The Quality Management Partnership (Mammography)
Within the healthcare system, the Quality Management Partnership focuses on defining, reporting, assuring, and improving quality through guidelines and standards. It involves expert advisory panels, governance structures, and program components to enhance healthcare quality in areas like mammography and colonoscopy.
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Presentation Transcript
The Quality Management Partnership (Mammography) Dr. Rene Shumak, Clinical Lead, Mammography Independent Diagnostic Clinic Association, Sept 12, 2014
Quality Management Partnership Mandate In March 2013, Ministry of Health and Long-Term Care directed Cancer Care Ontario (CCO) and College of Physicians and Surgeons of Ontario (CPSO) to partner to develop a provincial quality management program in o Colonoscopy o Mammography o Pathology Quality Management Partnership 2
Partnership Governance Structure MOHTLC Healthcare System Reference Group Steering Committee Leadership Team Colonoscopy Expert Advisory Panel Mammography Expert Advisory Panel Pathology Expert Advisory Panel Implementation & Operations Secretariat IM/IT Working Group Stakeholder Engagement & Communications Legislative & Regulatory Working Group Quality Management Partnership 3
Provincial Quality Management Program Five program components 1. Quality defined 2. Quality reporting 3. Quality assurance 4. Quality improvement 5. Quality by design Quality Management Partnership 4
1. Quality Defined How to define quality Guidelines, standards and indicators Quality Management Partnership 5
2. Quality Reporting How and what to measure and report on o E.g., cecal intubation rate o Turn data into information Quality Management Partnership 6
3. Quality Assurance Care must meet minimum standards o Provider (radiologist, MRT, pathologist, colonoscopist) o Facility o Region/province Quality Management Partnership 7
4. Quality Improvement How to improve performance o Provider o Facility (e.g., process for better flow-through) o Region (e.g., centralized referral to reduce wait times) Quality Management Partnership 8
5. Quality by Design System changes to improve quality o Provincial repository o Improve access to care Quality Management Partnership 9
Guiding Principles Patient-centred and include patient experience-based metrics 1. Applicable to all physicians, allied healthcare professionals and facilities 2. Supportive and educational but can use regulatory/funding levers 3. Based on collaboration and alignment with stakeholders 4. Value added by addressing inconsistencies, gaps, and duplication 5. Built on and leverage existingprograms 6. Adequately funded with efficiencies identified to offset investments 7. Based on a common model for using performance data that balances confidentiality with transparency 8. Quality Management Partnership 10
Expert Advisory Panels (EAPs) Clinical Leads 20+ panel members o Physicians and other healthcare providers, patient reps, organizational and regional reps, etc. Monthly meetings since Sep 2013 Quality Management Partnership 11
Approach and Timelines Phase 1 Phase 2 Work Stream Sep 2013 Mar 2014 Apr 2014 Mar 2015 Planning & Set Up Consultation Establish EAPs Identify Early Quality Initiatives Implement Early Quality Initiatives approved by MOHLTC Early Quality Initiatives Comprehensive Quality Management Program Preliminary Program Design Finalize Program Design Stakeholder Engagement & Consultation Webinars, surveys, focus groups, stakeholder updates, newsletters Phase 1 Report Phase 2 Report Reports to MOHLTC Quality Management Partnership 12
Current State of Mammography No quality program for o All mammographers Radiologists and MRTs o All patients o All facilities Quality Management Partnership 13
Current State of Mammography Existing programs o Ontario Breast Screening Program (OBSP) o CPSO Independent Health Facility (IHF) Assessment Program o Canadian Association of Radiology Mammography Accreditation Program (CAR- MAP) Quality Management Partnership 14
EAP Phase 1 Recommendations Conduct current state assessment of breast imaging Expand OBSP to all sites for women who meet program criteria Expand mammography provincial quality management program to all breast imaging Quality Management Partnership 15
EAP Draft Phase 2 Recommendations Design recommendations currently being finalized Nov 2014 o In-person consultation with IDCA executive o Broad web-based consultation with IDCA members and others Quality Management Partnership 16
EAP Draft Phase 2 Recommendations Optimize patient care o Equitable access o Informed decision-making o Follow-up of abnormal results o Standardized mammography (breast imaging) reports Quality Management Partnership 17
EAP Draft Phase 2 Recommendations High quality equipment and technology o DR o Image and report repository Quality Management Partnership 18
EAP Draft Phase 2 Recommendations Radiologist screening outcome reports o Abnormal call rate o Positive predictive value o Cancer detection rate (invasive, DCIS) o Interval cancer rate o Tumour size and nodal status Quality Management Partnership 19
EAP Draft Phase 2 Recommendations Facility level reports o Wait time to first assessment o Wait time to diagnosis without tissue biopsy (core or open) o Wait time to diagnosis with tissue biopsy (core or open) o Patient experience metrics (TBD) Quality Management Partnership 20
EAP Draft Phase 2 Recommendations Quality assurance o Regular QC o Regular physics inspections o MRT image reviews o CAR-MAP o Facility assessment Quality Management Partnership 21
EAP Draft Phase 2 Recommendations Quality oversight model o Provincial Quality Management Program Lead o Regional Quality Management Program Leads o Facility Quality Management Program Leads Quality Management Partnership 22
Goal Breast imaging services are of consistent high quality across Ontario and all women have access to these services Quality Management Partnership 23
Stay Informed and Provide Input QMP Newsletter Read and subscribe to the QMP Newsletter Watch for ongoing communications (newsletters, letters, presentations, FAQs, QMP website) Jul Oct 2014 In person consultations with key stakeholders Web-based consultation with all stakeholders Oct - Dec 2014 www.qmpontario.ca info@qmpontario.ca Visit www.qmpontario.ca E-mail us at info@qmpontario.ca info@qmpontario.ca Contact us Quality Management Partnership 24
