Qualitycast North

Visiting specialist clinics are a lifeline for patients with chronic disease in rural and remote communities across the North. They save patients travel time and costs and also provide care in context of their own local communities and available supports. But patient non-attendance at these clinics can negatively impact the quality of their longitudinal care leading to increased morbidity. In this episode, Dr. Angela How takes us through her quality improvement work based at her rural visiting specialist rheumatology clinic in Hazelton improving patient attendance through a culturally safe approach incorporating motivational interviewing techniques. At the same time, we hear how her 28 year commitment to her Hazelton clinic has been both personally rewarding and helped to build local trust by providing equitable patient care.

Our topic in this episode is the power and potential of good data for improving patient care. In a broad ranging interview with our guests Dr. Cole Stanley and Gayle Grout from Health Data Coalition (HDC), we hear about the origins and goals of HDC and how the aggregation of primary care electronic medical record data can provide Primary Care providers reassurance and drive improvements in care. We talk about the importance of feedback loops, the benefits and dangers of comparison and how such data can support a whole system quality approach. HDC is a great example of a how a non-profit, collaborative, physician-led and governed data coalition can drive better patient care whilst maintaining privacy. Health Data Coalition – Better Information. Better Care. Better Patient Outcomes. HDC Bright Spots: Bright Spots – Health Data Coalition HDC MD's Corner: MD’s Corner – Health Data Coalition LinkedIn: Health Data Coalition of BC | LinkedIn

As season 4 comes to and end and we enter our 5th year of the podcast with season 5, Shyr and Lee reflect on their favourite highlights from last season. With twice as many episodes as previous seasons, there was a lot to choose from and of course all our guests left an indelible impression. What can we look forward to in the season ahead? More great Quality Improvement projects, high profile guests and maybe even one or two surprises. Don’t want to miss an episode? Subscribe to our channel on Spotify, Apple Podcasts or wherever you get your podcasts.

From a healthcare quality perspective, you can’t get much better than the Mayo Clinic. Its global reputation for high quality patient care is unsurpassed. But what exactly makes the Mayo Clinic so good and what can other institutions learn from how the Mayo Clinic does business? To find out, the Doctors of BC recently arranged for a group of British Columbian physicians to visit the Mayo Clinic in Arizona, to hear, see and experience how they deliver care. To talk about their learnings and key takeaways from that trip are today’s guests, Dr. Kalah Blackstock a family physician in Smithers and Physician Co-chair and Advisor to Northern Health’s Physician Quality Improvement program, and Dr. John Hwang, a general surgeon at the Royal Columbian Hospital in Vancouver and the current Board Chair of The Doctors of BC. In our wide-ranging discussion, we talk about the importance of organizational vision, physician leadership, data and above all culture. Listen in and discover the Mayo’s special sauce.

Residents in British Columbia are no strangers to wildfires which have increased in number and ferocity over recent years. But when an out-of-control wildfire threatens a town, its residents and its healthcare facilities, it rapidly turns into a nightmare come true. The sudden need for healthcare facility evacuation is a recipe for potential chaos and confusion and poses increased risks for patients and care home residents. To talk about their amazing and award-winning Quality Improvement work in reducing the risks of emergency healthcare facility evacuation are today’s guests from Health Emergency Management BC (HEM BC) Gloria Hertz and John Coyne. Other abbreviations mentioned in this episode are IIHAR (Inter and Intra Health Authority Relocation), HSDA (Health Services Delivery Area), ACLS (Advanced Cardiac Life Support), BCEHS (British Columbia Emergency Health Services – formally BC Ambulance Services) and PHSA (Provincial Health Services Authority). Links: Health Emergency Management BC (including links to the IIHAR toolkit)

This week we’re returning to Northern Health’s C-Suite and interview Nicole Cross, Northern Health’s Vice President of Indigenous Health and Chief Planning and Quality Officer. In this treat of an episode, we cover a wide range of topics including her career journey from entry-level Indigenous Patient Liaison to the Northern Health’s Executive C-suite. Nicole explains her vision for engaging patients and communities in their own care and care system; how openness and transparency is the key to how the system learns and why quality should be embedded and not optional in our healthcare system, before finishing with a heart-warming account of how her early life experience in her home Nisga'a Village of Laxgalts'ap drives her motivation and work with the Executive team.

When those in short term police custody need acute medical care, getting them that care presents logistic problems often resulting in time consuming and labor-intensive visits to the local hospital emergency department with police escorts. This week’s guest is Dr. Michelle Brousson, a family physician in North Vancouver, who talks to us about her innovative solution for this complex problem providing the care these patients need without having to leave the police station, providing a win-win solution for everyone involved. During this episode Dr. Brousson provides us with a project masterclass on engaging and listening to stakeholders and delivering education in a meaningful way. This project was supported through the Shared Care Committee, a sister collaborative committee to the Specialist Services Committee. To contact someone about spreading this project to your community, access the link below. Links: Shared Care Resources Specialist Services Committee - Spreading Quality Improvement

Taking on your first leadership role as a physician can be a daunting prospect. New physician leaders can feel ill-prepared and ill-equipped when thrust into these positions. But it turns out training and experience in Quality Improvement can help prepare new physician leaders as many of QI skills translate directly into leadership. Our guest today is Dr. Gurpreet Narang, a radiologist based at the University Hospital of Northern British Columbia in Prince George who busts some of the myths surrounding physician leadership and tells us how to avoid that “deer in the headlights” moment commonly encountered by newbie physician leaders in the healthcare arena.

