Qualitycast North

Qualitycast North is excited to bring you a special 4-episode series celebrating the 25-year anniversary of The Royal Commission on the Future of Health Care in Canada and the subsequent, ground-breaking, Romanow Report. About the Royal Commission and Romanow ReportIn 2001, the Federal government launched the landmark Romanow Commission, to examine the future of Canada's publicly funded healthcare system. Led by Roy Romanow, the Commission combined extensive research, expert analysis, and one of the largest public consultations in Canadian healthcare history. Through engagement with healthcare professionals, governments, Indigenous organizations, and tens of thousands of Canadians, the Commission developed evidence-based recommendations aimed at strengthening the sustainability and accessibility of Medicare for future generations.In the fourth and final part of this special series we interview Dr. Gordon Hoag, a retired clinical pathologist, senior Physician Quality Improvement Co-Lead and one of the founders of British Columbia's Physician Quality Improvement Program.We talk about how the now 25-year-old Romanow Report remains relevant to issues facing healthcare today, how having conversations around improving health system quality remain paramount and how physician-led improvement continues to offer hope for health care's future in British Columbia.We hope you enjoyed this 4-part special series on the Romanow report. Please check out the links below for some useful resources and our website for more great Qualitycast North episodes.Links:Commission on the Future of Health Care in Canada: The Romanow Commission (Government of Canada)The Romanow Report (download)The Specialist Services CommitteeQualitycast NorthSpecial Series Credits:Hosts: Dr. Shyr Chui, Dr. Eiko WaidaExecutive Producer: Aman HundalProducer: Lee CameronTechnical Support: Mat Walker (Expression North), Stefanie GarrawayPart 1. The Rt. Honorable Jean Chrétien, former Prime Minister of Canada (Listen now)Part 2.  Greg Marchildon, former Chief of Staff to Roy Romanow (Listen now)Part 3. Dr. Verna Yiu, former CEO of Alberta Health Services (Listen now)

Qualitycast North is excited to bring you a special 4-episode series celebrating the 25-year anniversary of The Royal Commission on the Future of Health Care in Canada and the subsequent, ground-breaking, Romanow Report. About the Royal Commission and Romanow ReportIn 2001, the Federal government launched the landmark Romanow Commission, to examine the future of Canada's publicly funded healthcare system. Led by Roy Romanow, the Commission combined extensive research, expert analysis, and one of the largest public consultations in Canadian healthcare history. Through engagement with healthcare professionals, governments, Indigenous organizations, and tens of thousands of Canadians, the Commission developed evidence-based recommendations aimed at strengthening the sustainability and accessibility of Medicare for future generations.We're continuing our special series with this our third interview. Giving us insights into the relevance of the Report at the Provincial level and a masterclass in delivering high-impact health care system improvement on a Provincial scale is today's guest, Dr. Verna Yiu. Dr. Yiu, a pediatric nephrologist by training, is the current Board Chair of CIHI, the Academic Dean and Provost of The University of Alberta and the former CEO of Alberta Health Services from 2016 to 2022. In this episode, Dr. Yiu explains what she found inspiring about the Report before sharing her experience of successfully implementing large-scale improvements in healthcare delivery and how these can be applied in other jurisdictions. We also hear about the foundational importance of primary care, patient centered care and data system integration to delivering high quality and cost effective health care.Join us for the fourth and final part of this special series in which we talk to Dr. Gordon Hoag, Senior Provincial Quality Improvement Co-Lead about the spirit of the Romanow report and its ephemeral relevance for Canadian healthcare today. Listen now: The spirit of the Romanow Report lives on - improving health care in British Columbia today” featuring Dr. Gordon Hoag, Senior Physician Quality Improvement Co-LeadLinks:Commission on the Future of Health Care in Canada: The Romanow Commission (Government of Canada)The Romanow Report (download)Canadian Institute for Health Information (CIHI)University of AlbertaAlberta Health ServicesThe Specialist Services CommitteeQualitycast NorthSpecial Series Credits:Hosts: Dr. Shyr Chui, Dr. Eiko WaidaExecutive Producer: Aman HundalProducer: Lee CameronTechnical Support: Mat Walker (Expression North), Stefanie GarrawayPart 1. The Rt. Honorable Jean Chrétien, former Prime Minister of Canada (Listen now)Part 2.  Greg Marchildon, former Chief of Staff to Roy Romanow (Listen now)

