Pan-Canadian collaboration on health-care innovation can deliver real change

Across the industrialized world, governments and health-care organizations face aging populations and growing rates of chronic disease as well as patients and families with unprecedented access to health information and an appetite to be engaged in their care. In this environment, promoting innovation in health care has never been more important. As federal, provincial, and territorial health ministers recently stated: “service delivery innovation is a vital component of sustainable, quality health systems.” This year marks the 50th anniversary of medicare in Canada. Many provincial and federal commissions, and scores of research reports, have outlined approaches that would deliver better care, health, and value. Yet there remain persistent challenges to achieving this ‘triple aim.’ Despite significant public sector spending and the efforts of governments and health-care organizations, Canada ranks poorly on quality measures. The Commonwealth Fund’s 2014 health scorecard ranked Canada 10th of 11 countries, including last on timeliness of care and second last on safety and efficiency. Canadians report difficulty accessing after-hours care and same- or next-day appointments; the longest waits to see a specialist; the greatest use of emergency departments; and the highest readmission rates. And we are eighth of 11 in patient-centred care. How can we innovate to address this situation? We can methodically build out from innovations well-tested in real life on a small scale, so that better ways of doing things spread across the country—innovations that improve patients’ lives and produce more value for taxpayers. As the Advisory Panel on Healthcare Innovation chaired by Dr. David Naylor recently observed, “... pockets of extraordinary creativity and innovation dot the Canadian healthcare landscape. Local, regional and even provincial programs worthy of emulation have simply not been scaled up across the nation.” The Canadian Foundation for Healthcare Improvement is working with health sector partners to reverse this trend. A federally-funded, not-for-profit organization, we collaborate with healthcare providers, managers and executives in hospitals, health regions and provincial-territorial health ministries to spread evidence-informed solutions across provincial and territorial lines—ensuring that best practices are implemented from Victoria to Yellowknife and Halifax. This approach delivers real results. A 2014 independent evaluation by KPMG concluded: “It is clear that CFHI has been able to support substantive positive impacts on the Canadian healthcare system,” and CFHI generated “significantly more benefits to Canada than the funding investments being made .” Today, CFHI is spreading and scaling innovative programs across Canada. These innovations began as the ideas of physicians, nurses and healthcare managers who wanted better care for their patients. For example, an approach to curbing the inappropriate use of antipsychotic medications in long-term care facilities that improves care for residents with dementia. People with dementia can be aggressive, resist care and show other challenging behaviours. In such instances, antipsychotic medicines are often prescribed, but they provide limited benefit and can cause serious harm, including premature death. Currently, one-in-four residents of long term care in Canada is taking an antipsychotic medication without a diagnosis of psychosis. One solution: implementing more personalized care plans for residents, such as tailored recreation and music therapy that reduce reliance on antipsychotic medications. After supporting the Winnipeg Regional Health Authority to lower its use of antipsychotics, in 2014 we launched a pan-Canadian collaboration to spread this successful approach. Fifty-six long term care facilities across seven provinces and one territory participated, and more than half the residents had their antipsychotic medications discontinued or reduced without an increase in disruptive behaviours. Just as importantly, we saw a 20 per cent decline in falls by participating residents. The result: better quality care at lower cost. Next, CFHI will be working with provincial partners to scale across an entire province the success achieved by our pan-Canadian medication reduction collaboration. In the coming weeks we will announce the first such partnership to scale-up our antipsychotic initiative to every long-term care facility in a province. We are excited about this work and the benefits it will bring long-term care residents, their families, health-care professionals and the provincial healthcare system. But there are many more opportunities for improvement across the country, where pressing healthcare challenges can be met by supporting the implementation of best practices. Scaling-up proven health-care innovations is the best way to build innovative and affordable health-care systems. CFHI will continue to work as a catalyst for real change in health care—delivering real results for all Canadians.

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Pan-Canadian collaboration on health-care innovation can deliver real change

Scaling-up proven health-care innovations is the best way to build innovative and affordable health-care systems.

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