Optimal Health Services Lab
Ongoing
Projects
This project will elicit patient and caregiver priorities for improvement on general medical hospital wards, in order to drive quality improvement that is aligned with their preferences.
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General medical wards care for patients admitted to hospital for common conditions such as heart failure, lung disease, pneumonia and falls. The number of patients cared for on such wards has increased over the past decade, and is expected to continue to grow in line with population aging. It is important to engage patients and their families to understand what matters most to them so care improvements can be appropriately aligned. This project will use group concept mapping to first elicit contributors to the patient and caregiver experience. We will then ask patients and caregivers to rate and sort these ideas to create a map of key concepts, and to identify the top priorities for quality improvement.
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Throughout all steps of the process, we will focus on recruiting a diverse group of participants, to reflect the broad experience and perspectives of the general medical community. The Ontario General Medicine Quality Improvement Network (GEMQIN) is a government-funded program that brings together clinicians and administrators from Ontario hospitals who share the aim of improving the quality of care for patients admitted to general medical wards. The results of this study will directly inform new quality indicator development for GEMQIN physician and hospital performance reports, as well as improvement initiatives in the general medical healthcare community.
Walk-in Physician Care: An Integrated Knowledge Translation Project to Inform Quality Improvement
CIHR Funded project
Patient and Caregiver Priorities for Quality Improvement on General Medical Wards
Funded by CIHR, St. Michael's Hospital AFP-AMO and UHN AFP-AMO
The role of walk-in clinics in our healthcare system is a focus of debate - do they bring us closer to achieving high-quality primary care for all? The rapid access they offer must be balanced against other important measures of care quality. Despite their spread over the last 40 years, little attention has been paid to the degree to which walk-in clinics achieve this balance. We have a limited understanding of who works in such clinics and the care they provide. Reported concerns about walk-in care include poor integration of care and overuse of tests and treatments with little benefit. Since many patients only access primary care through walk-in clinics, a policy response may be needed to ensure the best possible patient outcomes when balancing access with other measures of high-quality care. Evidence-informed policy requires updated and comprehensive information. Using a novel data linkage, we propose to describe walk-in physicians, their practices, patients, quality of care, and perspectives. We will then work with policymakers to explore policy responses to support high-quality primary care for all.