Qualitycast North is excited to bring you a special 4-episode series celebrating the 25-year anniversary of The Royal Commission on the Future of Health Care in Canada and the subsequent, ground-breaking, Romanow Report. About the Royal Commission and Romanow ReportIn 2001, the Federal government launched the landmark Romanow Commission, to examine the future of Canada's publicly funded healthcare system. Led by Roy Romanow, the Commission combined extensive research, expert analysis, and one of the largest public consultations in Canadian healthcare history. Through engagement with healthcare professionals, governments, Indigenous organizations, and tens of thousands of Canadians, the Commission developed evidence-based recommendations aimed at strengthening the sustainability and accessibility of Medicare for future generations.In the second part of this 4-part, special series celebrating 25 years of the Romanow report, we speak to Greg Marchildon, Roy Romanow's Chief of Staff at the time of the inquiry and author of the book “Tommy Douglas and the Quest for Medicare in Canada”. In this episode, Greg takes us through the political context of the Commission, how Roy Romanow was recruited as Commissioner, and their whirlwind journey to gather, collate and summarize the opinions of health organizations and the Canadian public before generating the final report all within their18-month deadline.Join us for Part 3 in the series in which Dr. Verna Yiu, past CEO of Alberta Health Services, gives us a Provincial perspective on the Report and what it takes to implement successful health system improvement on a Provincial scale. Listen now: Generating high-impact health system improvement at the Provincial level featuring Dr. Verna Yiu, former CEO of Alberta Health Services.Links:Commission on the Future of Health Care in Canada: The Romanow Commission (Government of Canada)The Romanow Report (download)Tommy Douglas and the Quest for Medicare in Canada (Amazon)North American Observatory on Health Systems and PoliciesThe Specialist Services CommitteeQualitycast NorthGreg Marchildon and Roy Romanow interview (audio only)Greg Marchildon and Roy Romanow interview (video)Special Series Credits:Hosts: Dr. Shyr Chui, Dr. Eiko WaidaExecutive Producer: Aman HundalProducer: Lee CameronTechnical Support: Mat Walker (Expression North), Stefanie GarrawayPart 1. The Rt. Honorable Jean Chrétien, former Prime Minister of Canada (Listen now)Part 4. Dr. Gordon Hoag, Senior Physician Quality Improvement Co-Lead (Listen now)

Qualitycast North is excited to bring you a special 4-episode series celebrating the 25-year anniversary of The Royal Commission on the Future of Health Care in Canada and the subsequent, ground-breaking, Romanow Report. About the Royal Commission and Romanow ReportIn 2001, the Federal government launched the landmark Romanow Commission, to examine the future of Canada's publicly funded healthcare system. Led by Roy Romanow, the Commission combined extensive research, expert analysis, and one of the largest public consultations in Canadian healthcare history. Through engagement with healthcare professionals, governments, Indigenous organizations, and tens of thousands of Canadians, the Commission developed evidence-based recommendations aimed at strengthening the sustainability and accessibility of Medicare for future generations.We're kicking off the series with the original instigator of the Commission and the Report, Canada's past Prime Minister, The Right Honorable Jean Chrétien. In this interview, we discuss why he chose Roy Romanow to lead the enquiry.Don't miss Part 2 of the series in which we interview Greg Marchildon, Roy Romanow's then Chief of Staff, on the background to the Commission and the mammoth task of organizing, completing and delivering the Report within their tight, 18-month schedule. Listen now: “How we built it and life on the road” featuring Greg Marchildon, former Chief of Staff to Roy Romanow.Links:Commission on the Future of Health Care in Canada: The Romanow Commission (Government of CanadaThe Romanow Report (download)The Specialist Services CommitteeQualitycast NorthSpecial Series Credits:Hosts: Dr. Shyr Chui, Dr. Eiko WaidaExecutive Producer: Aman HundalProducer: Lee CameronTechnical Support: Mat Walker (Expression North), Stefanie GarrawayPart 3. Dr. Verna Yiu, former CEO of Alberta Health Services (Listen Now)Part 4. Dr. Gordon Hoag, Senior Physician Quality Improvement Co-Lead (Listen Now)

