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Hospital-wide engagement creates a quality improvement culture


Quality improvement champion Dr. John Hwang has teamed up with Royal Columbian Hospital administrators and frontline staff to build a culture of continuous improvement across the hospital.

The seed was planted in 2015 when Dr. Hwang and a team of frontline staff organized a “QI Day” for surgical services with the support of RCH administration. At the time, little was known about quality improvement activities around the hospital, so this was an opportunity both to teach participants about the importance of frontline engagement and to celebrate the accomplishments of unit-based QI teams.    

Based on feedback from the inaugural QI day, the organizing team developed a series of frontline engagement workshops.  The aim of these workshops was simple: to teach those working on the frontline that continuous quality improvement is part of every provider’s job, and that making small changes within their scope of practice can collectively lead to big improvements in patient care.  The following year, quality measures that had been stagnant for a decade showed notable changes in just about every area, ranging from surgical site and urinary tract infections to pneumonia. 

Buoyed by those successes, the QI team (newly dubbed the RCH QI League) expanded the effort right across the hospital in 2018 with a series of regular workshops leading into an annual QI Day in the spring.  Physicians, front line staff and administration from all clinical services and departments contribute ideas, and learn how move them into action. With the support of Facility Engagement, physicians are able to take time to attend the sessions and provide ongoing leadership and mentoring.  Participation has grown year after year.

Results are measured, and annual improvements are acknowledged, celebrated and spread across departments.  “The first year we saw remarkable results. But the success was not a result of just one thing,” says Dr. Hwang. “It was because we focused on culture. So I see this ongoing effort not just as a QI Day, but a culture day – the recognition that everyone on the team has a responsibility to look within our personal scope and improve care as we can.”   

Photo credit: Wendy D Photography/Fraser Health