Interview with Tara Sampalli

CFHI Interview with Dr. Tara Sampalli
Nova Scotia Health Authority – Central Zone (formerly Capital Health)

Improvement Conversations: Interview with Tara SampalliNova Scotia Health Authority – Central Zone (formerly Capital Health) and CCHL Executives at CCHL Awards: My Care My Voice Initiative receives 3M Quality Team Award. Dr. Sampalli is third from left.

In a new, occasional feature, we interview leads of CFHI-supported projects currently underway. This month, Dr. Tara Sampalli, Assistant Director, Research, Quality and Knowledge Management at Primary Health Care, Nova Scotia Health Authority (NSHA) – Central Zone, describes her team’s progress reducing wait times for patients with complex needs. This project recently won the Nova Scotia Health Authority (NSHA) Gold Quality Award and the Canadian College of Health Leaders (CCHL) 3M Quality Team Award.

Could you please briefly describe the ‘My Care My Voice’ project that won these prestigious awards?

The My Care My Voice Integrated Chronic Care Service (ICCS) initiative is about improving patient experience and patient engagement by including the patient voice in the care delivery processes for complex chronic care management. While the primary area of focus of the initiative was to enhance patient experience and engagement, we were also able to reduce wait times as a secondary outcome of this initiative.

Watch the video of the My Care My Voice initiative, ICCS initiative to improve care for complex patients.

Share some of the key results that made this a winning project.

First, embedding a patient engagement process that includes the patient’s voice - from intake to transition and from inform to collaborate (the IAP2 framework) in our care delivery process. Secondly, reducing wait times from 13 months in 2012 to no wait times in 2015. Read the publication.

What population did this project impact and how did it improve care for those patients?

Patients with multimorbidities, medically unexplained conditions, unknown diagnoses, chronic pain, fibromyalgia and related disorders, and individuals with significant functional health limitations despite receiving medical interventions. These individuals can be high users of our system, our emergency services and our primary care providers because they experience gaps in their care given the challenges of chronic conditions and the myriad symptoms.

These individuals also experience significant challenges to their day-to-day function and have a poor quality of life as a result of these complexities. By reducing wait times to care and enabling early access to timely and relevant care to individuals, and by including the patient’s voice in our care delivery process, we are able to support them in addressing the gaps in their care at intake and collaboratively develop a suitable care plan. We can also support individuals in meeting their self-selected functional health goals with relevant treatment, education and tools.

How did this initiative evolve from your CFHI-supported project in the Atlantic Healthcare Collaboration (AHC)?

Four service areas were selected to participate in the Atlantic Healthcare Collaboration at Capital Health; ICCS was one of those service areas. Our improvement initiative at Capital Health was to improve care and care experiences for chronic conditions and multimorbidities. Our two objectives were to identify improvements and strategies at a system-level and the other was to identify improvements at the program level for each of the participating service areas. My Care My Voice is a program-level initiative for ICCS with the focus of improving care experience in the management of complex chronic conditions. 

Did you gain any skills, knowledge or abilities through CFHI’s AHC that contributed to the success of the ‘My Care My Voice’ initiative? Please explain.

The Atlantic Healthcare Collaboration created several significant opportunities for learning, collaboration and sharing. Learning from experts such as Dr. Ed Wagner, fabulous mentors, amazing CFHI staff, from the Triple Aim session and CFHI workshops and webinars, plus access to tools and supports were all important contributions and references to our initiative.

Both these projects focused on improving care for people living with chronic disease. Why is this such a pressing healthcare issue and what are some of the biggest challenges?

We are aware of the challenges and burden of chronic disease management at various levels – the system, program, patient and provider. Multimorbidities are adding to this already familiar challenge. In Nova Scotia, these problems are more pronounced than in the rest of Canada. Addressing these issues was timely and contextual as part of this opportunity.

What is the biggest challenge in sustaining and spreading improvement efforts?

The recent shift to one health authority in Nova Scotia can be both a challenge and an opportunity for the spread and sustainability of our improvement efforts. Maintaining the true intention of this initiative and the new way of collaborating with our patients will be a learning opportunity for our care team and for our patients.

How will you continue to sustain and spread your ‘My Care My Voice’ initiative?

The methodology and approach that has developed has generalizable components and opportunities for spread. We have published our work in order to support the process of spread. Reducing wait times to care is an important topic in health care. This initiative and the ICCS model of care has already gained momentum and interest within the province, in Canada and internationally.

Watch the video of the My Care My Voice initiative, Improving Wait Times to Care for Individuals with Multimorbidities and Complex Conditions.