Centre de santé et de services sociaux de Québec-Nord

  • Natalie Petitclerc, Directrice générale adjointe, Centre de santé et de services sociaux de Québec-Nord, Québec, Quebec (Assistant Executive Director)

Développer la mesure pour soutenir l’amélioration continue de la qualité des services

Developing Measures to Support the Continuous Improvement of Service Quality

The needs of the population, knowledge development and the availability of resources are all factors exerting growing pressure on heath care institutions.

This increasing pressure is leading to a feeling of discomfort. Are we offering quality services? Are we doing the right things? How do we measure our outcomes? Are our sources of information reliable? How do we interpret our results? What is our position in relationship to that of others? Are we doing certain things well? How can we support the continuous improvement of our service quality? Uncertainty settles in and one wonders from which angle performance should be approached.

A review of evidence-based data makes it possible to examine the concept of performance and to learn how this change should be brought about.

Indeed, the aim of management is to constantly improve performance. There would be no performance without involving management in the adoption and implementation of change. For management to achieve its aim of improving population health, it must be able to define performance, to recognize the complexity of the processes in need of optimization, and to count on decision-making support tools. Therefore, it is necessary to resort to the use of an “Integrative” Model.

Whether it is integrative or not, establishing an assessment framework for organizational performance is a major challenge and constitutes complex change where the rate of success is usually quite low. It is in our interest to integrate lessons learned when examining evidence-based data on management and communications change in order to increase our chances of success.

We have learned that the consistency, credibility and legitimacy of a project need to be preserved by establishing a dialogue with all stakeholders early in the process so as to ensure a commitment to change and a common understanding of problems, solutions and supportive approaches.  It should be noted that the participation of all involved, the coordination and follow-up of results and quality communications are strategies that should not be overlooked.

We wish to emphasize that a major change requires a management approach separate from the administration of the day-to-day affairs of the organization, and that knowledge transfer and skill development should not be overlooked.

Finally, this project has made it possible to support continuous improvement of service quality. More specifically, we have:

  • Deployed an assessment framework for organizational performance based on the Global and Integrated Evaluation of the Performance of Healthcare Systems (EGIPSS in French);
  • Established a dashboard adapted to the needs of the organization’s various levels and stakeholders;
  • Set up management practices supported by the use of measurement indicators;
  • Supported the development of management skills with respect to performance assessment, continuous improvement and process review.

More than five hundred (500) people were involved from the beginning of the project and interesting results have been observed:

  • A one-stop shop for data has been created. Over the first five months of operation, one hundred and thirty-three (133) new requests for measurement indicators have been received and seven hundred and sixty-two (762) repeat requests have been identified;
  • The available information is now organized into a strategic dashboard based on the model and according to the four key issues and parameters set forth in the Global and Integrated Evaluation of the Performance of the Healthcare System.
  • The management team received a “white belt” according to the Lean Management approach and twenty-one (21) Managers received a “green belt”. Consequently, sixteen (16) continuous improvement projects were carried out. Two hundred and fifty (250) people took part in these projects, measured their processes and were exposed to the performance indicators. Fourteen (14) projects are in the planning stage and will be carried out by May 2014;
  • An environment, coordination measures, standards and measurement indicators have been set up to ensure the consistency of the projects targeting the continuous improvement of service quality.
  • The organizational plan was revised by integrating performance and information technologies at the Assistant Executive Director level.