuring, monitoring and assessing on the quality and safety of Alberta s healthcare system; identifying effective practices and assisting in their implementation and surveying Albertans on their experience and satisfaction with the health system. We achieve our mandate through effective collaboration with health system stakeholders such as the public, patients and their families; Alberta Health, Alberta Health Services, the health professions and academia. The HQCA was established in 2006 by the Health Quality Council of Alberta Regulation under the Regional Health Authorities Act. In 2012, the mandate was expanded under the Health Quality Council of Alberta Act, which gave the HQCA a more autonomous role in examining matters related to the quality and safety of the healthcare system, including the ability to appoint a panel to conduct inquiries. The HQCA is governed by a board of directors whose members include healthcare professionals, business leaders, academic representatives and members of the public. Core Business As per the Health Quality Council of Alberta Act: 3(1) The objects of the Council are to promote and improve patient safety and health service quality on a province wide basis. 3(2) The Council shall undertake the following activities in cooperation with health authorities: (a) measure, monitor and assess patient safety and health service quality. (b) identify effective practices and make recommendations for the improvement of patient safety and health service quality. (c) assist in the implementation and evaluation of activities, strategies and mechanisms designed to improve patient safety and health service quality. (d) survey Albertans on their experience and satisfaction with patient safety and health service quality. (e) other activities as provided for in the regulations. 6(1) (a) The board may from time to time establish any committees that it considers necessary for the efficient conduct of the business and affairs of the board and the Council 6(2) A committee established under subsection (1) may be established as a quality assurance committee that has as its primary purpose the carrying out of quality assurance activities, in which case it is a quality assurance committee for the purpose of section 9 of the Alberta Evidence Act. 12 The Council shall have reasonable access to information held by health authorities as necessary to carry out its objects related to: (a) collecting and analyzing information on patient safety, health service quality and significant incidents provided by quality assurance committees, health authorities or other sources. (b) identifying factors causing or contributing to problems with patient safety, health service quality or significant incidents. (c) reviewing reports made by a medical examiner or other investigative body or in the course of a public fatality inquiry. 2
(d) making recommendations on strategies for improving patient safety and health service quality and reducing significant incidents. 13 The Council shall network with health professions, health authorities, organizations providing health services, academic health centres and other related organizations for the purposes of: (a) sharing information on patient safety and health service quality issues. (b) identifying and assessing patient safety and health service quality issues, and (c) developing and recommending effective practices in patient safety and health service quality. 14 The Council shall: (a) report to Albertans on any survey it conducts under section 3(2)(d). (b) advise the Minister on: i. the quality of health services in the healthcare system. ii. results and recommendations of the work of the Council on patient safety and health service quality, and iii. other matters as requested by the Minister, and (c) at the request of the Minister, prepare and submit to the Minister any reports respecting the activities of the Council that the Minister requires. 15(1) On the request of the Minister, the Council shall assess or study matters respecting patient safety and health service quality that are referred to it by the Minister. 15(2) The Council may assess or study matters respecting patient safety and health service quality that are referred to it by a health authority. 16(1) For the purposes of carrying out activities under sections 3(2)(a) to (c) and 15, the board may authorize a person to: (a) enter and inspect any place under the jurisdiction of a regional health authority, community health council or subsidiary health corporation, and (b) require the production for examination of any documents or records in the possession of the regional health authority, community health council or subsidiary health corporation, and make copies of them or temporarily remove them for the purpose of making copies. 17(1) The Lieutenant Governor in Council, where it considers it to be in the public interest that an inquiry be held concerning a matter relating to the health system, may by order: (a) set out the nature and scope of the inquiry, including the date by which the report and recommendations, if any, of the Panel must be submitted under section 22. (b) direct the board to appoint a Panel. 3
Strategic Framework While the HQCA s responsibilities are set forth in the Health Quality Council of Alberta Act, our work is guided by a Strategic Framework, which highlights our Vision, Mission, and Values and defines four strategic areas of focus. By aligning ongoing and future projects to this Strategic Framework, we will continue to support our partners in improving health system quality and patient safety for Albertans. Vision Excellence in health system quality and patient safety for Albertans Mission With our patient and health system partners, continue to improve the quality of Alberta s health system through measuring and monitoring of performance, identifying opportunities for improvement and supporting implementation of improvement initiatives. Values Hold patients and the population at the forefront Be informed by evidence Analyze objectively Inform transparently Partner collaboratively Strategies Build capacity Enable high quality and safe patient care by assisting stakeholders at multiple levels to develop skills in system improvement. Quality and safety education program Frameworks and related resources Health ethics Measure to improve Measure, analyze and report on healthcare delivery to drive actionable improvement that enhances the quality of healthcare for Albertans. Patient-focused measurement Sector or service-focused measurement Assessments and studies Monitor the health system Monitor and report on health system level indicators to characterize health system performance over time and enable comparison where appropriate. System level indicator development Population level surveys Clinical standards monitoring and reporting Health system performance reporting Partner with the public To support and enable effective citizen participation in their healthcare and the healthcare system. HQCA Patient/Family Safety Advisory Panel Provincial citizen participation model and capacity building 4
