Quality Improvement

The WCCHN is committed to both quality improvement and quality assurance in pediatric cardiology.

The Saskatchewan Health Quality Council (2005) explains that

Quality Improvement and Quality Assurance are often thought to be one in the same.  Quality Assurance is a process for getting rid of that which is not up to standard.  Quality Improvement, on the other hand, is a cooperative process for raising standards across the board, narrowing the range between better and worse. (Quality Improvement Toolbook, page 5)

Two WCCHN sites, Saskatoon and Edmonton formally participated in quality improvement initiatives aimed at improving access to pediatric cardiology services. The outcomes outlined below were part of the centres' participation in the Canadian Collaborative, which was led by Improvement Associates Ltd. of Edmonton.

Saskatoon's quality improvement initiative was to decrease wait times for appointments with the Pediatric Cardiology Clinic in Saskatoon's Royal University Hospital or at the Regina General Hospital Partnership Clinic. Prior to the initiative, wait times to see pediatric cardiologists were 12 weeks in Saskatoon and 25 weeks in Regina. Through the adjustment of clinic visit times in Saskatoon, increasing partnership clinics in Regina, and recruitment of a third pediatric cardiologist in Saskatoon, they were able to decrease the wait times to 8 weeks in Saskatoon and 11 weeks in Regina. No additional changes are anticipated at this time. Saskatoon will continue to monitor the clinic wait times.

Edmonton had a six (6) month waiting time for an appointment in the Pediatric Cardiology Clinic at the Stollery Children's Hospital. To decrease the wait times, a Saturday morning Murmur Clinic was initiated. Children selected to be seen in this clinic were referrals older than 1 year of age and living within 1 hour of Edmonton. Twenty-five (25) patients were scheduled each Saturday morning. They were seen by a pediatric cardiologist, a pediatric cardiology nurse, and an electrocardiography technician. Parent and staff satisfaction, wait times to clinic visits, and wait times in the clinic were all measured.

Edmonton found that by adding Saturday Murmur clinics, they were able to reduce access times from six (6) moths to three (3) weeks. In addition, they found that the wait time in the clinic decreased from 3 hours to 18 minutes. Family satisfaction was overwhelmingly positive. By the end of December 2005, approximately 300 patients were assessed in Saturday Murmur Clinics. Of these, seventeen (17) patients returned for further tests (ie. Echocardiogram). Edmonton is planning to continue with Saturday morning Murmur Clinics once a month in addition to other initiatives to increase access to clinics during regular work weeks.

Family members who had gone to the Stollery Children's Hospital for their Pre-Admission Clinic (PAC) visit reported to the WCCHN that they had experienced very long wait times. A quality improvement committee was created to examine the wait times and the causes of any unexpected delays in the PAC unit. The committee has been able to identify a variety of factors that impact on the length of time or the wait time for a child in the PAC unit. The goal for a child's vist to the PAC unit is set at five hours. A PAC video is being developed to inform parents and children of the PAC process. More initiatives are planned for 2006 to further reduce the total time a child spends in the Pre-Admission Clinic.