In this episode we're returning to the rural community of Hazleton in Northwest BC. The demand for psychedelic-assisted psychotherapy is increasing as word spreads about its usefulness, but how should one design this service that best meets the clinical, social and cultural needs of its patients? That's the subject of Dr. Graham Bergstra's quality improvement project. By asking patients directly about their experience of care before, during and after their clinic visit, Dr. Bergstra explains how we can improve patient's experience of anxiety, vulnerability and satisfaction, whilst also ensuring they receive the most appropriate follow up care in the community. We also learn how this patient engagement work has been both rewarding to the care team and provided a template for expanding the service with new ketamine therapy clinics across the region.Links:Roots to Thrive Northern Health Physician Quality Improvement Program

When you think of Canadian health data, the organization that springs immediately to mind is the Canadian Institute for Health Information or CIHI. In this episode we interview Anderson Chuck, the President and CEO of CIHI, about how Canada is “data rich but information poor” and how using Pan-Canadian health data in the right way can drive improvements in health care quality. We also discuss how adopting the right data "mindset" can ensure sustainable Canadian healthcare in the future and improve economic resilience and prosperity for Canada as a nation.Links:CIHI(En)CIHI(Fr)Canadian Health Information Podcast

Delivering high-quality, emergency medicine education to rural practitioners and their teams for over 15 years, the Rural Coordination Centre of British Columbia's CARE course has been consistently rated amongst the best. But what are the secrets to its success? This week we interview its creators Dr. Jel Coward and Dr. Rebecca Lindley, both rural family docs based in Pemberton BC, on how delivering education that meets learners where they are, understands their reality and recognizes their humanity, provides the best learning environment possible. Links: Rural Coordination Centre of BC - The CARE courseRCCBC Rural Continuing Medical Education ProgramsThe CARE course

This week we're returning to the Executive C-Suite this time from a Physician's perspective with our guest Dr. Ronald Chapman, the Vice President of Medicine of Northern Health. We talk about his early commitment to a medical administrative career track, what a VP of Medicine does, his 13-year longevity in the role and what it takes to steer a large healthcare organization on a course towards higher quality care. We also touch on the benefits and challenges of living and working in rural communities and, if given his time again, why he wouldn't consider any other job in the world.Links: Northern Health home pageNorthern Health Physicians page

This week we're taking a well-deserved week off and so in preparation for this year's Rural Coordination Centre of BC's Rural Health Conference to be held in Prince George on May 29-31st, we're re-releasing one of our favorite archived episodes featuring RCCbc's own Dr. Ray Markham. In this episode, Dr. Markham takes us through his global career journey to his current practice in Valemount, NE BC, discusses some of the joys and challenges of rural family practice and shows us how rural primary care can also be high quality primary care. This recording was originally the first of two parts of a longer interview with Ray, and you can find the second part in our series archive as Series 4 Episode 9. Link: RCCbc Rural Health ConferenceMedicine at the Edge (Part 1) - If you're ever tempted to think medicine is practiced 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 PentagramRCCbcContinuing Medicine at the Edge (Part 2) - 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”.

One of the largest drivers of health outcome inequity for patients living in rural communities is access to care. This disparity is magnified when combined with low income, reduced patient mobility and the high costs of travel to tertiary centers, usually located in larger cities. Tackling this inequity head on is Hope Air, a non-profit organization which provides a lifeline for rural patients to access tertiary, specialist care. Currently celebrating Hope Air's 40th anniversary, today's guest, Mark Rubinstein, the CEO or “Chief Hope Officer” of Hope Air takes us through its incredible mission and gives us an insight into just how much can be achieved through a small team when its mission, values and impact are perfectly aligned. Links:Website www.hopeair.ca

