Scholarship Recipients 2019
Attending international conferences:
David Mak (UBC) - Attended the IHI/BMJ International Forum, Glasgow
Fatima Al-Roubaiai (UBCO) - Attended the 30th Annual IHI National Forum, Florida
Victoria Rea (UNBC) - Attended the 30th Annual IHI National Forum, Florida
Attending the Vancouver Quality Forum:
Katie Maclean (UBCO)
Kevala Van Volkenburg (UNBC)
Vivian Tsang (UBC)
Kim Lee (UBC)
Dhruv Pandev (UBC)
Saman Fouladirad (UBC)
Jamie Park (UBC)
Wayne Tse (UBC)
David Mak (UBC) - Attended the IHI/BMJ International Forum, Glasgow
Fatima Al-Roubaiai (UBCO) - Attended the 30th Annual IHI National Forum, Florida
Victoria Rea (UNBC) - Attended the 30th Annual IHI National Forum, Florida
Attending the Vancouver Quality Forum:
Katie Maclean (UBCO)
Kevala Van Volkenburg (UNBC)
Vivian Tsang (UBC)
Kim Lee (UBC)
Dhruv Pandev (UBC)
Saman Fouladirad (UBC)
Jamie Park (UBC)
Wayne Tse (UBC)
David Mak - Attended IHI/BMJ International Forum, Glasgow Scotland
Attending the IHI/BMJ International Forum on Quality and Safety in Healthcare in Glasgow was nothing short of life-changing. In a short span of 2 days, I was exposed to more inspiration, education, and motivation than I ever thought possible. The International Forum hosted more than 3000 healthcare professionals from over 70 countries, all united with a common goal to improve healthcare. From providing electric-powered cars for children to drive to the OR to reduce anxiety, to sharing “A-ha” moments and mistakes of leaders in quality improvement (QI), the learning and self-reflection I gained from attending this conference is one that I will take with me for the rest of my professional career, and I am so grateful to have had the support of the IHI scholarship to attend this conference.
Most people say that going to hockey games is much better than watching on TV because there is an inexplicable energy and passion in the arena that is impossible to replicate. The 2019 IHI/BMJ International Forum held in Glasgow, Scotland was exactly the same. I vividly remember 2 keynote presentations, who were presented by Don Berwick (Professor Emeritus, Past president and co-founder of IHI), Derek Feeley (current CEO and president of IHI), and Jason Leitch (National Clinical Director for the Scottish Government). When these superstars of the QI world were speaking, they were so engaging and injected so much passion and energy into the room that every single person was glued to their every movement and clinging on to every word. A large topic of their keynote address surrounded the idea of activating Agency for improvement, which is the power and courage to make change. Activating Agency requires 1) Power and courage; 2) Supportive culture; 3) A method for change (QI); and 4) Widening one’s horizons. The stories they shared on how to use this recipe to create change from an individualized level to nation-wide initiatives were powerful yet humble, and left me inspired and motivated. The most prolific example of this was how Scotland was able to use agency to establish the Scottish Patient Safety Programme, which in the 10 years since its formation, has dramatically decreased the rate of hospital deaths within 30 days, heart attacks, pressure sores, and has resulted in 190 fewer stillbirths in the past 5 years. I could only help but think of the impact such a program could have on the health and well-being of Canadians anywhere, who live in a country 125x larger than Scotland, with 7x the population. The leaders of these initiatives started right where I was sitting, with a passion to learn more about QI and with a simple and clear goal to improve the lives of their communities. It was these stories of change that inspired me the most, to show me that with these skills and experiences, there is no limit to what I could do for our patients.
As a 4th year medical student about to begin residency, I attended recommended sessions for students and junior doctors. One of the major quotes that resonated with me throughout the whole conference was “We all have a seat around the table, but we don’t all have a voice”. As healthcare professionals, it is extremely common practice for us to gather for noon rounds or ward meetings, only to have 20% of the participants dominate 80% of the conversation. This may stem from the level of extroversion or introversion of participants, as well as their position in the ‘hierarchy’ of healthcare. However, this presentation showed how to completely change that paradigm with Lego! The speakers spoke on how it was common for people to doodle during meetings as a means of expressing creativity in a non-verbal manner. They took this one step further by distributing Lego during meetings, which furthered this notion and supported the sharing of ideas. This was due to the fact that often times, we don’t speak up in meetings because we are afraid of looking bad or being embarrassed. However, the “fear of looking bad” is eliminated with Lego, because everyone understands that nothing built with Lego is going to be, or supposed to be, a true representation of something. In this sense, the barrier to creativity and discussions were largely removed.
This was put into practice when we were told to build Lego structures to represent what leadership and quality improvement meant to us. The diversity and personal interpretations of what this meant to each attendee was absolutely amazing. As you can see from the photo to the left, each structure was vastly different, but with common similarities. For example, the use of bridges represented connections between people and ideas; clear bricks represented transparency and accountability, and the green flags often represented the common end goal we were all working towards in our respective communities. In medicine, we often think and have meetings in a very “left-brain” oriented manner, focused on the analysis of results, well-defined problems and quantifiable metrics for improvement. This session impressed upon me the importance of introducing the “right brain” to these meetings, to achieve a sense of balance when looking after our patients. It was amazing to see the resounding sense of responsibility, purpose, and agency that all participants had, despite coming from different backgrounds and countries.
