Continuous Quality Improvement
The Saskatchewan Health Quality Council shares stories of continuous improvement that are making health care better and safer in Saskatchewan.
1. Continuous Quality Improvement Across Saskatchewan's Health Care System
Saskatchewan's health care system has a goal of achieving a fully integrated patient-first health system with no waits, waste, or defects, while continually improving quality. To achieve a transformed patient-first health system, Saskatchewan integrates continuous improvement approaches and methodology with patient safety, quality, risk management, accreditation, and patient- and family-centred care.
By engaging staff and patients in improvement work, Saskatchewan uses proven methodology, including Lean, to put the needs and values of patients and families at the forefront. Lean is the continuous pursuit of improvement through the elimination of waste as defined by the patient. Lean engages and empowers employees to generate and implement innovative solutions, and to fundamentally improve the patient experience on an ongoing basis.
Saskatchewan is the first province in Canada to use this approach across the entire health care system. More than 1,500 continuous improvement projects have been launched in Saskatchewan's health system.
For more information, visit the Saskatchewan Health Quality Council. The council accelerates improvement of health and health care across Saskatchewan by building improvement capability, and spreading innovation throughout the province through education, improvement initiatives and research.
2. Continuous Quality Improvement Contacts
| Health Quality Council | 306-668-8810 ext. 110 |
| Ministry of Health | 306-787-7507 |
| Cypress Health Region | 306-741-3669 |
| Five Hills Health Region | 306-691-7664 |
| Heartland Health Region | 306-882-4111 ext. 2302 |
| Kelsey Trail Health Region | 306-752-8815; 306-873-6617 |
| Prairie North Health Region | 306-820-4856 |
| Prince Albert Parkland Health Region | 306-765-6410 |
| Regina Qu'Appelle Health Region | 306-766-0795 |
| Saskatoon Health Region | 306-655-0160 |
| Sun Country Health Region | 306-842-8207 |
| Sunrise Health Region | 306-786-0421 |
| Keewatin Yatthé Health Region | 306-235-5839 |
| Mamawetan Churchill River Health Region | 306-425-4823 |
| Athabasca Health Authority | 306-439-2200 |
| Saskatchewan Cancer Agency | 306-625-2052 |
| 3sHealth | 306-347-5588 |
| eHealth Saskatchewan | 306-337-0615 |
3. Glossary
Lean is a patient-centred approach to identifying and eliminating all non-value-adding activities and reducing waste within an organization.
Kaizen
Kaizen means "continuous improvement" or "change for the better." Typically, it's a short team-based improvement effort.
Production Preparation Process (3P)
3P is a Lean tool used when a totally new process or design is required. Often used in facility design, the goal is to ensure quality, safety, flow and efficiencies are built into the new design. 3Ps are typically week-long events involving a team of providers, staff and patients.
Rapid Process Improvement Workshop (RPIW)
RPIW is a week-long event where teams of patients and family members, staff and clinics focus on one problem, identify the root causes, and create and test solutions. By week's end, they are ready to implement the solution in the workplace. The team checks the solution at 30, 60 and 90 days to see if it has worked and has been sustained.
Hoshin Kanri
Hoshin Kanriis a management method that comes from the Lean approach to improvement and is used to deploy strategic priorities throughout an organization.
Mistake Proofing
Mistake proofing examines the root cause for mistakes and aims to prevent them before they create defects. Making proofing also eliminates rework and reduces costs.
5S
Five terms beginning with "s" used to create a clean and well-organized workplace, which in turn promotes teamwork and safety, cuts costs and improves productivity:
- Sort: Separate the necessary from the unnecessary items.
- Simplify: Find the best place for everything and keep it in its place.
- Sweep: Identify potential problems and deal with unsafe conditions or damaged items or equipment.
- Standardize: Define how a task should be done and communicate this best practice to everyone involved.
- Self-discipline: Ensure the area remains clean and organized and that everyone maintains the new processes.
A way of automatically signalling when new parts, supplies or services are needed, in the quantity needed, and at the time they're needed. A Kanban signal is usually a card, indicating the need to reorder supplies. However, it can be a special container or another type of visual cue.
Value Stream Map
A visual tool used to help see and understand the flow of patients, supplies, or information through the health care experience. It maps all actions currently required to deliver a service or product and provides a big picture perspective that focuses on improving the whole from the standpoint of the patient.
Gemba
Place where the work is performed i.e. hospital floor or cafeteria.
Lead time
The total time of the patient experience process being observed. This is measured with a stopwatch. For example:
- From the time the patient walks into the hospital until the time they are through admitting.
- From the time the patient registers for day surgery until the time they are discharged home.
Waste is anything that does not add value through the eyes of the patient. There are seven identified wastes in health care. They are:
- Inventory: Too much. For instance, anything kept for "just in case."
- Motion: Having to walk to multiple locations in search of supplies or information.
- Defects: Errors that make it to the patient.
- Transportation: Moving patients from room to room or various other locations.
- Processing: Capturing patient information in multiple locations.
- Overproduction: Creating 100 packages when only 15 are needed in the week.
- Time: On the part of the patient or staff.