In this episode, we return to Bulkley Valley District Hospital in Smithers, Northwest BC who, by combining high-level collaboration between local physicians, front line staff and operational leaders with quality improvement methodology, have generated startling improvements in what matters to staff throughout the hospital. Today's guest Dr. Kalah Blackstock, a local family physician and the Physician Quality Improvement Advisor for Northern Health takes us through their work building a healthier and more satisfied workforce whilst at the same time delivering a QI masterclass in multi-stakeholder collaboration and problem solving. Special shout out from Dr. Blackstock to the incredible team who made this work happen: Irindu Liyanage, Levi Giles, Ashley van der Meulen, Kate Niethammer, Darren Jakubec, Elena Raykov, Jen Comeau, Sophia Oumzil, Darcie Wadley, Cormac Hikisch, Billiejean Beaubien, and Emily Beirnes.Their collective efforts exemplify what can be achieved when people come together with shared purpose, curiosity, and care for both patients and one another.IHI Framework for Improving Joy in Work

As overfilled hospitals everywhere are struggling to cope with a busy winter of respiratory disease and influenza, many in healthcare are calling for a more “upstream” approach to preventing Emergency Department visits and hospital admissions. But intervening upstream is more difficult than it sounds. Today's guests have done just this. Talking us through their award-winning, quality improvement work in reducing ED visits and hospital admissions for patients with Chronic Obstructive Pulmonary Disease are Donna Jouantapp, Lina Alsakran and Dr. Zoe Pullan from Cowichan on Vancouver Island. In this interview, we learn how a well-designed project with a dedicated, inclusive and nimble team can overcome obstacles on the path to sustainable, cost effective and patient-centered care. Links: The INSPIRED COPD Outreach Program and COPD Care and Education Nova Scotia

Listeners will be familiar with the physician-led healthcare quality improvement work featured on this podcast, but they may not be familiar with how this work is formally supported at the Provincial level. In this episode, we interview Cindy Myles, the Vice President of the Specialist Services Committee, who gives us a primer on British Columbia's unique, Joint Collaborative Committees and the importance of multipartite collaboration when addressing healthcare's “wicked” problems. We hear how collaboration generates more sustainable change and how, during this challenging time for healthcare delivery, working together to improve the system can bring us hope for healthcare's future.Links:SSC NewsThe Exchange, a database of quality improvement projects supported by SSC and the Shared Care Committee JCC Website

In our current technological age, the most successful information platforms are those that provide exactly the information the user needs quickly and accurately. This is the underlying premise behind British Columbia's hugely successful medical information platform Pathways. In today's episode we interview its two eminent founders Dr. Kathleen Ross and Dr. Tracy Monk, about its early origin story and how it developed into the universal healthcare provider directory and an amazing, multifunctional, timesaving and educational resource in its current form. We hear how their strong guiding principles drove development of Pathways' form and function, how listening to users led to some of its best features and how quality improvement through innovation is not only rewarding but also fun.Pathways Links:To register go to www.pathwaysbc.ca and select "request access" at lower rightInfo pagehttps://pathwaysbc.ca/infoBackgrounder https://pathwaysbc.ca/ci/8684

In this gem of an interview, we chat with Christina Krause, the CEO of Health Quality BC about a whole range of topics around patient safety from the role of Provincial quality and safety organizations and the new BC Patient Safety Strategy to what's changed in our understanding of safer patient care. Through personal stories and experiences, Christina shares valuable insights into safer care through listening to patients' and families, the importance of psychological safety, and why everyone should just take just a little more time to understand one another's viewpoints. Listen and let Christina's infectious enthusiasm bring you to a new understanding of safer patient care.Links: HQBC Patient Safety StrategyHQBC “What matters to you?”