Improvement is an innate skill that we have been practicing since we were babies, as we learned from our mistakes to develop the skills to walk, talk, and grow. The approach to improving healthcare is no different. As healthcare professionals, it can be easy to become jaded and cynical, as we work in the rigorous demands of healthcare day after day. Yet, if we take the time to learn from our mistakes and implement processes to address these demands, the passion and drive of why we first got into healthcare easily emerges once again. Throughout this conference, I was constantly amazed by how most often, the simplest solutions made the biggest impact. It was extremely powerful and moving to see how simply restructuring and reallocating existing resources can make such a world of different. I realized that you don’t have to re-invent the wheel or be the most brilliant or educated person in order to make a big impact on those around you. Recognizing there is a problem you can fix and taking that first steps to address it is all that is needed. As I embark on my residency, I fondly remember one of the quotes shared at the conference: “Tell me and I forget. Teach me and I remember. Involve me and I learn”
I would encourage everybody to involve themselves in quality improvement, for it is the collective effort of like-minded individuals that drives advancement and progress. From completing the IHI Basic Certificate in Quality and Safety, to applying for IHI scholarships to attend these eye-opening conferences, it is an experience that will be of immense benefit in your personal and professional development. I am so thankful to the BC Patient Safety and Quality Council and the UBC Chapter of IHI for supporting and for providing me the opportunity to have this inspiring and transformative experience.
Victoria Rea - Attended 30th Annual IHI National Forum, Florida, USA.
I am writing to thank you for the generous scholarship that allowed me to attend the 2018 IHI National Forum in Orlando, Florida from December 9-12 2018. I was ecstatic to learn that I was the recipient of this scholarship, as I am passionate about leadership and healthcare improvement, and I would not have been able to attend the forum otherwise. Being an Undergraduate student at the University of Northern British Columbia, attending this conference was the opportunity of a lifetime as I was surrounded by individuals that I look up to, and was able to have a voice for Northern BC at the conference. I am a fourth year biomedical studies major at UNBC, and have been in the process of applying to medical school. Among other lessons, this conference reignited my passion for healthcare improvement and leadership, in a time in my life that I needed it most. At the National Forum, I attended many workshop sessions that taught me lessons that I can bring back to the Prince George IHI UNBC Chapter. On the first day of the conference, I attended the pre-conference keynote with Dr. Zubin Damania, also known as Z-Dogg MD online. There was not a dry eye in the audience as he spoke about burnout, his work in quality improvement, and how one of the largest determinants of health is where a patient was born and raised. After Dr. Damania’s eye opening keynote, I made my way to the presenter and student reception where I had appetizers, and was able to network and meet new people involved with quality improvement and IHI. The second day of the conference involved a keynote by Derek Feeley and Jason Leitch, and workshops called: how to co design an environment where staff can thrive, activating global health change agents for health equity, engaging students as catalysts in improvement work, and a second keynote called women in action paving a way for better care. Some major points at each of these workshops was learning how to close the “know do gap”, the value of a patient centered value system in QI work, the need to refocus existing resources already available instead of starting improvement interventions from scratch, and creating an environment that students can work so that they feel appreciated and motivated. Learning about how to create an environment that students can be involved in without feeling taken advantage of, or under appreciated was of great importance to me as our IHI UNBC Chapter grows. Personally, I have been in a negative working environment before, and I want the IHI UNBC Chapter to reflect a safe space where all involved are appreciated, respected, and motivated. To conclude the first day of the conference, a moving keynote was conducted by Maureen Bisognano, Dr. Celine Gounder, Dr. Mona Hanna-Attisha and Vania Deonizio, where each person explained their experiences being a woman in medicine and quality improvement; again, many tears were shed hearing the inspirational stories from these women. Specifically, the “Dancin' Power” movement was explained by founder and executive director, Vania Deonizio; this is a quality improvement effort where Vania incorporated dancing into the everyday lives of those who might benefit from artistic expression in long term hospital care. I was so intrigued by the movement, as I was a competitive figure skater growing up, that I am currently in the process of researching to see if this could be viable in the University Hospital of Northern BC in Prince George. Ultimately, the first day of the IHI National Forum was a success. The second day of the IHI National Forum was a moving keynote by Gregory Boyle, where he talked about his improvement work through his company called “Homeboy Industries.” I have never been in the presence of somebody as wise, well spoken, and passionate as Gregory, as he told us his emotional stories about quality improvement by working with marginalized populations as he helped reintegrate gang members, and previously incarcerated individuals back into society through Homeboy Industries. After the keynote, I moved into a full day of workshops where I attended sessions that taught me how to leave the forum with a sticky message, activating leaders as agents for change, preparing personally and professionally for end of life conversations, followed by a final keynote by Dr. Don Berwick. I was interested in learning about how to recruit leaders to act as change agents as I thought that this could be directly related to the IHI UNBC Chapter, and aid in recruitment and chapter sustainability. Specifically, I learned how unleashing intrinsic motivation, and finding a way to do this in chapter members at an individual level, is a way to ensure that motivation, and action is maintained. Lastly, the keynote by Dr. Don Berwick was also a take away of the National Forum where he further talked about closing the health gap among marginalized populations as previously mentioned by Dr. Damania, and further expressed health issues in the United States regarding the issue of how where we grow up heavily determines our health outcomes for the rest of our lives. In all, I learned valuable lessons from the keynote speakers and the multiple workshops that I attended. I was able to network, and connect with likeminded individuals who offered to provide support when I need it in the future. Furthermore, I am taking many valuable lessons back to the IHI UNBC Chapter in regards of student recruitment, creating a positive environmentthat encourages QI Interest and motivation at an individual level, and ultimately creating an environment where we can thrive while creating changes in the health system. I left the IHI National Forum more inspired than I have ever been. I have been reminded that with proper support, we can make a change in the health system that needs improvement, and I am motivated to help make these changes happen. I would like to thank the BC Patient Safety and Quality Council and the IHI BC Chapters Quality Improvement for providing me with the outstanding opportunity to attend the IHI National Forum, as it was an experience that I will never forget. I would also like to thank the Institute for Healthcare Improvement for hosting such an incredible conference! Lastly, I would like to thank my peers in the IHI UNBC Chapter for informing me of the conference and scholarship opportunity, and for providing a platform that can truly help create change in the North!
