No need to re-invent the wheel in health care

Letters to the Editor (The Guardian)
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(Editor’s Note: On November 6 and 7, P.E.I. is hosting 85 health-care leaders from across Canada. The four Atlantic provinces are hosting this effort to improve care, to share with others, and help each other advance the way to combat chronic disease)

Dr. Richard Wedge

In hospitals and long-term care homes, doctors’ offices and physiotherapy clinics across Canada there are no doubt countless innovations that are improving healthcare right now. Some are initiatives started by governments, others by health-care professionals and others still by patients themselves.

Too often, despite the best intentions of everyone working in our health-care systems, these great ideas remain isolated pockets of excellence. Any organization working to improve quality for patients and value-for-money for taxpayers today should ask, “What’s out there that works?” Nowhere is this more relevant than in a small province like P.E.I. with limited resources. The last thing we should do is to try and reinvent the wheel.

That’s why P.E.I. has joined with Newfoundland and Labrador, New Brunswick and Nova Scotia in the Atlantic Healthcare Collaboration for Innovation and Improvement in Chronic Disease. Every health authority from all four provinces has signed on; we have agreed on our priorities and started looking at what great ideas are already out there.

Together we’re focusing on chronic diseases like diabetes, mental illness and chronic obstructive pulmonary disorder (COPD). To help us identify the best practices and work through the nuts and bolts of putting them into place, we have enlisted the Canadian Foundation for Healthcare Improvement, a not-for-profit organization that has helped hundreds of organizations improve healthcare for patients. Ten teams from all four provinces are taking those good ideas and putting them into practice.

One-in-three Islanders has a chronic condition, higher than the national average. More than half of our residents are obese, which is also higher than the rest of Canadians. We smoke more and so, not surprisingly, many more of our friends, family and neighbours die of respiratory diseases.

The good news is that there are proven ways of tackling the health-care challenges that chronic diseases pose, while continuing to promote healthy living. P.E.I. has two of the 10 improvement projects that will take the best practices, put them into place and measure how well they are working.

Through the Atlantic Collaboration, we talked with our colleagues in Nova Scotia who were facing similar challenges with COPD — a condition that damages people’s airways, making it difficult to move air in and out of their lungs, often leaving them breathless, getting worse over time, and leading to other health problems like chest infections and heart problems.

COPD is the fourth most common cause of death in Canada and the most common cause of admission to hospitals across the country, including P.E.I. Our Primary Care staff are working with our hospitals to introduce an innovative model of care that will help patients with COPD .

INSPIRED is a COPD outreach program, created by Dr. Graeme Rocker, CFHI’s Clinical Improvement Advisor, which consists of health-care providers giving patients more support to manage their illness at home through tools such as COPD action plans and advance care plans —written instructions on what steps patients and their families should take if their condition worsens. When the program was introduced at Capital Health in Halifax, emergency room visits and hospital admissions among COPD patients dropped by more than 60 to 80 per cent. All because patients learned what to do and how to get the care they needed at home.

Health P.E.I.’s second project is focusing on developing new ways of working with patients as partners in their own health and health care. When patients see their family doctors and nurse practitioners in the community, we want them to work together to set realistic health goals that can be sustained over their lives. With individualized, comprehensive health goals, we can help patients and families live healthier, and longer. For patients with chronic conditions, it means setting goals that promote their self-efficiency, their ability to succeed in managing their own health and play an active role in co-designing their treatments and care.

We’re sharing good ideas and spreading them — across regions and provinces, all while keeping focused on what our Island patients and their families need.  By working together, we’re all accelerating the pace through which we will be able to improve care.

Health care in Canada is often accused of being the land of pilot projects; our inter-provincial improvement effort shows that it doesn’t have to be. By rolling up our sleeves and working together, we can achieve a lot more than by working alone. Together we are making progress towards our goal of providing the right care, by the right provider in the right place.

Commentary

By Dr. Richard Wedge

Dr. Richard Wedge is CEO of Health P.E.I. and a member of the Atlantic Healthcare Collaboration, an initiative of the Canadian Foundation for Healthcare Improvement.

Organizations: 7, P.E.I., Canadian Foundation for Healthcare Improvement, Atlantic Healthcare Collaboration for Innovation Capital Health Health P.E.I.

Geographic location: Canada, P.E.I., Nova Scotia Newfoundland and Labrador New Brunswick Halifax

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