In this episode we feature another award-winning, quality improvement project this time based in Victoria, Vancouver Island. Our guests are Alanna Summers, Program Manager and a registered psychiatric nurse, Jennifer Sandburg, Team Lead occupational therapist, and Jane Dolan, MHSU Clinical recreational therapist, from the South Island Mental Health and Substance Use team. Starting with the gap in care they first identified, they take us through how they developed their cost effective and successful Bridging Care program for patients in mental health crisis. This program not only provides effective, patient-centered care but has also reduced hospital admissions and inpatient length of stay. We hear how local healthcare leadership had the foresight to support the original vision, powerful testimonials from some of the program's patients, and how developing the program itself brought positive benefits to the provider team. Links:Counselling, Treatment & Recovery | Island HealthNewsAdults experiencing mental health challenges benefit from Island Health's Bridging Care Program | Island Health

In this episode, we head upstream in our health system with this podcast's first ever guests from the public health sector. Northern Health's Medical Health Officer Dr. Diana Bark and Director of Public Health Lara Frederick take us through their QI work identifying, analyzing, and addressing a gap in dental health screening and dental caries prevention in pre-kindergarten age children in Northeast BC. We learn how QI methodology can be applied to complex problems in public health and how, through enhanced community engagement, their team provided valuable, preventative, dental care and improved health equity at the same time. Links: https://www.northernhealth.ca/services/programs/dental-health-program-for-children#baby-0-to-12-months-old

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 qualitycomms@northernhealth.ca.

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 qualitycomms@northernhealth.ca 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 qualitycomms@northernhealth.ca 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

Depression is a common and debilitating mental health condition affecting millions of people worldwide. Despite the availability of various treatment options, a significant proportion of individuals with depression do not achieve adequate symptom relief. One promising newer treatment is ketamine infusion therapy, but its current availability is relatively limited. Dr. Darren Jakubec is a GP anesthetist practicing in Smithers, where in addition to supporting surgeries at Bulkley Valley Regional Hospital, he provides pain management, counselling, and runs a dream clinic. Dr. Jakubec saw a unique quality improvement opportunity to use his skills and experience with anesthesia and mental health to bring ketamine infusion therapy to patients experiencing refractory depression in his local area of Northwest BC. The QI project was a true team effort that included patient partners, a patient peer advocate, a psychiatrist, clerical and nursing support. The project achieved positive patient outcomes and received very positive patient feedback. Dr. Jakubec shares the successes and challenges of this innovative approach to supporting mental health, and also discusses the joys of hockey, impromptu dance parties, and the value of paying attention to our dreams.

One of the most important aspects of quality in healthcare is patient safety. We often read or hear media reports of healthcare failures in patient safety, system errors and patients falling between the gaps but there is another piece to patient and public safety which is ensuring that our licensed physicians are safe to practice medicine in the first place. This role usually falls to the Provincial and Territorial Colleges and is a crucial one when it comes to protecting the public. In this episode, we are joined by Dr. Patrick Rowe, who has practiced emergency medicine in Northern BC and provided leadership for emergency medicine and trauma programs in Northern Health for many years before recently taking on a new role as the Registrar of the College of Physicians and Surgeons of BC. Dr. Rowe provides some insights into what the College of Physicians and Surgeons of BC does to protect the safety of patients accessing medical care in BC, the various quality programs it oversees, and the upcoming initiatives the CPSBC is engaged in to maintain and improve the quality of care in BC.

In this episode we're talking about a topic which every practicing clinician seems to have an opinion on, whether good or bad. Healthcare IT systems and electronic medical records or ‘EMR's. Over the last few decades, we've seen a massive expansion in the number and reach of these IT systems into every aspect of medicine and across our entire healthcare infrastructure. And although bringing benefits to the care we provide to patients; a new IT system somehow always seems to receive a mixed reception from front line clinical staff.  Here today to talk about healthcare IT and EMRs, our guest today is Dr. Bill Clifford. Dr. Clifford is that rare combination of both physician and software developer, previously awarded the Order of BC and the Doug Cochrane Leadership in Quality Award for his leadership work as the (now retired) Chief Medical Information Officer for Northern Health and creator of the no. 1 ranked, Electronic Medical Record in Canada ‘MOIS' (which stand for medical office information system). Dr. Clifford shares his experiences with medical information and technology, which interestingly began with a career in forestry and inspiration from forestry growth and yield modelling. We also chat about the future role of emerging technologies such as AI (artificial intelligence) and machine learning in improving healthcare quality. You can read more about Dr. Clifford's work and achievements here: Bill Clifford - Health Quality BC 