Katie Maclean- Attended BCPSQC 2019 Quality Forum, Vancouver, B.C.
Truly grateful to receive a scholarship to attend the BC Patient Safety & Quality Council’s Quality Forum in Vancouver. I am apart of the IHI Open School Chapter at UBCO, and extremely passionate about improving quality care to patients across all sectors, and attending the Quality Forum was incredible to say the least! Throughout the entire event, I was inspired by the passion and knowledge being shared among such a diverse group of health care providers. Every presentation I attended encouraged me to better my own community and practice to improve care for all. In particular, I attended a rapid fire presentation called “Imagine All the People: Engaging Youth and Community for Better Care” which discussed the power of utilizing youth in their own care decisions. One of the speakers, Skye Barbic, who works at Foundry located in Vancouver, delivered an exceptional presentation about Foundry’s mission to provide a multitude of services for youth under one roof. I am apart of the youth council at the Foundry in Kelowna and took the opportunity to connect with Skye and share what is happening at each location. It’s these little connections and collaborations that fueled my passion for quality improvement and the valuable insight gained from talking with other like-minded individuals. Every presentation stood out in it’s own way, and sparked new ideas and incentives for me to take back to my own community. Another incredibly moving presentation was the rapid fire presentation: “Compassion at the End of Life”. Specifically, “Improving the Palliative ICU Experience Through Lasting Memories and Compassion”. During this presentation, two nurses from Kelowna General Hospital, presented their project for which they started a keepsake initiative in the KGH ICU. What this program does is provide families and patients the opportunity to engage in jewelry making with an imprint or special message to remember their loved one by. I speak not only for myself, but the entire room when I describe the compassion felt from the stories of those they cared for and who took part in the program. The cherry on top was when an audience member stood up and showed one of the necklaces she was wearing that she made from this exact program when her son had died. It’s projects like these that remind me how lucky I am to be a health care provider and the lasting impact we make on the lives of others. That to me is the best reward that any career can offer. Lastly, I have to say that the integration of Indigenous peoples in the Quality Forum was incredibly moving. From the heartbreaking stories of the burden their people have suffered with the health care system, to their perspective on how we can better the experience for their people, minorities and cultural difference need to be addressed within society today. We need to open the conversation in order to provide effective and culturally safe care. During the Quality Forum, I realized I had a lack of knowledge regarding present treatment of indigenous peoples. I had no idea the stigmatization that is still occurring today and the hardship that their people’s fight against everyday. I believe in the importance of ridding the stigma around Indigenous people’s and hope that their collaboration with the BCPSQC will lead to better treatment and care for all, and a greater understanding of their cultural needs. From my experience at this conference, I am empowered to help minorities and those from different cultures receive exceptional care, and advocate for my patient’s when they don’t have a voice.I cannot thank the BCPSQC enough for providing me with one of the best experiences of my life. The knowledge, passion, creativity, and connections that I made and learned at this conference will propel me through my final years in nursing school, and aid me forward in my career as a health care provider to actively work on bettering the care of my patients. Thank you to all the amazing presenters and staff that made this event possible, and I cannot wait to see the quality improvements to come.
Vivian Tsang - Attended BCPSQC 2019 Quality Forum, Vancouver, B.C.
What I appreciate most about the BC Patient Safety and Quality Forum is the unique coming- together of health professionals from various clinical, research, and geographical areas across BC to facilitate the sharing of ideas and experiences from the past year. Such interdisciplinary intersections contribute to the success of the forum in bringing together teams who are conducting similar projects in order to form networks and connections to expand research horizons. Sharing pitfalls and strengths of past interventions also help to expedite ongoing and upcoming projects. Having attended the event previously when in my undergraduate years, attending the sessions this year as a medical student allowed me to appreciate the connections between clinical medicine and research. Many of the workshop presenters were physicians who had lectured me in the past or who I had shadowed in clinic. This contributed to a more nuanced understanding of the significance of their research projects and the difference it made both for patients and the healthcare system. At the front lines of medical care, clinicians shared their fondness for quality improvement projects because it allows them to see the direct effects of their efforts. Their motivation is further propagated by their team of staff who benefit from increased efficiency and improved patient and systems outcomes. Of particular interest was Dr. Andrea MacNeil’s session on the environmental impacts of surgery. Dr. MacNeil is a general surgeon specializing in sarcoma with a special interest in reducing the environmental impacts of surgery. This emerging area of research has great potential to improve health as well as the financial and environmental expenditures of the healthcare system. It has been proven that pollution from health care activities as a whole generate as much disability as medical error. Her studies have shown that single-use items consume more carbon that reusables even when factoring laundering considerations. In addressing the fact that North America’s largest greenhouse gas emissions are rooted in anesthetic gases, Dr. MacNeil collaborated with colleagues in anesthesia to make the simple switch from using desflurane to sevoflurane in an operation helps decrease CO2 emissions. These examples of quality improvement work demonstrate not only the rigour of research in the field but also illustrates the opportunities to include seemingly unrelated areas of research interest into a full-time clinical career. During the storyboard session, I had the opportunity to present my research on non-contact opioid monitoring devices for people who use drugs. This work was completed in collaboration with the BC Centre for Disease Control under Dr. Jane Buxton. The fentanyl crisis in Vancouver and other parts of the world has itself been an incentive for the development of smartphone applications amongst both private and public organizations. With increasing numbers of these smartphone applications that promise to prevent and recognize opioid overdose, there has been no measures thus far to evaluate the acceptability and accessibility of these devices for the population who will be using them. My project compiled data from the BC Harm Reduction Survey along with key informant interviews to gather answers to this issue. Being able to present as well as enjoy the workshops offered a delicate balance of learning and contributing to the research community. I want to thank the IHI for the opportunity to be sponsored to attend this incredible conference and look forward to attending similar events in the next years.
