Improving the efficiency and effectiveness of the kidney transplant process in Eeyou Istchee
This project aims to address the development of a case management process that will reduce the amount of travel and number of stays, while providing more responsive and culturally safe services for Eeyou Istchee (EI) clients entering the kidney pre-transplant process. The EXTRA team hopes to reduce the amount of travel and the duration of the process, while improving the quality of care and services.
The current situation will be modified to a case management process that will seek opportunities that favour telehealth and on territory appointments. For services unavailable on the territory, or unavailable in a reasonable delay, the case manager will attempt to combine multiple appointments during the same stay.
Ultimately, the data and results of this project will guide decisions regarding clients’ travel policy and the reorganization of Wiichihiituwin and Specialized Services processes.
‘’The perioperative trajectory: co-constructing the care episode for a better patient experience’’
The objective of this project is to diminish anxiety associated with the surgical process through a co-construction of the thoracic surgery care episode. To this end, we want to create a partnership while maintaining a strong shared responsibility with the person and their loved ones as well as the care team. The project is aimed at integrating the patient-partner in the development of tools to support communication and collaboration in the clinical choices concerning them, in keeping with a holistic vision throughout the perioperative trajectory in pulmonary oncology. This approach is in line with our organization’s strategic directions, and we want to use validated measurement tools to demonstrate the positive impacts on anxiety management and patient satisfaction during their care episode.
“Two heads are better than one – Strengthening medical-administrative leadership to better serve the patient”
Medical-administrative co-management is a “management model in which a physician and a clinical/administrative manager share management responsibilities within a client program or service unit.” – (Ann Langley, Ph.D., October 2011). The gap between the co-management behaviours expected by managers, the difficulty in moving toward common goals in managing activities, and the lack of management skills are some of the problems (among others) that slow down “attempts to overcome heroic and romantic conceptions of leadership based on a single individual.” At the CHU de Québec — Université Laval, physicians feel ill-equipped because of their lack of management training and skills, as well as their lack of knowledge and understanding of the administrative process and organizational hierarchy. This is also true of administrative managers, who have scarce knowledge of the medical hierarchy and lack the tools, operating structure, and follow-up mechanism for project co-management. The EXTRA project will serve to strengthen medical-administrative co-management at the CHU de Québec - Université Laval. Targeted co-management team: medical and administrative managers in gastroenterology.
“Enhanced quality of care by improved practice support for nurse practitioners in primary health care”
The project takes a collaborative approach, with the members (managers, nurse practitioners in primary care (NP-PHC), professors, and professionals) working together to put in place a process and tools for improving the quality of nursing interventions by NP-PHCs. These activities will help managers support NP-PHCs in their work and thus promote best practices while ensuring safe, competent care and the assistance and resources required to fill and/or remedy gaps, as needed.
Finally, with this project, the EXTRA team hopes to improve patient and family care and to foster greater reflexivity in nurse practitioners in order to promote their professional development.
“Establishing a service offer and a centre of expertise in crisis intervention throughout Montérégie-Est in accordance with the needs of the population and in collaboration with local partners.”
Designing an offer of community crisis intervention services adapted to the emerging needs of the population and the socio-health and cultural context is an organizational priority for the CISSS de la Montérégie-Est.
Based on best practices and influenced by the experiences of stakeholders, improvements to our service offer are expected to be made in accordance with the following four pillars:
Each component will be supported by a cross-cutting framework for measuring the performance and satisfaction of the main stakeholders concerned (patients, employees, or community partners).
“Democratizing learning and innovation: a pillar for excellence in care and services”
The premise of our improvement project is to bring about an organizational culture of learning by democratizing access to the best knowledge in order to accelerate its application in clinical, administrative, and management practices, while also promoting innovation in our technological and/or real estate solutions. In recent years, the CISSS de Chaudière-Appalaches (CISSSCA) has set up control rooms, which are tools supporting the organizational performance measurement and management system. These rooms are connected to the processes that the organization has put in place to better manage its portfolio of organizational projects. Our main objective is to improve these processes in order to achieve a better balance between the four pillars of the performance of CISSSCA’s Vrai Nord by putting greater focus on the “learning-innovation” dimension. Improving the management of this dimension will serve as a common thread, helping to more intensively share and mobilize the best available knowledge and promoting the co-construction of innovations by all participants in care and services. The project aims to adopt the means, in the context of SAPA control rooms, to better define and measure learning and innovation in an integrated, coordinated and sustained way, in order to continuously improve these elements and create real value.
“Continuum of integrated outpatient care and services - complex pediatric clienteles”
This innovative project aims to develop a model of integrated outpatient care for pediatric clients with a complex clinical care profile requiring multidisciplinary care and health services. This model of integrated outpatient care aims to break down silos between institutions, promote clinical cooperation and service integration, and decrease hospitalization episodes. Consistent with the premises of the management model set forth by the MSSS, we will promote the integration and coordination of care and services by eliminating breaks in the continuity between transition points. We want to ensure that integrated services revolve around the child, and to prioritize evolving family needs and the maintenance of family dynamics in our decision-making, by bringing children’s care closer to home. This will transform the hospitalization experience into an outpatient one, thanks to the values of diligence, compassion, and collaboration that will guide our decisions throughout our process.
“Ensuring that no one with a complex mental health issue has to suffer alone.”
The EXTRA team aims to develop adapted, integrated, and preventive services for "heavy users" of emergency services through an approach that promotes the recovery of the person in their natural environment and with the increased involvement of their loved ones.
In this way, the person and the various resources will be part of a single integrated network in which all parties interact to create a coherent trajectory from the standpoint of the service user's experience.
Implementing an intervention plan tailored to the complex needs of patients will ensure the fluidity and continuity of care within the community consistent with the life project of the person living with the issues.
It would be interesting to explore a new interdisciplinary team model, which, in a 24/7 context, could assist patients in planning their discharge from the hospital to an adapted resource or home. The objective is to accelerate patients’ return to their own environment after long, repetitive hospital stays.
With this project, we hope to improve the service offer in the community in order to provide effective and efficient services for these people who are often caught in the “revolving door” syndrome.