Engage. Align. Influence: Empowering Implementation April 21 st, 2017 The Springer House Burlington, Ontario Table of Contents Symposium agenda Page 2 Message from the president Page 3 Health Quality Ontario (HQO): Wound Care Quality Standards (Process of Development and a Look at the Final Draft Standards) • Lacey Phillips Page 4 o Quality Standard v Clinical Practice Guideline v Professional Standards of Care Page 4 o What is distinct about Quality Standards? Page 5 o The Standards Development Process Page 6 o The finalized products of the Standards process Page 7 o HQO’s Current Scope Page 8 o HQO’s Anticipated Development Timeline Page 8 o Quality Statements for Pressure Injuries Page 9 • Lee Fairclough Page 10 o Implementation Planning Approach Page 10 o The Committee Page 10 o The Quality Standards Implementation Process Page 11 o Turning Recommendations into an Action Plan Page 11 o What does successful implementation involve? Page 12 o Implementation recommendations Page 12 o Putting the Plan into Action Page 12 o Quality standards implementation plan Page 13 o Ontario Quality Standards Committee Page 13 o Preliminary Implementation Feedback: Wound Care Quality Standards Page 13 • Terry Irwin o Successes and Gaps Page 14 o Key recommendations that have been heard to date Page 14 • Candace Tse o Breakout Session Review Page 15 o Pressure Injury Statements Page 17 • Sandra Pupatello o Reaching the Government – Message, Marketing & Medium Page 18 • OntWIG Annual General Meeting and Financial Statement Page 20 • OntWIG Sponsors Page 21 2 Copyright ONTWIG April 21, 2017. All Rights Reserved 2017 Symposium Agenda 0830-0845 Welcome and program objectives 0845-0930 HEALTH QUALITY ONTARIO: Wound Care Quality Standards: Process of development and a look at the final draft statement Lacey Phillips- Manager, Quality Standards Program HQO Terri Irwin- Director of Quality Standards at HQO 0930-1015 HEALTH QUALITY ONTARIO: Wound Care Quality Standards How can standards improve the quality of care in Ontario? Lee Fairclough, Vice President, Quality Improvement, HQO 1030-1130 Stakeholder feedback on the implementation of HQO Wound Care Quality 1130-1215 Dissemination of breakout group discussions to all delegates 1215-1315 Lunch & Networking 1315-1415 Influencing Government Relations Sandra Pupatello, Director of Business & Global Markets at Pricewaterhouse Cooper 1415-1530 Closing remarks, OntWIG Report 3 Copyright ONTWIG April 21, 2017. All Rights Reserved Message from the President Valerie Winberg RN(EC), MN, NP-PHC, ENC(C), IIWCC Valerie is a Primary Health Care Nurse Practitioner and Clinical Wound Specialist. Since graduating from the NP program at the University of Windsor in 2002, she has worked in Primary Care, Long-term Care and Emergency medicine. Currently, Valerie is the Executive Director/Clinical Lead NP at Twin Bridges Nurse Practitioner-Led Clinic in Sarnia ON, seeing clients for Primary Health Care as well as wound care referrals. Wound care became a passion for Valerie as she started her NP career and began working with LTC nurses and residents. She has become an international speaker and educator in the wound care arena since. As an advocate for improved access to wound care for all, Valerie, was a founding member of the Ontario Wound Interest Group and is currently the President. Dear Stakeholder and Woundcare Colleague; The Ontario Woundcare Interest Group held the 7th Annual OntWIG Symposium on April 21, 2017. It is our distinct pleasure to present this document as an outcome of the Symposium which once again engaged a cross-section of clinicians, industry partners and interested stakeholders. The attendees engaged in lively breakout group discussion and interactive presentations with the keynote speakers. The OntWIG executive team hopes that in sharing this proceedings document, we can continue the conversations that concern all of us regarding wound health policy. OntWIG is committed to pursuing the priority action items identified at the Annual Symposia through the input of the delegates, stakeholders and membership. Your ongoing commitment and contributions to the advancement of evidence-based wound health policy is exemplary. Over the past year, many of the current OntWIG executive team and members have participated with Health Quality Ontario (HQO) to develop quality standards for wound care. This has been a formidable task for HQO and the interdisciplinary team gathered to review evidence, current literature and existing guidelines. It has also been an honor and a pleasure to be part of the process. The Symposium report provides you with a summary of this work and the next steps. A special thanks our industry partners for their unrestricted educational grant support. These generous contributions