Jamie Park - Attended BCPSQC 2019 Quality Forum, Vancouver, B.C.
As a pharmacy student, we learn a lot about clinical practice, pathophysiology and
pharmacology of medications. However, there are lack of opportunities for pharmacy students to learn more about innovative and interprofessional quality improvement projects that are occurring in British Columbia. This year, I had the honour to attend Quality Forum 2019 through the BCPSQC & IHI BC Chapters Quality Improvement Scholarship. It was a unique and enlightening experience where I got to learn more about various health topics and meet likeminded individuals in different backgrounds in health care. In particular, I loved the Randomize Coffee Trial, which was an opportunity to connect with an assigned partner and learn about each other’s contributions to healthcare, passions and ideas for change. My partner was a Senior Analyst at BC Emergency Health Services. It was very interesting to learn about her career path and her current projects that she is involved with. As a health care professional
student, it was fascinating to learn about the Emergency Department and what their work flow was like. She emphasized the importance of interdisciplinary collaboration since her work involved a lot of interactions with physicians. Later on, I got to know her at a personal level by sharing both our interests in travelling. 2019 Quality Forum provided a great medium for students like myself to meet and connect with inspiring mentors. As a future practicing pharmacist, I plan to include clinical research as a key part of my practice. I would particularly like to combine my interests in health outcomes research with desire to improve health care services to patients through technology. 2019 Quality Forum had a Storyboard Reception where they had over 100 posters with various topics such as improvement capability, population health and clinical practice. I was surprised to see so many Quality Improvement Projects in the field of eHealth. The poster that was most memorable was “Innovation in Real Time Data Collection For Releasing Time to CareTM.” There are many health apps that are currently available for us and health care professionals to use. However, we are not exposed to the development process and how we can further improve future apps to ensure that the app is
BCPSQC & IHI BC Chapters Quality Improvement Scholarship Blog Post – Jamie Park improving the current workflow. I was able to learn about the step-by-step process through this poster. The project was about an evidence-based, continuous quality improvement program called Releasing Time to CareTM (R2TC). It was developed with the consultation with the front-line staff to ensure that the app is indeed useful and relevant to the app users. With the development of this app, there have been major improvements such as reduced time to clean and tabulate data. It was enlightening to learn about the process of app development and the importance of constant communication and feedback between staff and developers. As well, I was able to get inspirations for future research poster projects. As I went through the numerous posters, I jotted down notes about how to make research posters visually appealing and easy to follow. 2019 Quality Forum allowed Undergraduate students interested in research to explore various areas of innovative health topics and also connect with researchers or students with the same interest. Once again, I would like to thank the IHI BC Chapters and the BCPSQC for providing me an amazing opportunity to not only recognize the incredible work that is currently being done to improve care in British Columbia but also to share my perspectives to achieve better patient care. I highly recommend students to attend next year’s Quality Forum to meet passionate and experienced individuals who strive to improve quality of care and learn about various quality improvement projects that are occurring in British Columbia. I hope to attend the conference again in the near future as well!
Saman Fouladirad - Attended BCPSQC 2019 Quality Forum
With the generous support of the IHI BC Chapters and BCPSQC, I was able to attend the 2018 Vancouver Quality Forum during my reading break and it proved to be an incredibly rewarding experience. This opportunity exposed me to the current state of patient care, the way professionals across the different districts in Vancouver work together to improve healthcare, the obstacles we are currently facing and modern approaches and methods that are being implemented to improve patient care and safety.
As an aspiring physician, I was very fascinated about the plethora of topics covered in this conference. It was one of the few conferences where I had no obligations so I was able to fully devote myself to the many talks, workshops, tours, and debates while having a chance to connect with and learn from a diverse group of dedicated and passionate healthcare professionals about the ideals and standards of quality care. The pre-conference selections that I made was specifically geared towards providing accessible services in rural communities and the talk that really grasped my attention was about the Mobile Maternity Project (MOM), which is why I’ve dedicated my blog in explaining the premise and implications of this initiative.
The Mobile Maternity Project (MOM) is an integrative systems approach in supporting rural maternal services through Telehealth. This pilot project was initiated in B.C in response to the effects of regionalization that resulted in the loss of over 20 rural maternity services in B.C. The data presented was very alarming as it unequivocally showed that the greater distance that is now required to seek care put mothers and their infants at a greater risk of poorer health outcomes. This does intuitively make sense though, as regionalization takes away specialized support, access to technology, allied health professionals and much more.
The MOM was thus created to increase primary health care capacity and improve patient and population outcomes by providing a specialized obstetrics Telehealth service. This pilot initiative allows the patient to meet with their out of town specialist using a computer monitor/video and supports in facilitating a 3-way conversation between specialist, GP and patient. The consultation options presented were surprisingly plentiful as it ranged from booked, elective tele-video appointments to urgent bed-side assessment in hospital, clinic or home.
This seemed like the perfect innovative solution to a problem that is not only prevalent in B.C, but across Canada. However, as with any project or research endeavour, the initial stages will have its trails and tribulation. Through the dozen or so consultations that the investigators conducted, they have had lower than the anticipated uptake as less than the expected number of peoples across the different communities were coming on board for this project. This gap between theory and practice was something that I started discussing with other members of the audience and it provided me with many interesting ideas as to why the case may be. Could it that people have a lack of awareness of the project? Was it an overestimation of the need for such a service? May it be that people have a bigger desire for interpersonal consultations? Perhaps a complete larger shift in paradigm is needed before this form of practice is accepted. It was very fascinating to see how the panel members were discussing these ideas back and forth while proposing multiple working hypothesis in addressing the foreseeable challenges.
