Governments face ever-increasing demands on healthcare systems. In Saskatchewan, more than 40 percent of the provincial budget goes to healthcare1, and there is constant pressure to spend more. Quality Improvement Science could help reduce this pressure by identifying effective and sustainable approaches that lead to better health, better value, better care, and better teams.
Defining Quality in Healthcare
The Institute of Medicine (2001) provides a definition of quality: ‘Quality is defined as the degree to which services and treatments increase the likelihood of desired outcomes and are consistent with current professional knowledge (e.g. clinical practice guidelines)2.
What is Quality Improvement?
Quality improvement in healthcare is an approach to achieving and sustaining changes that lead to better care and a sustainable healthcare system. It refers to the application of Quality Improvement (QI) science, which provides tools and concepts to implement, test, improve, and scale-up effective QI practices3. There are many QI approaches, including Lean Management, which is very progressive with a broad focus. Other QI or quality management interventions are Continuous Quality Improvement Systems, Total Quality Management (TQM) Systems, clinical pathways, clinical protocols, checklists, care maps, and algorithms.
What is Quality Improvement Science?
Quality Improvement Science is a process of identifying the most effective interventions to improve and sustain healthcare services and outcomes. It’s a systematic quest and investigation of the methods and mechanisms that best work to facilitate QI4. In fact, according to the Health Foundation in the UK, the aim of QI sciences is ‘to ensure that QI efforts are based as much on evidence as the best practices they seek to implement’4.
The overall goal of my research program is to advance the science of health quality improvement with a strong focus on knowledge synthesis (KS) and knowledge translation (KT). Specific objectives for the research program are as follows:
- To synthesize, catalog, and update the internationally available evidence on integrated care models that improve the quality of care (e.g., clinical pathways, protocols, and checklists).
- To rigorously investigate the most frequently used quality improvement concepts such as Lean Management and other Total or Continuous Quality Management (QI) approaches to improve our knowledge and understanding of effective and evidence-based QI interventions.
- To advance the science of KS and KT to improve the evidence base and to close the evidence-practice gap in healthcare.
- To provide decision makers with an understanding of for whom, in which circumstances, and why healthcare interventions work (or why not), through ‘realist’ reviews, ‘theory building’, and ‘real world’ (realist) evaluations such as the Lean investigation in Saskatchewan.
- To provide state-of-the-art teaching and supervision and to develop innovative academic programs and resources (capacity building) for undergraduate/graduate students and continuous education for healthcare professionals in the health regions.