Strategic Clinical Improvement Committee Newsletter

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Quality Improvement (QI) Education

Headlines This Edition

Building Quality Improvement Capacity • Clinical Innovator Career path articulated •Supporting development and implementation of an integrated quality curriculum across DoM •Creating Linkages between AHS quality management framework and DoM On Jan 28th, 2017 Dr Khalid Aziz held the first EPIQ Workshop to •18 attendees •Physicians (UAH, RAH, MIS) •Executive Directors(UAH and RAH) •Department of Medicine Administration leadership On March 3, 2017 held a 1.5hr EPIQ Overview session as part of the DoM Academic Learning Series

Featured Quality Improvement Project

Inappropriate Laboratory Ordering Dr Inka Toman , Dr Narmin Kassam and Pamela Mathura

On the University of Alberta Hospital General Internal Medicine units, CBC and basic chemistries account for more than 50% of all laboratory testing. Upon admission, CBC and basic chemistry are commonly ordered on a repeating daily basis. On UAH GIM Unit 5D2 there is no standard process for laboratory test ordering to be reviewed upon admission and during inpatient care. This process increases the number of inappropriate and over utilized laboratory tests which creates system-wide wastes, increases operational costs and negatively impacts patient experience. Goal: To decrease the total number of CBC, electrolytes, creatinine and urea tests ordered on UAH unit 5D2 by 10% during a one-month study period •Completed one plan do study act (PDSA) cycle (Jan to Mid Feb 2017) and starting will start the second PDSA in mid march 2017. Preliminary findings demonstrating successful impact •Presented at Choosing Wisely Canada-Feb 27, 2017


Congratulations! Inappropriate Laboratory Ordering QI project presented at Choosing Wisely ConferenceCalgary Alberta Feb 27th 2017.

ACCESS Partnership Project Project has five phases with a goal to improve the integration between acute/specialty care and primary care by collaboratively standardizing the referral process for twelve specialties within the Department of Medicine (DoM). This work is required to support a long term goal of a Edmonton zone wide centralized referral process whereby patients are centrally referred to the most appropriate DoM subspecialty based on specific patient issues in order to avoid multi-specialty referrals, unnecessary waits, and reduce inappropriate referrals. Inconsistent referral processes have been identified by primary care as a major source of frustration for both practitioners and patients.

Awarded two EZMSA Quality grants for the Access Partnership Project And the Inappropriate Laboratory Ordering Project.

Phase 1: Referral Guideline •50% (6/12) of the DoM have drafted referral guidelines that are accessible within the Alberta Referral Directorywww.albertareferraldirectory.ca

Submitted 5 Quality grants for CMO Funding, submitted March 3, 2017 …fingers crossed!

Did you know…The ARD is a link in Netcare?…check it out! – search under resources and you will see AB Referral Directory tab

Events In April

Phase 2: Current state Mapping •70% of the DoM Divisions current referral process has been mapped. The maps have identified areas for improvement and process strengths that can be shared within DoM divisions.

•Tableau training – April 11&12, 2017 •SCIC Meeting-– April 20, 2017 •Good Friday – April 14, 2017

Coming Soon

The CISU-Clinical Inquiry System Unit is working on an ambulatory dashboard and is updating the eCLINICIAN minimal use dashboard

•DoM Admin working group are planning to develop standard referral procedures in spring 2017 •Engagement planning with Primary Care Networks is underway.

Contact: pam.mathura@albertahealthservices.ca for further questions/comments

A DoM Excel tracking grid for each division listing the inpatient measures


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