In the end, the topic really resonated with me because it showed the potential that eHealth practice can have in addressing challenges that patients, physicians and society on a whole face as it is not bound by geographical barriers. I believe that platforms such as Telehealth will continue to play a significant role in providing quality care in the future as we strive to transition towards an integrative and efficient system that allows rapid and accurate transmission of data while providing equitable access to information that is safe and secure in order to improve patient care and safety.
The Quality Forum was the perfect platform in helping me better understand the issues surrounding healthcare that are rarely discussed in most education settings. This was a wonderful learning opportunity and proved to be an invaluable experience for me as I continuously try to hone my skills, understanding and knowledge about our healthcare sector to one day be in a position to deliver the most optimal care to my future patients.
I thank the IHI BC Chapters and BCPSQC for giving me this opportunity. I highly recommend this conference to others and I cannot wait until next year’s Quality Forum!
Attending the IHI/BMJ International Forum on Quality and Safety in Healthcare in Glasgow was nothing short of life-changing. In a short span of 2 days, I was exposed to more inspiration, education, and motivation than I ever thought possible. The International Forum hosted more than 3000 healthcare professionals from over 70 countries, all united with a common goal to improve healthcare. From providing electric-powered cars for children to drive to the OR to reduce anxiety, to sharing “A-ha” moments and mistakes of leaders in quality improvement (QI), the learning and self-reflection I gained from attending this conference is one that I will take with me for the rest of my professional career, and I am so grateful to have had the support of the IHI scholarship to attend this conference.
Most people say that going to hockey games is much better than watching on TV because there is an inexplicable energy and passion in the arena that is impossible to replicate. The 2019 IHI/BMJ International Forum held in Glasgow, Scotland was exactly the same. I vividly remember 2 keynote presentations, who were presented by Don Berwick (Professor Emeritus, Past president and co-founder of IHI), Derek Feeley (current CEO and president of IHI), and Jason Leitch (National Clinical Director for the Scottish Government). When these superstars of the QI world were speaking, they were so engaging and injected so much passion and energy into the room that every single person was glued to their every movement and clinging on to every word. A large topic of their keynote address surrounded the idea of activating Agency for improvement, which is the power and courage to make change. Activating Agency requires 1) Power and courage; 2) Supportive culture; 3) A method for change (QI); and 4) Widening one’s horizons. The stories they shared on how to use this recipe to create change from an individualized level to nation-wide initiatives were powerful yet humble, and left me inspired and motivated. The most prolific example of this was how Scotland was able to use agency to establish the Scottish Patient Safety Programme, which in the 10 years since its formation, has dramatically decreased the rate of hospital deaths within 30 days, heart attacks, pressure sores, and has resulted in 190 fewer stillbirths in the past 5 years. I could only help but think of the impact such a program could have on the health and well-being of Canadians anywhere, who live in a country 125x larger than Scotland, with 7x the population. The leaders of these initiatives started right where I was sitting, with a passion to learn more about QI and with a simple and clear goal to improve the lives of their communities. It was these stories of change that inspired me the most, to show me that with these skills and experiences, there is no limit to what I could do for our patients.
As a 4th year medical student about to begin residency, I attended recommended sessions for students and junior doctors. One of the major quotes that resonated with me throughout the whole conference was “We all have a seat around the table, but we don’t all have a voice”. As healthcare professionals, it is extremely common practice for us to gather for noon rounds or ward meetings, only to have 20% of the participants dominate 80% of the conversation. This may stem from the level of extroversion or introversion of participants, as well as their position in the ‘hierarchy’ of healthcare. However, this presentation showed how to completely change that paradigm with Lego! The speakers spoke on how it was common for people to doodle during meetings as a means of expressing creativity in a non-verbal manner. They took this one step further by distributing Lego during meetings, which furthered this notion and supported the sharing of ideas. This was due to the fact that often times, we don’t speak up in meetings because we are afraid of looking bad or being embarrassed. However, the “fear of looking bad” is eliminated with Lego, because everyone understands that nothing built with Lego is going to be, or supposed to be, a true representation of something. In this sense, the barrier to creativity and discussions were largely removed.
This was put into practice when we were told to build Lego structures to represent what leadership and quality improvement meant to us. The diversity and personal interpretations of what this meant to each attendee was absolutely amazing. As you can see from the photo to the left, each structure was vastly different, but with common similarities. For example, the use of bridges represented connections between people and ideas; clear bricks represented transparency and accountability, and the green flags often represented the common end goal we were all working towards in our respective communities. In medicine, we often think and have meetings in a very “left-brain” oriented manner, focused on the analysis of results, well-defined problems and quantifiable metrics for improvement. This session impressed upon me the importance of introducing the “right brain” to these meetings, to achieve a sense of balance when looking after our patients. It was amazing to see the resounding sense of responsibility, purpose, and agency that all participants had, despite coming from different backgrounds and countries.
Improvement is an innate skill that we have been practicing since we were babies, as we learned from our mistakes to develop the skills to walk, talk, and grow. The approach to improving healthcare is no different. As healthcare professionals, it can be easy to become jaded and cynical, as we work in the rigorous demands of healthcare day after day. Yet, if we take the time to learn from our mistakes and implement processes to address these demands, the passion and drive of why we first got into healthcare easily emerges once again. Throughout this conference, I was constantly amazed by how most often, the simplest solutions made the biggest impact. It was extremely powerful and moving to see how simply restructuring and reallocating existing resources can make such a world of different. I realized that you don’t have to re-invent the wheel or be the most brilliant or educated person in order to make a big impact on those around you. Recognizing there is a problem you can fix and taking that first steps to address it is all that is needed. As I embark on my residency, I fondly remember one of the quotes shared at the conference: “Tell me and I forget. Teach me and I remember. Involve me and I learn”
I would encourage everybody to involve themselves in quality improvement, for it is the collective effort of like-minded individuals that drives advancement and progress. From completing the IHI Basic Certificate in Quality and Safety, to applying for IHI scholarships to attend these eye-opening conferences, it is an experience that will be of immense benefit in your personal and professional development. I am so thankful to the BC Patient Safety and Quality Council and the UBC Chapter of IHI for supporting and for providing me the opportunity to have this inspiring and transformative experience.