Returning to the podcast is everyone’s favourite physician QI coach and social media maven Dr. Lawrence Yang. He’s a family doc, physician wellness advocate and QI coach but is probably most well well-known for his social media presence and legions of posted selfies with fellow Quality Improvers. In this interview we go deep as Lawrence explains the importance of connection and mutual support within the QI community as well as his own personal motivation behind his networking superpower. We also talk about self-compassion, the dangers of working in silos, generational attitudes to work and identifying as ‘whole people’. Links: Kristin Neff and self-compassion Specialist Services Committee Physician Quality Improvement Alum Hub Health Data Coalition

It’s a problem which we read and hear about in the media on an all too regular basis. But violence and mental health is not only a problem on our city streets, it’s also an issue in our hospitals. This week’s guest is Northern psychiatrist Dr. Barb Kane. In this episode we talk about why violence and mental health is such a big problem, how it came about and her proposed Northern solution. Links: Read about and sign the petition at change.org

Patients with alcohol use disorder (AUD) are some of the heaviest users of western healthcare resources and particularly emergency departments. Effective treatments for alcohol use disorder have recently become available but only a very small proportion of eligible AUD receive treatment. To talk about their excellent quality improvement work in identifying eligible AUD patients and directing them towards appropriate care from the emergency department, are our two guests today, Dr. Aron Zuidhof, Medical Director for Emergency Services in Interior Health and Dorrie Fasick , Transformational Lead for the Interior Health Emergency Services Network. They talk us through the groundbreaking, wrap-around, care-pathway for AUD they’ve helped develop and at the same time, offer a masterclass in spread and implementation of this initiative to all 28 facilities in their health region. Links: AUD in ED Work Flow FV Help is Available AUD Outpatient Prescription

British Columbia’s Physician Quality Improvement (PQI) program celebrates its 8th birthday this year. Since inception, this program has produced amazing improvement work some of which we’ve showcased on this podcast. PQI has also generated a culture shift towards quality amongst the physician community throughout the province. Our special guest today is Dr. Curt Smecher, aka “Papa QI”, the person responsible for PQIs original vision and first training cohort. In this episode, we talk to Curt about PQI’s humble beginnings, the progress and impact of the program to date and its exciting next phase. We also hear how redefining barriers as “speed bumps” and a thoughtful, incremental approach towards its goals, has produced the program’s impressive results. Abbreviations used during this episode: PQI – Physician Quality Improvement SSC – Specialist Services Committee, a collaborative committee between the Doctors of BC and the British Columbian Ministry of Health Ministry – BC Ministry of Health Fraser – Fraser Health Authority We love to hear from you, our listeners. Send us your feedback or ask us a question about healthcare quality improvement by emailing us at [email protected] .

In this special “mic swap” episode, Lee Cameron and guest co-host Dr. Gurpreet Narang turn the tables on our regular co-host Shyr Chui to ask him about his journey into QI, some of his current projects and memorable highlights from over 20 years of QI work. Amongst other things, we touch on Whole System Quality, building strong QI teams, artificial intelligence and what gets him out of bed every morning. Links: IHI White paper on Whole System Quality (Juran’s Quality Trilogy) Qualitystream North

Today’s guest is a giant and well-respected figure in British Columbian Emergency Medicine. In addition to his many research and quality improvement projects, Dr. Jim Christenson helped create the British Columbia Emergency Medicine Network improving the quality of emergency care across the province. But far from slowing down in retirement, he’s continued pioneering work, turning his attention to the rural, indigenous communities on the west coast of Vancouver Island. In this insightful and moving interview Dr. Christenson talks about the current state of healthcare in these remote communities, the challenges of addressing inequity, his personal motivation for this work and some of the incredible and heartwarming encounters he’s experienced on the way. Links: Northern Health PQI E-mail us!

In the second part of our interview with Northern Rural Family Physician, Dr. Ray Markham, we discuss some of his leadership work supporting rural communities across the province through the Rural Coordination Centre of BC. We discuss how to build a provincial support network and how the constraints of geography and remoteness can be turned to advantage by fueling innovation to improve care “at the edge”. Links: Partnership Pentagram RCCbc

Each year, the Institute of Healthcare Improvement holds its annual forum in December. Over 4 days, between 3 to 4 thousand healthcare quality improvers from across the world join together for a packed program of workshops, QI project reports, improvement science education and keynote lectures from renown speakers. This year, a large contingent of Canadians made the trip including some from Northern British Columbia so we decided to bring these Northern Physicians together for a fun panel discussion about their experiences and what they learned from this year’s forum. This is the recording of that discussion moderated by our regular Qualitycast North host Dr. Shyr Chui. We talk about our key takeaways, Dr. Anthony Fauci’s keynote, power networking and tips for first-time forum attendees. Links: Institute for Healthcare Improvement Dr. Kedar Mate and Dr. Thomas Lee Keynote

