Why does Canada need a National Quality and Patient Safety Framework for Health Services?
- Topics
- Patient safety
- Policy
- Audience
Healthcare leader
Policy advisor or analyst
Point of care provider
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The need for a national patient safety and quality framework
Health services across Canada are comprehensive, complex and at times complicated. Every person in Canada deserves safe, high-quality healthcare when and where they need it. For the most part, this is our experience.
But we don't always get it right. People may be inadvertently harmed by the services intended to help them.
The reality is that unintended harm occurs in a Canadian hospital or home care setting every minute and 18 seconds.
Every 13 minutes and 14 seconds, someone dies.
Patient safety incidents are the third leading cause of death in Canada.
We observe substantial variation in care by age, gender, race, ethnicity, geography, and socio-economic status. Systemic barriers make accessing high-quality health services more difficult for First Nations, Inuit and Métis, Black communities, racialized and newcomer populations, 2SLGBTQIA+ people, persons with disabilities, those with low income, and many others who face intersecting forms of marginalization. While some jurisdictions have quality and safety plans or frameworks in place, people continue to experience healthcare differently across the country.
These considerations, when added to the heightened need for consistency and coordination in healthcare as a result of the COVID-19 pandemic, prompt us to ask: How can we focus and align quality and safety improvement throughout the country, regardless of jurisdiction?
The Framework is the first of its kind in Canada
We can all work together to accelerate quality and patient safety across health systems in Canada by focusing all stakeholders coast to coast on five goals for safe, quality care.
This people-centred framework defines five goal areas designed to drive improvement and to align Canadian legislation, regulations, standards, organizational policies and public engagement on patient safety and quality improvement.
It includes action guides and resources customized for each stakeholder group to support you in putting the goals into practice.
Share your experience
How have you used the Canadian Quality and Patient Safety Framework to drive quality and safety improvements? Please email leadingpractices@healthstandards.org and share your experience with us for an opportunity to be profiled as a leading practice or a case study.
Mapping tool
A mapping tool was developed to help you map your organization's current quality and patient safety improvement initiatives to the goals, objectives and outcomes of the Framework. This exercise will help demonstrate your organization's strengths in aligning with the Framework and uncover opportunities to work toward these key goals for safe, high-quality care.
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Why do we need a framework?
To truly align efforts across Canada toward better and safer care we must prioritize coordinated action. Collective action across jurisdictions in Canada is needed now more than ever before. The Canadian Quality & Patient Safety Framework (the Framework) is the roadmap that can align the country as we work to safely enhance health services. It is already being used in many jurisdictions at different levels.
Read case studies to learn how organizations have been using the framework to improve patient safety in their organizations.
For any questions, comments or to share your experience using the Framework, please contact qualityservicesforall@healthstandards.org.
Developed with broad consultation, including with patients and families
The Framework was developed in consultation with members of the public, health leaders, policy makers, board members and health teams (including patients and families). The processes also included numerous committee meetings, international and national environmental scans, key stakeholder interviews, a national public consultation and further targeted consultations with key stakeholder groups.
This comprehensive approach was prioritized to ensure the Framework package reflects both current and emerging trends and the realities of health systems across Canada, regardless of jurisdiction. The accompanying action guides, resources and indicators are curated implementation tools to support all stakeholders with using and implementing the Framework package, regardless of their role or care.
Highlights of the Canadian Quality and Patient Safety Framework evaluation
Everyone in Canada deserves safe, high-quality healthcare where and when they need it. Yet inequities and systemic barriers mean that access to this fundamental right is not the same for all. These considerations prompted Healthcare Excellence Canada (HEC) and Health Standards Organization (HSO) to ask: “how can we focus and align quality and safety improvement throughout the country, regardless of jurisdiction?”
The Canadian Quality and Patient Safety Framework for Health Services is the first of its kind in Canada. It spearheads a coordinated effort to align stakeholders and providers in how they work to provide safe, high-quality care.
Following the implementation phase of the Framework, HSO and HEC facilitated an impact evaluation to understand how well the Framework’s strategies were shared, the short-term impacts of increased awareness around patient safety and how the Framework resulted in early indications of quality and safety practice changes within the health system. A summary of the evaluation findings can be accessed here.
Five goals for safe, quality care
Goal 1: People-Centred Care
People using health services are equal partners in planning, developing, and monitoring care to make sure it meets their needs and to achieve the best outcomes.
Goal 2: Safe care
Health services are safe and free from preventable harm.
Goal 3: Accessible care
People have timely and equitable access to quality health services.
Goal 4: Appropriate care
Care is evidence-based and people-centred.
Goal 5: Integrated care
Health services are continuous and well-coordinated, promoting smooth transitions.
How you can use The Canadian Quality & Patient Safety Framework for Health Services
We all have different roles to play in healthcare in Canada. Along with members of the public, health teams (including patients), health leaders, board members and policy makers, this Framework outlines the essential role of families, caregivers and care partners in enabling quality health services and patient safety.
The Framework provides custom action guides to 5 stakeholder groups.
Tracking Your Success
Key Indicators to track your progress
The Canadian Quality and Patient Safety Framework package includes key indicators to help you track progress towards improving quality and patient safety. The indicators should help you create appropriate performance measures for each objective. Each indicator‒when measured using a national, jurisdictional, or local data source‒will offer insight into your success in improving quality and patient safety.
We aimed to create an indicator set that is both comprehensive and practical. Each indicator was selected based on:
Its relevance to the objective.
How comprehensively it reflects the objective.
The existence of data sources that can be used to measure the indicator.
The adaptability of the indicator to various local contexts.
The availability of national data to facilitate interjurisdictional comparisons.
We also strived to keep the total number of recommended indicators low. In total, the Framework contains 18 indicators across 13 objectives. In most cases, an objective can be tracked by a single indicator.
Measuring your success
The indicators should help you create appropriate performance measures for each objective. Each indicator‒when measured using a national, jurisdictional, or local data source‒will offer insight into your success in improving quality and patient safety.
The indicators are not required to be measured using a specific data source. You should identify data sources for each indicator that are suitable to your context. We have, however, identified example data sources you can use as a guide in developing your own measures and for cross-jurisdictional comparisons. We encourage you to build measures for indicators with data that best represent your own context and jurisdiction.
As you measure the indicators, we encourage you to look for ways to compare results across various sociodemographic and geographic groups‒including underserved populations. These comparisons can help you see whether objectives are being met equitably across these sub-groups. Some of the indicators are worded in a way that encourages these comparisons. You should look for ways to measure equity wherever possible.
Finally, this set of indicators, along with the example data sources, is intended to be a ‘living document.’ Some sectors, such as the acute care sector, are better represented by currently available data and‒as a result‒better represented in our recommended data sources. As newer and better indicators and data sources become available‒including those that better represent other sectors ‒ we will work to update these indicators accordingly.
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