Victoria Rea - Attended 30th Annual IHI National Forum, Florida, USA.
I am writing to thank you for the generous scholarship that allowed me to attend the 2018 IHI National Forum in Orlando, Florida from December 9-12 2018. I was ecstatic to learn that I was the recipient of this scholarship, as I am passionate about leadership and healthcare improvement, and I would not have been able to attend the forum otherwise. Being an Undergraduate student at the University of Northern British Columbia, attending this conference was the opportunity of a lifetime as I was surrounded by individuals that I look up to, and was able to have a voice for Northern BC at the conference. I am a fourth year biomedical studies major at UNBC, and have been in the process of applying to medical school. Among other lessons, this conference reignited my passion for healthcare improvement and leadership, in a time in my life that I needed it most. At the National Forum, I attended many workshop sessions that taught me lessons that I can bring back to the Prince George IHI UNBC Chapter. On the first day of the conference, I attended the pre-conference keynote with Dr. Zubin Damania, also known as Z-Dogg MD online. There was not a dry eye in the audience as he spoke about burnout, his work in quality improvement, and how one of the largest determinants of health is where a patient was born and raised. After Dr. Damania’s eye opening keynote, I made my way to the presenter and student reception where I had appetizers, and was able to network and meet new people involved with quality improvement and IHI. The second day of the conference involved a keynote by Derek Feeley and Jason Leitch, and workshops called: how to co design an environment where staff can thrive, activating global health change agents for health equity, engaging students as catalysts in improvement work, and a second keynote called women in action paving a way for better care. Some major points at each of these workshops was learning how to close the “know do gap”, the value of a patient centered value system in QI work, the need to refocus existing resources already available instead of starting improvement interventions from scratch, and creating an environment that students can work so that they feel appreciated and motivated. Learning about how to create an environment that students can be involved in without feeling taken advantage of, or under appreciated was of great importance to me as our IHI UNBC Chapter grows. Personally, I have been in a negative working environment before, and I want the IHI UNBC Chapter to reflect a safe space where all involved are appreciated, respected, and motivated. To conclude the first day of the conference, a moving keynote was conducted by Maureen Bisognano, Dr. Celine Gounder, Dr. Mona Hanna-Attisha and Vania Deonizio, where each person explained their experiences being a woman in medicine and quality improvement; again, many tears were shed hearing the inspirational stories from these women. Specifically, the “Dancin' Power” movement was explained by founder and executive director, Vania Deonizio; this is a quality improvement effort where Vania incorporated dancing into the everyday lives of those who might benefit from artistic expression in long term hospital care. I was so intrigued by the movement, as I was a competitive figure skater growing up, that I am currently in the process of researching to see if this could be viable in the University Hospital of Northern BC in Prince George. Ultimately, the first day of the IHI National Forum was a success. The second day of the IHI National Forum was a moving keynote by Gregory Boyle, where he talked about his improvement work through his company called “Homeboy Industries.” I have never been in the presence of somebody as wise, well spoken, and passionate as Gregory, as he told us his emotional stories about quality improvement by working with marginalized populations as he helped reintegrate gang members, and previously incarcerated individuals back into society through Homeboy Industries. After the keynote, I moved into a full day of workshops where I attended sessions that taught me how to leave the forum with a sticky message, activating leaders as agents for change, preparing personally and professionally for end of life conversations, followed by a final keynote by Dr. Don Berwick. I was interested in learning about how to recruit leaders to act as change agents as I thought that this could be directly related to the IHI UNBC Chapter, and aid in recruitment and chapter sustainability. Specifically, I learned how unleashing intrinsic motivation, and finding a way to do this in chapter members at an individual level, is a way to ensure that motivation, and action is maintained. Lastly, the keynote by Dr. Don Berwick was also a take away of the National Forum where he further talked about closing the health gap among marginalized populations as previously mentioned by Dr. Damania, and further expressed health issues in the United States regarding the issue of how where we grow up heavily determines our health outcomes for the rest of our lives. In all, I learned valuable lessons from the keynote speakers and the multiple workshops that I attended. I was able to network, and connect with likeminded individuals who offered to provide support when I need it in the future. Furthermore, I am taking many valuable lessons back to the IHI UNBC Chapter in regards of student recruitment, creating a positive environmentthat encourages QI Interest and motivation at an individual level, and ultimately creating an environment where we can thrive while creating changes in the health system. I left the IHI National Forum more inspired than I have ever been. I have been reminded that with proper support, we can make a change in the health system that needs improvement, and I am motivated to help make these changes happen. I would like to thank the BC Patient Safety and Quality Council and the IHI BC Chapters Quality Improvement for providing me with the outstanding opportunity to attend the IHI National Forum, as it was an experience that I will never forget. I would also like to thank the Institute for Healthcare Improvement for hosting such an incredible conference! Lastly, I would like to thank my peers in the IHI UNBC Chapter for informing me of the conference and scholarship opportunity, and for providing a platform that can truly help create change in the North!
Katie Maclean- Attended BCPSQC 2019 Quality Forum, Vancouver, B.C.
