Each year, we submit a Quality Improvement Plan (QIP) to the Ministry of Health and Long-Term Care. Our QIP identifies specific priorities for quality improvement in five dimensions including effectiveness, efficiency, patient-centredness, safety, and timeliness. This year, we submitted separate QIPs for each of our hospital sites. At the Kingston General Hospital site we are aiming to improve patient satisfaction with the information they receive from hospital staff after they leave the hospital, reduce readmission rates for patients with COPD and unnecessary time spent in acute care, increase the proportion of palliative patients who are discharged home with support and the proportion of patients receiving medication reconciliation upon admission, improve patient satisfaction with emergency care, reduce the incidence of hospital acquired pressure ulcers and reduce emergency department wait times. At the Hotel Dieu Hospital site we are aiming to help patients understand how to best manage their care by providing them with sufficient verbal and written information at their appointments, reduce readmission rates for patients with COPD, achieve high levels of patient satisfaction with ambulatory care and urgent care, ensure effective clinic utilization and timely communication with referring physicians following patients' clinic visits, increase the number of designated patients receiving medication reconciliation, and achieve wait time targets in the urgent care centre. For more information on our hospital QIPs, visit the KGH site or the HDH site.
Accreditation is a voluntary process that allows health-care providers to assess every aspect of health care and service against national standards of excellence. Both our Kingston General Hospital and Hotel Dieu Hospital sites received the Accredited with Exemplary Standing during our last Accreditation Canada surveys. This means that our organizations have surpassed stringent national standards of quality and quality improvement in terms of governance, clinical leadership, people, processes, information, and performance. We are scheduled to undergo our next survey in the spring of 2018. This represents a unique opportunity for KHSC to use the Accreditation Canada standards as a way of unifying clinical areas across both hospital sites around common standards of excellence.
KHSC is a top performer on the essentials of quality, care, and service
In 2017-18 Together with patients and families, we will:
Achieve or exceed seventy-five per cent of KGH & HDH Quality Improvement Plan targets
Use Accreditation Canada Standards to learn, improve, and model excellence
How are we doing?
Quality Improvement Plans:
All indicators identified in the Quality Improvement Plans (QIPs) at both sites of KHSC speak to the commitment of KHSC to improve five dimensions of patient care: effectiveness, efficiency, patient‑centredness, safety and timeliness.
Q1 effectiveness indicators illustrate that progress is being made at both sites to reduce readmission rates of patients with chronic obstructive pulmonary disease (COPD) by introducing evidence‑based care processes across the SE LHIN for patients with COPD. A sample of clinic patients at the HDH site responded that they were provided with sufficient information at their clinic appointment. Q1 results are not yet available to determine if patients at the KGH site felt they received enough information prior to discharge about what to do if they were worried about their condition or treatment after leaving the hospital. Some Q1 indicators of efficiency were slightly below target: timely communication with referring doctors at the HDH site and alternate level of care (ALC) days at the KGH site. Clinic utilization at the HDH site was on target. Performance will continue to be monitored and improvement opportunities identified. Data for three patient‑centredness indicators was not yet available from standardized patient experience surveys. However, targets were met for two indicators: % of palliative care patients discharged from hospital with the discharge status "Home with Support" (KGH site) and patient satisfaction with care received in a sample of clinics at the HDH site.
Patient safety indicators at both sites emphasize medication reconciliation, which is an effective way of reducing medication discrepancies and enhancing patient safety. Some Q1 medication safety indicators were slightly below target; however, medication reconciliation processes have been established and will continue to be reviewed and communicated to ensure compliance. Q1 targets at both sites that reflect timely access to care were achieved: total ED length of stay (KGH site) and wait times in the Urgent Care Centre (HDH site).
In Q1 the document review from prior HDH and KGH accreditation surveys was completed, and the accreditation coordinator confirmed preliminary accreditation survey details with Accreditation Canada, e.g. which standards will be used, which services are offered at both sites. A high‑level accreditation readiness plan and time line was developed and endorsed by KHSC Executive, with discussions around a preliminary high‑level list of risks and concerns. An Accreditation Communication Plan has been developed in conjunction with Strategy Management and Communications. A Patient Safety Quality and Risk (PSQR) accreditation coordination team has been established; accountabilities have been assigned for the accreditation team leads, executives, and PSQR, as well as leads for accreditation standards and Patient Safety ROPs.