Build capacity Enable high quality and safe patient care by assisting stakeholders at multiple levels to develop skills in system improvement. Business Plan The HQCA has planned its business activities to align with the Ministry of Health Business Plan 2015-18 priorities and initiatives which includes: 2.6 Develop initiatives with Aboriginal partners and the federal government to improve health services. 3.1 Improve access to health care providers across the province and develop sustainable strategies that ensure the appropriate education, scope of practice, supply and distribution of health care providers. 3.2 Enhance accountability and promote practice excellence among regulated health care providers. In 2016-17 we will continue to deliver a quality and safety education program in partnership with the University of Calgary Faculty of Continuing Education and W21C through our Centre for Collaborative Learning and Education that provides our health-care partners with certificate-level patient safety and quality management courses. We will also continue the development of educational resources and tools to support learning for the concepts and topics within the Quality and Patient Safety Education Framework. Internally, we will develop and implement a targeted ongoing quality and safety education plan for the HQCA Board of Directors. The HQCA works with stakeholders to develop skills in system improvement and provides frameworks and related resources in specific areas of healthcare quality and safety. In 2016-17, we will develop educational resources to support the implementation of the provincial quality and patient safety management framework that is broadly applicable across the health system. To encourage an atmosphere of trust where people are supported in sharing safety-related information, we will develop an online toolkit of resources to support the spread of a just culture across Alberta s health system. In addition, we will promote uptake of the Simulation Based Mock-up Evaluation Framework provincially, nationally, and internationally through strategic relationships with organizations involved in healthcare design. This framework uses patient simulation to inform design decisions for the built environment of healthcare delivery spaces that will optimize cost effectiveness as well as safe and efficient patientcentred care. Lastly, we will update the 2007 Patient Concerns/Complaints Resolution Provincial Framework to reflect current leading practices and regulations Consideration of health ethics remains a focus for the HQCA and in 2016-17 we will complete the development of an internal ethics framework that will provide a structure and process for identifying and addressing ethics issues in all of our work. We will also establish an ethics deliberative resource within the HQCA utilizing board members, patient /family safety advisory panel members and staff. The HQCA is an active participant and partner with provincial and national quality and safety organizations and committees which allows us to provide input and work collaboratively with our sister organizations across Alberta and Canada. 5
Measure to improve Measure, analyze and report on healthcare delivery to drive actionable improvement that enhances the quality of healthcare for Albertans. Alignment with the Ministry of Health Business Plan 2015-18 priorities initiatives: 1.1 Expand home care which includes enhancing home and community care capacity. 1.2 Create 2,000 public long-term care spaces over four years to improve seniors care and take pressure off acute care systems. 1.4 Enhance the delivery of primary health care services to enable Albertans to be as healthy as they can be. 1.6 Improve the quality of care provided to continuing care clients. 3.4 Increase access to primary health care services. The HQCA will continue its work in patient-focused measurement to help improve patient safety and health service quality. The HQCA will pursue excellence in best practices in quality of healthcare research and will collaborate with strategic partners both across the province and internationally to achieve this. Surveys are an important part of the HQCA s legislated mandate to measure, monitor, assess, and report to Albertans about their experience and satisfaction with the quality of healthcare services they receive. In 2016-17, the HQCA will release the results of the Home Care Long Term Maintenance Client Survey, begin work on data collection for the Primary Care Patient Experience Survey, continue the ongoing data collection and reporting process for surveying patients at the 17 largest and busiest emergency departments, and initiate planning for the next Long Term Care Family Experience Survey to be conducted in 2017/2018. Work will also continue on the second iteration of the 2016-17 Supportive Living Resident and Family Experience Survey designed to capture residents and family members observations and experiences with the quality of care and services they receive while at their supportive living facility. In the areas of measurement and reporting, the HQCA will continue its work on sector or service focused measurement such as primary care. This includes the development of a collaborative, scalable and sustainable measurement program in which primary care measurement data is used by primary care physicians to inform practice improvements that will impact the care of their specific patient populations. 6
Monitor the health system Monitor and report on health system level indicators to characterize health system performance over time and enable comparison where appropriate. Alignment with the Ministry of Health Business Plan 2015-18 priorities initiative: 4.5 Improve performance of emergency departments for enhanced patient flow through the acute care system. The HQCA will evaluate and redesign the Satisfaction and Experience with Healthcare Services Survey to ensure relevance to our health system stakeholders to inform improvements in patient safety and health service quality. Through a collaborative and iterative process with health system stakeholders, the HQCA will identify, develop and publicly report health system performance on key patient experience, economic and clinical indicators that support the HQCA s mandate to monitor and report on health service quality and patient safety. Specifically, in 2016-17 the HQCA will publicly report on system level metrics for emergency department reporting and then conduct an evaluation to understand if, and how, system stakeholders are using the information to inform quality improvement efforts. We will also continue to support a health economist panel to advise the HQCA on development and reporting of health service value for money indicators. The HQCA will continue its work in determining and evaluating analytical approaches and methods for measuring relationship, information and management continuity. 7
Partner with the public To support and enable effective citizen participation in their healthcare and the healthcare system. A key area of strategic focus for the HQCA is to partner with the public and facilitate ways that Albertans can actively participate in their healthcare system. One of the ways we do this is by supporting and engaging the Patient/Family Safety Advisory Panel to leverage the experiences and perspectives of patients and their families to inform effective ways to promote safety principles, concepts and actions in the healthcare system. Another way we do this is through a provincial citizen participation model and capacity building. The HQCA will launch a Quality and Safety Patient Experience Awards Program in 2016 to recognize initiatives that focus on the patient experience. With our patient/family/citizen partners, we will assess the need to enable citizen groups across Alberta to effectively partner in health system design/re-design and explore what the HQCA s role could be to facilitate this. The HQCA worked in partnership with the Health Quality Network to bring Change Day to Alberta in 2016. We will build on the success of the inaugral program to coordinate Change Day for spring 2017. Change Day is centred on the idea that one act can lead to improvement in care for patients, clients, residents, familiies and the health system as a whole. We will continue to look for ways to engage our stakeholders to enhance the work we do and also execute a multi-faceted approach to raise awareness of the HQCA s mandate and current work with our stakeholders. 8