allow OntWIG to continue to provide exceptional events at reasonable cost. Additionally, it is essential to acknowledge the tireless volunteer efforts of the executive team as they engage with membership regularly and have provided leadership to the working groups over this past year. I look forward to the on-going work of OntWIG and greatly appreciate the contribution of all of you along the journey. Valerie Winberg, RN(EC), MN, NP-PHC OntWIG President 4 Copyright ONTWIG April 21, 2017. All Rights Reserved Health Quality Ontario (HQO): Wound Care Quality Standards Process of Development and a Look at the Final Draft Standards Lacey Phillips Lacey Phillips is a Manager within the Quality Standards program at Health Quality Ontario. In this role, she works with a dynamic and talented team to develop, implement, and evaluate evidence-based quality standards for the Ontario health system. Throughout 2016, she led the development of the three sets of wound care quality standards (diabetic foot ulcers, venous and mixed venous/arterial leg ulcers, and pressure injuries). Lacey has eight years of previous experience in the area of national and international health care quality standards development through her work at Accreditation Canada. She holds a Master of Allied Health Services Research from Dalhousie University. Backgrounder To implement the quality standards program for wound care in Ontario is to follow a mandate set forth in the Excellent Care for All Act to promote health care that is supported by the best available scientific evidence. Then to make recommendations to health care organizations and other entities on standards of care in the health system based on or respecting clinical practice guidelines and protocols. The birth of the quality standards program was designed to fulfill the mandate. Wound care has been identified as being among the key areas in which to develop quality standards. The implementation of the quality standards should be done in a way that places patients first. This process involves: • Supporting evidence-based quality improvement to address variations and gaps in care across different sectors (primary care, home care, acute care, LTC, etc.) that are caused by factors outside of patient choice • Providing patients and the public with relevant information, based on the best evidence, designed to help them understand exactly what to look for in seeking care • Understanding the data that demonstrates regional variations and contrasts in the quality of care that Ontarians are receiving in order to improve consistency across the province. Quality Standard vs. Clinical Practice Guideline vs. Professional Standards of Care Quality Standards are known to reference a smaller set of high-impact statements that describe optimal care where identified quality gaps are known to exist in Ontario. These statements are based on the best available evidence from the public and are designed to “raise the ceiling” for wound care and the overall health system. Clinical Practice Guidelines often include conditional or equivocal recommendations that may or may not be specifically designed for or relevant to the Ontario health system. Professional Standards of Care are typically mandatory practices that are intended to maintain the minimum expectations of practice for individual health care professionals. 5 Copyright ONTWIG April 21, 2017. All Rights Reserved What is distinct about Quality Standards? • They Must Be Concise: The standards contain 5-15 quality statements as opposed to the number that can appear in many clinical practice guidelines. • They Must Be Accessible: The standards allow for clinicians to know exactly what type of care they should be providing, as well as for patients to know exactly what type of care to expect. • They Must Be Measurable: Each quality statement is accompanied by one or more process indicators and if appropriate, structural indicators to understand the impact. • They Must Be Implementable: Associated quality improvement tools and resources specific to each quality standard are available to support the adoption of the quality standards. There is an evolution from Quality Standards through Clinical practice guidelines to Professional Standards of Care. Quality standards are a smaller set of high-impact statements that describe optimal care where identified quality gaps exist. Clinical Practice Guidelines often include conditional or equivocal recommendations which may not be designed for the Ontario health system. Finally, professional standards of care are mandatory practices intended to maintain minimum expectations of practice for individual health care professionals. The Standards Development Process HQO follows a structured Quality Standards Development Process