Truly grateful to receive a scholarship to attend the BC Patient Safety & Quality Council’s Quality Forum in Vancouver. I am apart of the IHI Open School Chapter at UBCO, and extremely passionate about improving quality care to patients across all sectors, and attending the Quality Forum was incredible to say the least! Throughout the entire event, I was inspired by the passion and knowledge being shared among such a diverse group of health care providers. Every presentation I attended encouraged me to better my own community and practice to improve care for all. In particular, I attended a rapid fire presentation called “Imagine All the People: Engaging Youth and Community for Better Care” which discussed the power of utilizing youth in their own care decisions. One of the speakers, Skye Barbic, who works at Foundry located in Vancouver, delivered an exceptional presentation about Foundry’s mission to provide a multitude of services for youth under one roof. I am apart of the youth council at the Foundry in Kelowna and took the opportunity to connect with Skye and share what is happening at each location. It’s these little connections and collaborations that fueled my passion for quality improvement and the valuable insight gained from talking with other like-minded individuals. Every presentation stood out in it’s own way, and sparked new ideas and incentives for me to take back to my own community. Another incredibly moving presentation was the rapid fire presentation: “Compassion at the End of Life”. Specifically, “Improving the Palliative ICU Experience Through Lasting Memories and Compassion”. During this presentation, two nurses from Kelowna General Hospital, presented their project for which they started a keepsake initiative in the KGH ICU. What this program does is provide families and patients the opportunity to engage in jewelry making with an imprint or special message to remember their loved one by. I speak not only for myself, but the entire room when I describe the compassion felt from the stories of those they cared for and who took part in the program. The cherry on top was when an audience member stood up and showed one of the necklaces she was wearing that she made from this exact program when her son had died. It’s projects like these that remind me how lucky I am to be a health care provider and the lasting impact we make on the lives of others. That to me is the best reward that any career can offer. Lastly, I have to say that the integration of Indigenous peoples in the Quality Forum was incredibly moving. From the heartbreaking stories of the burden their people have suffered with the health care system, to their perspective on how we can better the experience for their people, minorities and cultural difference need to be addressed within society today. We need to open the conversation in order to provide effective and culturally safe care. During the Quality Forum, I realized I had a lack of knowledge regarding present treatment of indigenous peoples. I had no idea the stigmatization that is still occurring today and the hardship that their people’s fight against everyday. I believe in the importance of ridding the stigma around Indigenous people’s and hope that their collaboration with the BCPSQC will lead to better treatment and care for all, and a greater understanding of their cultural needs. From my experience at this conference, I am empowered to help minorities and those from different cultures receive exceptional care, and advocate for my patient’s when they don’t have a voice.I cannot thank the BCPSQC enough for providing me with one of the best experiences of my life. The knowledge, passion, creativity, and connections that I made and learned at this conference will propel me through my final years in nursing school, and aid me forward in my career as a health care provider to actively work on bettering the care of my patients. Thank you to all the amazing presenters and staff that made this event possible, and I cannot wait to see the quality improvements to come.
Vivian Tsang - Attended BCPSQC 2019 Quality Forum, Vancouver, B.C.
What I appreciate most about the BC Patient Safety and Quality Forum is the unique coming- together of health professionals from various clinical, research, and geographical areas across BC to facilitate the sharing of ideas and experiences from the past year. Such interdisciplinary intersections contribute to the success of the forum in bringing together teams who are conducting similar projects in order to form networks and connections to expand research horizons. Sharing pitfalls and strengths of past interventions also help to expedite ongoing and upcoming projects. Having attended the event previously when in my undergraduate years, attending the sessions this year as a medical student allowed me to appreciate the connections between clinical medicine and research. Many of the workshop presenters were physicians who had lectured me in the past or who I had shadowed in clinic. This contributed to a more nuanced understanding of the significance of their research projects and the difference it made both for patients and the healthcare system. At the front lines of medical care, clinicians shared their fondness for quality improvement projects because it allows them to see the direct effects of their efforts. Their motivation is further propagated by their team of staff who benefit from increased efficiency and improved patient and systems outcomes. Of particular interest was Dr. Andrea MacNeil’s session on the environmental impacts of surgery. Dr. MacNeil is a general surgeon specializing in sarcoma with a special interest in reducing the environmental impacts of surgery. This emerging area of research has great potential to improve health as well as the financial and environmental expenditures of the healthcare system. It has been proven that pollution from health care activities as a whole generate as much disability as medical error. Her studies have shown that single-use items consume more carbon that reusables even when factoring laundering considerations. In addressing the fact that North America’s largest greenhouse gas emissions are rooted in anesthetic gases, Dr. MacNeil collaborated with colleagues in anesthesia to make the simple switch from using desflurane to sevoflurane in an operation helps decrease CO2 emissions. These examples of quality improvement work demonstrate not only the rigour of research in the field but also illustrates the opportunities to include seemingly unrelated areas of research interest into a full-time clinical career. During the storyboard session, I had the opportunity to present my research on non-contact opioid monitoring devices for people who use drugs. This work was completed in collaboration with the BC Centre for Disease Control under Dr. Jane Buxton. The fentanyl crisis in Vancouver and other parts of the world has itself been an incentive for the development of smartphone applications amongst both private and public organizations. With increasing numbers of these smartphone applications that promise to prevent and recognize opioid overdose, there has been no measures thus far to evaluate the acceptability and accessibility of these devices for the population who will be using them. My project compiled data from the BC Harm Reduction Survey along with key informant interviews to gather answers to this issue. Being able to present as well as enjoy the workshops offered a delicate balance of learning and contributing to the research community. I want to thank the IHI for the opportunity to be sponsored to attend this incredible conference and look forward to attending similar events in the next years.
Jamie Park - Attended BCPSQC 2019 Quality Forum, Vancouver, B.C.
