By: Dr. Joshua Tepper and Michelle Noble
Earlier this year, Globe and Mail health writer André Picard wrote a column about innovation in health care. "One of the most frustrating traits of the Canadian health-care system is its failure to recognize and embrace success," he began. "Imagine if we took all our successful local innovations and pilot programs and actually implemented them on a larger scale," he wrote later.
In Ontario, spreading innovation in health care is not something to be imagined. It is actually taking place.
ARTIC (Adopting Research to Improve Care) is a partnership between Health Quality Ontario and the Council of Academic Hospitals of Ontario (CAHO), and is one of the only Canadian programs focused exclusively on accelerating the spread of proven health care.
In the past year alone, ARTIC has improved the health of Ontarians by:
- Expanding the use of primary care Memory Clinics by supporting the implementation of 17 clinics in rural, remote and underserviced communities across Ontario to improve care for patients with memory problems associated with dementia. They provide training for family medicine teams and professionals, meaning patients can receive appropriate care closer to home.
- Reducing emergency room visits and improving care and the patient experience for up to 2,000 patients annually with opioid or alcohol addiction by supporting META:PHI (Mentoring, Education, and Clinical Tools for Addiction: Primary Care-Hospital Integration). The program has developed rapid access addiction medicine clinics in seven communities where opioid supports are much needed. They integrate care received in emergency departments and hospitals, primary care and front-line community services, enabling patients to seamlessly transition to a rapid access clinic and then, once stable, to a primary care provider. ARTIC and the Ministry of Health and Long Term Care are now supporting the further expansion of the clinics in communities across Ontario.
- Expanding the use of a proven new tool that provides patients with clear and easy-to-understand instructions to help them manage their care after being discharged from hospital. A report by Ontario's Avoidable Hospitalization Expert Panel in 2011 found communication of discharge instructions by hospitals to patients was often poor, in part because patients did not understand medical terms or were too stressed at the time of discharge to absorb critical information. Co-developed by patients and health care providers, PODS (Patient Oriented Discharge Summary) is being adopted in 27 hospitals and will benefit approximately 50,000 patients in the first year of its expanded use. If you are interested in adopting PODS at your hospital, contact ARTIC.
ARTIC will continue this important work in 2018. ARTIC has just issued a new call for proposals for high-impact clinical interventions or practice changes that are proven to work and are ready to spread across the province.
What is unique about this year's call is that proposals are being sought for proven interventions or practice changes that align with Health Quality Ontario quality standards. Quality standards outline for clinicians and patients what quality care looks like and focus on conditions or topics where there are large variations in how care is delivered, or where there are gaps between the care provided in Ontario and the care patients should receive.
Based on the best available evidence, the standards are intended to enable critical conversations between patient and health care professional by providing them with tailored guidance to make them more comfortable and knowledgeable about the relevant condition.
To date, quality standards are been developed for a wide range of conditions including dementia, heavy menstrual bleeding, hip fracture, major depression, palliative care, opioid prescribing for both acute and chronic pain, and for the treatment of opioid use disorder.
To be eligible for ARTIC funding, proposed clinical interventions or practice changes must have already been proven and successfully implemented in at least one site, and must have involved patients and families in the development of the initiative and plans for its future spread. How patients are involved is a key criteria in assessing project proposals. If you have or know of an intervention that's ready to be spread across Ontario, we encourage you to apply.
As André Picard noted in his article, too often successful health innovations are piloted at one organization but never spread further. ARTIC is solving that problem by successfully seeding innovative projects in communities across Ontario, thereby providing quality care to patients and families.
Dr. Joshua Tepper is President and CEO of Health Quality Ontario and Michelle Noble is the Executive Director of the Council of Academic Hospitals of Ontario.