About Quality Improvement
Read the sections below to learn more about the DFCM Quality Improvement Program.
We believe that health care professionals desire to continuously improve.
COMPLEXITY – We believe that:
- Within the complex adaptive systems of health care, primary care is the most complex. This implies that:
- Impact from interventions to improve quality is often unpredictable;
- Conceptual frameworks that rely on the intuition and tacit knowledge of front-line providers, as much as evidence-based explicit knowledge, are necessary to improving primary care processes.
- Navigating and improving primary care complex systems favours an approach of building relationships that share integrative solutions through generative reasoning with minimal specification, rather than reductionist thinking and standardization to increase control. 
TEAMS – We believe that:
- In providing care to populations who have increasingly complex needs, the best outcomes will be achieved through a high functioning, interprofessional team.
- When teams identify as learning organizations, they are energized and sustained through curiosity and reflection, challenge assumptions and beliefs, recognize improvement opportunities, test ideas for change, and implement those with meaningful impact.
- High functioning teams are patient focused – patient centered in their clinical application, conscious of improving the patient experience, feel an affiliation to their communities and engage with their patients and communities in co-designing all aspects of care.
- The optimal primary care team culture holds to a lived experience of continuously seeking improvement, mutual trust and respect amongst team members, setting team goals as priorities, and all team members feel empowered to identify, and contribute to improvement opportunities and system design.
- Effective leadership of primary care teams reflects concern for team creativity, team engagement in the design and testing of novel solutions, supporting individual learning and growth, and effectively interfacing with the team’s environment in building relationships in its community.
IMPROVEMENT– We believe that:
- There is a systematic approach to improvement, which can be effectively applied to improve primary care.
- There are many modalities in which improvement in primary care can be demonstrated. 
- The learning system of primary care teams is grounded in the interplay between a) content knowledge that is reinforced through experience, with b) Deming’s Theory of a System of Profound Knowledge and its study and interactions of its four paradigms (i) system complexity, (ii) variation, (iii) testing and learning from system performance and changes, (iv) and human behaviour.
EDUCATION– We believe that:
- There is a systematic approach to education, which can be effectively applied to improve primary care.
- Educating for improvement in primary care goes beyond enhancing competence; it’s a process of adaptation and learning from internal and external environmental change.
- Educating primary care providers and their teams must be supportive to their context and not prescriptive.
- The first stage in learning for primary care teams is reflection – in action and on action.
INNOVATION– We believe that:
- There is a systematic approach to innovation, which can be effectively applied to improve primary care.
- The dynamic and emergent nature of primary care systems, leads to ever changing patient, provider, and community health care needs.
- Ever changing health care and organization needs will require best practice application of innovative thinking to attain novel solutions for improvement.
- Fear of failure is a barrier to innovation; however, failure itself is often a necessary step to positive change.
DFCM QUALITY IMPROVEMENT PROGRAM– We believe that:
- We commit to holding ourselves accountable within academic family medicine to disseminate what we learn to enable others in building their quality culture.
- To ensure sustainability, the QI Program will need to attract new resources and leverage relationships into collaborative partnerships.
- Priorities for improvement as identified, must be aligned with real world system needs, such as access, better system integration, and challenges for system sustainability.
 It is seductive in addressing problems in complex systems to simplify and gravitate to linear thinking with solutions such as guidelines, “best practice” algorithms and standards. Our real world is messy where context is critical to understanding each environment. More effective solution finding processes arise from non-linear methods such as reflection and storytelling.
 Examples being improvement methodologies, organizational behaviour, education such as Continuing Education, knowledge translation, audit and feedback, academic detailing, etc.
The QI Program will:
- Enable primary care teams to live a quality culture as evidenced by continuous learning through team reflection, goal setting, purposeful testing, and implementing positive change via continuous improvement.
- Guide primary care teams to achieve better collaboration through communication, mutual trust and respect, and effective leadership.
- Facilitate primary care teams to sustain their quality culture in order to demonstrate impact on care effectiveness, patient experience, and value of service delivery.
- Share and disseminate what we learn.
Goals, Action Steps and Projects
DFCM Core Team
For all general inquiries, questions, feedback, or program inquiries contact:
|name||title||phone number and email||room #|
Dr. Philip Ellison, MD MBA CCFP FCFP
*Read bio below
|Fidani Chair, Improvement and Innovation &
Vice Chair, Quality Improvement
|Dr. Jeremy Rezmovitz, MSc, MD, CCFP||Lead, Education and Innovation|
|Trish O'Brien||Program Manager||416-978-5112
|Marisa Schwartz||Program Assistant||416-978-3793
Continuing Education & QI Administrator
Quality Program Committee - Family medicine teaching unit and member name
The mandate of the Quality Program Committee (QPC) at the Department of Community and Family Medicine is to improve patient care by promoting and enabling the integration of quality improvement into all aspects of DFCM education, research and professional development activities.
The QPC is comprised of physicians from our 14 affiliated family medicine academic sites. Below is a list of current QPC members:
|Vice Chair, Quality Improvement||Dr. Philip Ellison|
Lead, Education and Innovation
Dr. Jeremy Rezmovitz
|QI Program Manager||Ms. Trish O’Brien|
|QI Program Assistant||Ms. Marisa Schwartz|
|CE and QI Administrator||
Ms. Laura Surdianu
|Department of Family and Community Medicine (DFCM)||
Mr. Cecil Canteenwalla - Strategic and International Relations Coordinator
Dr. Paul Krueger - Research Program
|Markham Stouffville Hospital||Dr. John Maxted|
|Michael Garron Health Centre||
Dr. Sam Tirkos
Dr. Tia Pham
|Mt. Sinai Hospital||Dr. Sakina Walji|
|North York General Hospital||
Dr. Joanne Laine-Gossin
Dr. Tiffany Florindo
|Royal Victoria Hospital||
Dr. Brent Elsey
Dr. Melissa Witty
|Southlake Regional Health Centre||Dr. David Makary|
|St. Joseph's Health Centre||Dr. Linda Weber|
|St. Michael's Hospital||
Dr. Tara Kiran
Dr. Mary Beth Derocher
Ms. Susan Blackers – Division of Palliative Care
|Sunnybrook Health Centre||Dr. Debbie Elman|
|The Scarborough Hospital||
Dr. Susanna Fung
Dr. Rosemarie Lall
|Toronto Western Hospital||
Dr. Lesley Adcock
Dr. Mark Broussenko - PGY1 Resident Representative
|Trillium Health Partners||
Dr. Frances Cousins (Summerville)
Dr. James Pencharz (Credit Valley)
Dr. Manisha Sharma (Credit Valley) - Division of Palliative Care
|Women’s College Hospital||
Dr. Nikita Patel
Dr. Nathalie Codsi - PGY1 Resident Representative
About Dr. Philip Ellison: Fidani Chair, Improvement and Innovation and Vice Chair, Quality Improvement
When the Department of Family and Community Medicine (DFCM) at the University of Toronto received a generous gift to establish the Fidani Chair, Improvement and Innovation in Family Medicine, we achieved a major milestone, bringing us closer to our vision of excellence in research, education and innovative clinical practice.
We are proud to share that Dr. Philip Ellison is the inaugural Fidani Chair. Dr. Ellison is a distinguished and experienced leader in academic family medicine and health system consultation and an Associate Professor with the Department. He has spent years in leadership roles at the University Health Network’s Toronto Western Hospital in family medicine, inpatient service and as a medical director. In his role as Fidani Chair, Dr. Ellison continues the improvement and innovation work that is already leading a culture change in the delivery of primary and community health care in Ontario.