Drones, which are basically autonomous flying robots, have a variety of applications from controversial military operations to agriculture, cinematography, and package deliveries. Can this technology support improved healthcare services and healthcare equity in rural locations? Northern British Columbia comprises a vast geographical area the size of France, with a significantly smaller and dispersed population. Road links and municipal infrastructure to many of the smaller communities is limited and the harsh Canadian winters compound challenges to living during 6 months of the year. These challenges especially impact remote Indigenous communities, where accessing simple diagnostics or a pharmacy is greatly limited. These obstacles may seem intractable when it comes to providing healthcare, but rural physicians have responded by exploring the use of drone technology in their pursuit of healthcare equity. In this episode, we hear from Dr. John Pawlovich and project manager Sandy Lee about the UBC Drone Transport Initiative (DTI), an innovative project trialing the use of drone technology to improve geographic health equity in rural Northern BC that has developed in partnership between the Stellat'en First Nation, the Village of Fraser Lake, and the UBC Faculty of Medicine. Our guests share the joys of practicing and supporting medicine in rural and Indigenous communities, the importance and reward of community-led initiatives, and love for living and working in the beautiful province of BC.

Today, the practice of modern medicine has changed and is now far more intense, complex and demanding of physicians than ever before. It may not come as a surprise to find, therefore, that physicians are now burning out at an ever increasing rate. The issue is one that often remains hidden or unrecognized but has implications for the resilience and sustainability of our healthcare system.  On todays episode we're talking about Physician wellness and burnout, and the inspirational work local physicians are engaging in to tackle this growing issue. Dr. Ingrid Cosio is a family physician who has been practicing in Prince George for over 18 years. In addition to being an award-winning family doctor and providing medical leadership to the Northern Gender Clinic, in Summer 2022, she successfully applied on behalf of the PGMSA for the Physician Peer Support Pilot Project, a Physician Health Program initiative. The Prince George Physician Peer Support Program was created as a way to combat burnout and support the mental well-being of other physicians. She also shares her own strategies for self-care such as early morning running and the drawing from stoic philosophy.

It is well established that Indigenous peoples accessing the health system are subject to harm, and a lower quality of care. Many healthcare organizations are acknowledging this truth and making commitments to address systemic anti-Indigenous racism and improve cultural safety within the healthcare system. In this episode, we're hearing from Northern Healths collaborative medical leads for Indigenous Health Drs Todd Alec and Sheona Mitchell-Foster. Dr. Alec is an Indigenous physician originally from Nak'azdli Whut'en, Beaver Clan. He currently practices family medicine with Carrier Sekani Family Services, located on the traditional territories of the Lheidli T'enneh (colonially known as Prince George), and also provides care through the First Nations Health Authority's Virtual Doctor of the Day program.  Dr. Sheona Mitchell-Foster is a settler obstetrician-gynecologist also based on unceded Lheidli T'enneh territory. In addition to providing high risk obstetrical care and full spectrum surgical gynecology, she teaches with the Northern Medical Program and has research interests in low-barrier options of cervical cancer screening for Indigenous women in the north. Drs Alec and Mitchell-Foster share their experiences and learnings, and discuss how healthcare providers can strive to deliver culturally safe care, to uphold Indigenous people's rights to self- determined health and wellness. They also share how they live their values, and find joy in sharing time  and staying active with their families in Northern BC. We'd like to note that Indigenous is a general term inclusive of First Nations, Métis, and Inuit. We acknowledge that inclusive terms have the potential to diminish diversity and the unique realities of different peoples. The use of Indigenous in this case is intended as an inclusive commitment to improving health outcomes for each group. 