If you’re ever tempted to think medicine is practised the same everywhere in British Columbia, think again. Small rural communities present specific challenges to healthcare delivery due to their size and location, no more so than in the North where we also have long, snowy winters to contend with. That’s not to say that rural care can’t be high quality care. Providing valuable insights into rural family practice is today’s guest Dr. Ray Markham. This interview was so good we split it into two separate episodes. In this first part, Ray talks about his rural, generalist practice in Valemount, how to promote good teamwork and the unsung benefits of working in rural medicine. Links: Partnership Pentagram RCCbc

We’re returning to Northeast BC today and the subject might make some listeners squirm a little in their seats. We talk to Dr. Damian Fay, a rural GP and sexual health practitioner based in Hudson’s Hope about his QI work improving his vasectomy service. We talk about the challenges patients experience in accessing care in the North before the conversation takes a lighthearted turn towards the pros and cons of living and working in the north, craft beer and a novel way to get your triathlon track times down.

We’ve showcased a lot of excellent physician-led quality improvement work on this podcast with its corresponding positive impact on patient care. But what is the effect of doing this work on the physicians themselves? Talking about the benefits of doing QI on her day-to-day work, life and career is today’s guest Dr. Daisy Dulay, a cardiologist based in Victoria, BC. In this episode we discuss career paths, purpose, rediscovering joy in our work and “slow medicine”. Links: Northern Health PQI Spreading Quality Improvement | SSC

Recruitment and retention of front-line staff is a major challenge across healthcare systems globally right now, and no more so than in small, rural communities across Northern British Columbia. Today’s guest Dr. Kate Niethammer, a rural GP and obstetrician based in Smithers, BC, explains how she, using a QI approach and asking what mattered to them, was able to reverse nurse shortages and help re-establish full staffing levels in her unit. In this episode we talk about the benefits of living in the North and the universal power of pizza. Links: Institute of Healthcare Improvement (IHI) Framework for Improving Joy in Work Northern Health PQI

With the current challenges faced by healthcare organizations around the world, maintaining staff morale and Joy in Work is a daunting task. The response of one medical imaging department in Northern British Columbia? Competitive baking! This week we interview James Cheesman, a Medical Radiation Technologist at The University Hospital of Northern British Columbia about “The Great X-Ray Bake Off”. With staff bakers competing for the Grandmaster Baker title and trophy, all other staff tasting and scoring the delicious entries and a resulting improvement in departmental morale and camaraderie, it’s a win-win solution for everyone. If you enjoyed this episode, please subscribe to our channel. If you have a question about healthcare quality improvement or feedback for us at Qualitycast North, email us at [email protected] and your question could feature on a future episode. Links: Northern Health Physician Quality Improvement Program Cake by Numbers – The UHNBC Grandmaster Bake off

When improving or making changes to the way organizations provide health care, it often seems the last person consulted is the patient themselves. This seemingly perverse order of priority is a lingering throwback to a more historical and paternalistic model of care. One person looking to change this is today’s guest Kim Eggers, the Patient Partner Advisor for Northern Health’s Physician Quality Improvement program. In this episode we learn about Kim’s background, her motivation for patient advocacy and her vision for the co-creation of health care services. Resources: Patient Voices Network of British Columbia Northern Health Physician Quality Improvement Program

We’re back for our fourth season with our new co-host, Lee Cameron. Our season opener is a cracker featuring special guest Ciro Panessa, the new CEO of Northern Health. In this episode we talk about Ciro’s journey to CEO, his first 9 months, and Northern Health’s priorities over the next 5 years. We also touch on life on the road and why ultimately, he’s grateful. Resource links: Northern Health Northern Health Physician Quality Improvement “The First 90 Days” book by Michael D. Watkins

It’s our Season 3 finale and a special episode tinged with a little sadness as it’s our Producer and Co-host Deanna’s last episode with QCN. This week I turn the tables on Deanna and ask about her experiences on the show and to take us through her favourite interviews from our first three seasons. Which guests did she choose? You’ll have to listen to find out! Qualitycast North will return in the Autumn with Season 4 and we’re planning a special QI clinic episode in which we answer listeners’ questions on healthcare quality improvement. Where are you struggling? What advice do you need? We want to hear from you so email us at [email protected] with your question.

According to Statistics Canada, Canada is currently experiencing a huge increase in unmet mental health needs. The prevalence of anxiety, depression and social phobia have jumped since the Covid pandemic. How can our health systems cope with this surge in demand for mental health services when the medical community itself is in crisis with physician shortages and burnout commonplace? Well, there’s good news in British Columbia. A hugely successful, community-based, mental health service based on in-person and virtual group medical visits is spreading throughout the province. It’s called Mind Space and, in this episode, we interview one of it’s founders, Dr. Fiona Petigara, about its origins, how it operates and why it’s been so successful. More information about Mind Space for interested patients and physicians can be found on their website at https://mind-space.ca and the BC Medical Journal at https://bcmj.org/shared-care/cbt-skills-spread-initiative-building-program-support-doctor-and-patient-mental-health