Background
The New Brunswick Medical Society (NBMS) and Choosing Wisely New Brunswick (CWNB) recognize the importance of providing training and support for New Brunswick physicians to lead quality improvement (QI) projects. As a result, the Physician Quality Improvement Initiative has been developed to provide grants for QI training and projects in New Brunswick with a focus on reducing unnecessary tests and treatments through Choosing Wisely Canada’s recommendations and resources.
Purpose
The Physician Quality Improvement initiative aims to:
Increase QI capacity throughout the province.
Increase physician engagement in Choosing Wisely New Brunswick initiatives.
Enhance the delivery of high quality, patient-centered care while fostering resource stewardship.
Strengthen collaborative research teams and opportunities.
2022 Successful Grant recipients
Optimizing Stroke Imaging NB (OSI-NB)
Primary Investigators: Dr. Archer and Kathleen MacMillan
This project will evaluate the utility of an expanded radiological interpretation of an augmented CT scan for stroke. The results of this analysis could lead to recommendations that would rapidly diagnose the cause of stroke and reduce the need for subsequent imaging.
Optimization of laboratory tests and blood transfusions in Vitalité Health Network
Primary Investigator: Dr. Ihssan Bouhtiauy
The Edmundston Regional Hospital has been recognized as a Designated Using Labs Wisely Hospital by Choosing Wisely Canada. This project will expand the labs optimization project throughout all hospitals in Vitalité Health Network (VHN). Additionally, the national Using Blood Wisely guidelines will be implemented to improve transfusion efforts across VHN.
Improving Platelet Utilization Project
Primary Investigator: Dr. Jonaki Manna
This project aims to improve platelet utilization by examining platelet data for indications and doses of platelets transfused to determine appropriateness. Appropriate platelet usage ensures availability of a product to those who need it most especially since platelets are inherently in short supply due to a short shelf life of 5 to 7 days. The percent platelet outdate data will also be collected and this will aid in platelet inventory management. Clinician education will be developed according to the results.
A review of the management of catheter related bloodstream infections within the Horizon Health Network
Primary Investigators: Dr. Martin MacKinnon and Dr. Natasha Larivee
This project will review how catheter related bloodstream infections (CRBSIs) are currently being managed within the Horizon Health Network Nephrology program and compare that to what is seen within the literature. The results will be used to optimize duration of therapy, reduce risk of relapse infections and encourage appropriate antibiotic management.
Utilization and Implementation of Cancer Care Ontario, ASCO Guidelines for the Management of the Axilla in Early-Stage Breast Cancer in Rural New Brunswick
Primary Investigator: Dr. Gurpreet Singh-Ranger
This project will allow us to review diagnostic pathways and improve the quality of care of breast cancer patients by:
a) Reviewing the past management of the axilla in Early-Stage Breast Cancer at the Upper River Valley Hospital
b) Implementing current CCO and ASCO Guidelines for Axillary Management in Early Breast Cancer by providing each surgeon with a toolkit and auditing implementation over a year.
c) Improving appropriate screening mammography in patients aged 40-49 years with breast problems by providing family physicians in the URVH zone with a toolkit and following their pathway over the year.
Deprescribing benzodiazepines in recently discharged patients from an acute psychiatric unit
Primary Investigator: Dr. Theveshen Padayachee
This project aims to reduce the number of patients who receive Benzodiazepine prescriptions for more than 3 months following their discharge from the Psychiatric Unit of the Dr. Everett Chalmers Hospital by ensuring that steps to deprescribe the benzodiazepine(s) are included in discharge planning.
Quality Improvement Training: Lean Six Sigma Black Belt Training & Certification in Healthcare
Primary Investigator: Dr. John Amirault
Helpful Resources and Training Opportunities
The College of Family Physicians of Canada – Practice Improvement Initiative
The College of Physicians & Surgeons of Alberta (CPSA) – Competence Resources
Centre for Quality Improvement and Public Safety
CHA Learning: HealthCareCAN - Health Quality Innovation Program
Data sources
The New Brunswick Institute for Research, Data and Training (NB-IRDT) is a New Brunswick organization that facilitates effective research and decision-making by providing access to secure, privacy-protected data and other resources. The NB-IRDT has access to a multitude of datasets, including:
The NB-IRDT can also assist with research development, data analysis and guidance throughout your project. The NB-IRDT also has the capacity to receive user collected data and link it (for example, physicians’ EMR, clinical trials, etc.). To find out more, please visit the NB-IRDT website, or contact Ted McDonald.
Other potential sources of data include:
· Patient Medical Records (e.g. physicians orders)
· Prescription/pharmaceutical records
· Administrative records
· Health Statistics (Federal or Provincial)
· Peer-reviewed literature