We're back with our 3rd season of Qualitycast North, with a great episode on improvement in the Ultrasound department. Ultrasound departments everywhere have never been busier and patients with complaints involving all parts of the body visit the department every day.  Ultrasound is the first line choice for visualization of the appendix when diagnosing possible appendicitis in children, young adults and pregnant women. When the appendix is not visualized on ultrasound, the patient may be scheduled for a CT which introduces additional radiation and may delay diagnosis and therefore delay treatment. At the University Hospital of Northern BC (UHNBC), finding the appendix was proving to be challenging and the department was visualizing the appendix at rates much lower than expected based on the literature.  Karina Hansen, the former ultrasound supervisor of the UHNBC ultrasound department and Carly Phinney, a Northern Health Quality Improvement Facilitator, teamed up with a local radiologist to tackle the problem. They were able to support the department to improve their appendix visualization  and brought the rate up to 76.9%, representing a total increase in visualization of 42.4% from baseline. The change ideas they trialed were so successful, they have been adopted as routine practice by the sonographers, and are being spread to other facilities throughout Northern BC.

Approximately 10% of the population (which translates to around 500,000 people in BC) believes they have a penicillin allergy and are labelled as such in their patient records, but in reality, more that 90% of these patients do not have a true penicillin allergy.  These false penicillin allergy labels can have serious consequences to both individual patients and the system; a false allergy label can lead to the use of an alternative antibiotic, which may have increased side effects, increased costs, and can lead to antibiotic resistance. Proactively ‘de-labelling' patients that have an inaccurate penicillin allergy label can help avoid these risks. Dr. Tiffany Wong is a pediatric allergist based at BC Women's and Children's Hospital and is an advocate for choosing the best medications for patients, which involves proving or refuting true drug allergies. Dr. Wong and her team have developed a mobile de-labelling tool to support healthcare providers to do this work in their own settings with their patients. This involves a risk assessment and follow-up processes to accurately diagnose patients deemed as high-risk in a way that is safe, standardized, and evidence based. She has also been working with patient partners to co-design patient resources, so patients and caregivers can be empowered to understand penicillin allergies. These resources are available at https://www.dropthelabel.ca/. This work is also currently being adopted at the University Hospital of Northern BC, with support from the Spreading Quality Improvement Initiative, so the benefits of penicillin allergy de-labelling, and associated improvements to patient care, will be realized in the North. Dr. Wong also shares how having a pet and participating in family based activities with her children and husband out in nature helps her to avoid burnout. Links: Drop the Label resources for providers, patients, and caregivers: https://www.dropthelabel.ca/ Assessment of multiple-opinion referrals and consults at the BC Children's Hospital Allergy Clinic Allergy, Asthma & Clinical Immunology Adam P. Sage and Elliot James and Megan Burke and Edmond S. Chan and Tiffany Wong DOI: 10.1186/s13223-023-00806-2 06/2023

In this episode, we are featuring the Physician Quality Improvement (PQI) program's provincial alumni co-leads, Dr. Lawrence Yang and Dr. Hussein Kanji. Dr. Yang practices in a ‘family-family' practice alongside his wife and brothers, providing cradle-to-grave care in Surrey, BC. Dr. Kanji is a critical care physician that works primarily in the ICU at Vancouver General Hospital and is passionate about developing the ECMO (extracorporeal membrane oxygenation) programming there. Both Drs Yang and Kanji came to the PQI program though a need to solve their own frustrations with the healthcare system. After graduating from their respective level 3 PQI cohorts (which is equivalent to the Virtual Action Learning, aka ‘VALS', series offered by Northern Health PQI) and engaging with PQI for several years, they collectively took on the roles of provincial alumni co-leads. All physicians in BC that graduate from the PQI trainings join the provincial alumni network, which provides these physicians who are now experienced and knowledgeable in quality improvement methodologies and tools, to continue to apply their skills and passions to ongoing system improvement, while also engaging in a province-wide community. As provincial alumni co-leads, Drs Yang and Kanji work together (Kanji describes himself as the ‘yin' to Lawrence's ‘Yang') to support, embody, and connect with all quality improvement enthusiasts across the province, and facilitate ‘cross-pollination' of ideas to drive positive change. They also share their love of all of the spectacular nature we are blessed to have in BC and share their strategies for preventing burn-out and maintaining mental health while working in such fast paced careers.