Advancing Family Medicine Globally Through Quality and Innovation

Mar 12, 2018


An upcoming conference could be a stepping-stone to foster international dialogue about improving primary health care.

The Department of Family and Community Medicine’s (DFCM) Quality and Innovation team is hosting its first international conference on improving quality in primary care, bringing together world-leading experts in Toronto. Organizers say it is now time to start talking about quality improvement and moving it forward globally.   

“Primary health care quality improvement is still a nascent field. In Canada, specifically, we are still very naïve about how we go about improving primary health care in our immediate practice environments,” says Dr. Philip Ellison, Vice-Chair in Quality and Innovation and Fidani Chair in Improvement and Innovation.

“There are no systemic financial incentives to improve quality in health care. In most businesses, when you improve quality, you will grow your business and reduce cost whereas in healthcare, because a lot of the funding is based on volume or block funding agreements, there are not these same sorts of market-based incentives.”

Quality improvement in health care raised its profile in 1999-2000 through two American reports from the Institute of Medicine (IOM) which raised the alarm on the crippling state of safety and quality in hospitals. The publications titled “To Err Is Human: Building a Safer Health SystemandCrossing the Quality Chasm: A New Health System for the 21st Centuryshed light on harsh realities of the American health care system. Patients were dying because of health care. Some were dying because of illnesses contracted in hospital, medication complications or surgical errors, for example. The often quoted analogy of the mortality rate due to adverse events in American hospitals was like ‘a full 747 airplane crashing and killing everyone on board every 36 hours, for a year’.

In Canada, work led by Ross Baker, Peter Norton and others documented a high rate of adverse events in Canadian hospitals as well in the report “The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada”.

In the second of the two IOM’s publications “Crossing the Quality Chasm”, a framework for quality improvement was recommended with six major parameters: Patient-centeredness, equity, efficiency, effectiveness, timeliness of care (accessibility) and safety.

The health care community in Ontario has been responding. When establishing family medicine health teams, they also built in a focus on quality improvement through the establishment of the Quality Improvement and Innovation Partnership (QIIP) to facilitate the development and implementation of strategies to improve primary health care.

The Manager of the Quality and Innovation Improvement Program at DFCM Trish O’Brien was Director at QIIP at the time of this initiative. QIIP was one of several organizations with a focus on health care quality that was subsequently consolidated into the present Health Quality Ontario.

Quality improvement in primary health care is a growing process in many health care systems throughout the world, and Dr. Ellison thinks the process could be accelerated by bringing the community together. He believes that through this conference, the time is right to look at the quality improvement from all types of international health care systems and find learning opportunities.

The conference brings together a group of global thought leaders in primary health care quality to share their experiences from their practice environment and commit to advancing family medicine and primary health care through future annual meetings. Next year’s conference will be open to all.

“We are building a movement. In future meetings, we would like to see a shared commitment to advancing this movement through the development of multiple conference themes reflecting the multiple avenues being taken to advance our disciplines through health care improvement. The timing is right to move this forward.”

This conference is supported by a partnership with Health Quality Ontario.

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