As a pharmacy student, we learn a lot about clinical practice, pathophysiology and
pharmacology of medications. However, there are lack of opportunities for pharmacy students to learn more about innovative and interprofessional quality improvement projects that are occurring in British Columbia. This year, I had the honour to attend Quality Forum 2019 through the BCPSQC & IHI BC Chapters Quality Improvement Scholarship. It was a unique and enlightening experience where I got to learn more about various health topics and meet likeminded individuals in different backgrounds in health care. In particular, I loved the Randomize Coffee Trial, which was an opportunity to connect with an assigned partner and learn about each other’s contributions to healthcare, passions and ideas for change. My partner was a Senior Analyst at BC Emergency Health Services. It was very interesting to learn about her career path and her current projects that she is involved with. As a health care professional
student, it was fascinating to learn about the Emergency Department and what their work flow was like. She emphasized the importance of interdisciplinary collaboration since her work involved a lot of interactions with physicians. Later on, I got to know her at a personal level by sharing both our interests in travelling. 2019 Quality Forum provided a great medium for students like myself to meet and connect with inspiring mentors. As a future practicing pharmacist, I plan to include clinical research as a key part of my practice. I would particularly like to combine my interests in health outcomes research with desire to improve health care services to patients through technology. 2019 Quality Forum had a Storyboard Reception where they had over 100 posters with various topics such as improvement capability, population health and clinical practice. I was surprised to see so many Quality Improvement Projects in the field of eHealth. The poster that was most memorable was “Innovation in Real Time Data Collection For Releasing Time to CareTM.” There are many health apps that are currently available for us and health care professionals to use. However, we are not exposed to the development process and how we can further improve future apps to ensure that the app is
BCPSQC & IHI BC Chapters Quality Improvement Scholarship Blog Post – Jamie Park improving the current workflow. I was able to learn about the step-by-step process through this poster. The project was about an evidence-based, continuous quality improvement program called Releasing Time to CareTM (R2TC). It was developed with the consultation with the front-line staff to ensure that the app is indeed useful and relevant to the app users. With the development of this app, there have been major improvements such as reduced time to clean and tabulate data. It was enlightening to learn about the process of app development and the importance of constant communication and feedback between staff and developers. As well, I was able to get inspirations for future research poster projects. As I went through the numerous posters, I jotted down notes about how to make research posters visually appealing and easy to follow. 2019 Quality Forum allowed Undergraduate students interested in research to explore various areas of innovative health topics and also connect with researchers or students with the same interest. Once again, I would like to thank the IHI BC Chapters and the BCPSQC for providing me an amazing opportunity to not only recognize the incredible work that is currently being done to improve care in British Columbia but also to share my perspectives to achieve better patient care. I highly recommend students to attend next year’s Quality Forum to meet passionate and experienced individuals who strive to improve quality of care and learn about various quality improvement projects that are occurring in British Columbia. I hope to attend the conference again in the near future as well!
Saman Fouladirad - Attended BCPSQC 2019 Quality Forum
With the generous support of the IHI BC Chapters and BCPSQC, I was able to attend the 2018 Vancouver Quality Forum during my reading break and it proved to be an incredibly rewarding experience. This opportunity exposed me to the current state of patient care, the way professionals across the different districts in Vancouver work together to improve healthcare, the obstacles we are currently facing and modern approaches and methods that are being implemented to improve patient care and safety.
As an aspiring physician, I was very fascinated about the plethora of topics covered in this conference. It was one of the few conferences where I had no obligations so I was able to fully devote myself to the many talks, workshops, tours, and debates while having a chance to connect with and learn from a diverse group of dedicated and passionate healthcare professionals about the ideals and standards of quality care. The pre-conference selections that I made was specifically geared towards providing accessible services in rural communities and the talk that really grasped my attention was about the Mobile Maternity Project (MOM), which is why I’ve dedicated my blog in explaining the premise and implications of this initiative.
The Mobile Maternity Project (MOM) is an integrative systems approach in supporting rural maternal services through Telehealth. This pilot project was initiated in B.C in response to the effects of regionalization that resulted in the loss of over 20 rural maternity services in B.C. The data presented was very alarming as it unequivocally showed that the greater distance that is now required to seek care put mothers and their infants at a greater risk of poorer health outcomes. This does intuitively make sense though, as regionalization takes away specialized support, access to technology, allied health professionals and much more.
The MOM was thus created to increase primary health care capacity and improve patient and population outcomes by providing a specialized obstetrics Telehealth service. This pilot initiative allows the patient to meet with their out of town specialist using a computer monitor/video and supports in facilitating a 3-way conversation between specialist, GP and patient. The consultation options presented were surprisingly plentiful as it ranged from booked, elective tele-video appointments to urgent bed-side assessment in hospital, clinic or home.
This seemed like the perfect innovative solution to a problem that is not only prevalent in B.C, but across Canada. However, as with any project or research endeavour, the initial stages will have its trails and tribulation. Through the dozen or so consultations that the investigators conducted, they have had lower than the anticipated uptake as less than the expected number of peoples across the different communities were coming on board for this project. This gap between theory and practice was something that I started discussing with other members of the audience and it provided me with many interesting ideas as to why the case may be. Could it that people have a lack of awareness of the project? Was it an overestimation of the need for such a service? May it be that people have a bigger desire for interpersonal consultations? Perhaps a complete larger shift in paradigm is needed before this form of practice is accepted. It was very fascinating to see how the panel members were discussing these ideas back and forth while proposing multiple working hypothesis in addressing the foreseeable challenges.
In the end, the topic really resonated with me because it showed the potential that eHealth practice can have in addressing challenges that patients, physicians and society on a whole face as it is not bound by geographical barriers. I believe that platforms such as Telehealth will continue to play a significant role in providing quality care in the future as we strive to transition towards an integrative and efficient system that allows rapid and accurate transmission of data while providing equitable access to information that is safe and secure in order to improve patient care and safety.
The Quality Forum was the perfect platform in helping me better understand the issues surrounding healthcare that are rarely discussed in most education settings. This was a wonderful learning opportunity and proved to be an invaluable experience for me as I continuously try to hone my skills, understanding and knowledge about our healthcare sector to one day be in a position to deliver the most optimal care to my future patients.
I thank the IHI BC Chapters and BCPSQC for giving me this opportunity. I highly recommend this conference to others and I cannot wait until next year’s Quality Forum!
