2021 EXTRA Improvement Projects

Cree Board of Health and Social Services of James Bay

Improving the efficiency and effectiveness of the kidney transplant process in Eeyou Istchee

Christina Biron – Regional Proximity Director, CBHSSJB
Jannelle Dupuis – Coordinator, Specialized Services, CBHSSJB
Helen Belanger – Director, Wiichihiituwin, CBHSSJB
Nora Bobbish – Assistant Director- Financial Management Units, Financial Resources, CBHSSJB
Catherine Bessette – Regional Improvement Advisor, Strategy and Organizational Department, CBHSSJB

This project aims to address the development of a case management process that will reduce the amount of travel and number of stays, while providing more responsive and culturally safe services for Eeyou Istchee (EI) clients entering the kidney pre-transplant process. The EXTRA team hopes to reduce the amount of travel and the duration of the process, while improving the quality of care and services.

The current situation will be modified to a case management process that will seek opportunities that favour telehealth and on territory appointments. For services unavailable on the territory, or unavailable in a reasonable delay, the case manager will attempt to combine multiple appointments during the same stay.

Ultimately, the data and results of this project will guide decisions regarding clients’ travel policy and the reorganization of Wiichihiituwin and Specialized Services processes.

CISSS de la Montérégie-Centre

‘’The perioperative trajectory: co-constructing the care episode for a better patient experience’’

Isabelle Paradis – Assistant to the director, hospital services – emergency, operating block, and front-line services, CISSS de la Montérégie Centre
Véronique Guimont – Director, hospital services – emergency, operating block, and front-line services, CISSS de la Montérégie Centre
Nathalie Moreau – Director, oncology program, oncology, CISSS de la Montérégie Centre
Lyne Noël – Director, multidisciplinary services, CISSS de la Montérégie Centre

The objective of this project is to diminish anxiety associated with the surgical process through a co-construction of the thoracic surgery care episode. To this end, we want to create a partnership while maintaining a strong shared responsibility with the person and their loved ones as well as the care team. The project is aimed at integrating the patient-partner in the development of tools to support communication and collaboration in the clinical choices concerning them, in keeping with a holistic vision throughout the perioperative trajectory in pulmonary oncology. This approach is in line with our organization’s strategic directions, and we want to use validated measurement tools to demonstrate the positive impacts on anxiety management and patient satisfaction during their care episode.

CHU de Québec - Université Laval

“Two heads are better than one – Strengthening medical-administrative leadership to better serve the patient”

Mélanie Dubé – Director, DOSAS [ophthalmology and specialized outpatient services], CHU de Québec-UL
Julie Asselin – Assistant director, critical care, CHU de Québec-UL
Karine Martin – Assistant to the director / cross-cutting projects, general administration, CHU de Québec-UL
Louis-Jacques Lalonde –Director, information resources, CHU de Québec-UL
Julien Clément – Assistant director, professional services, surgery, CHU de Québec-UL

Medical-administrative co-management is a “management model in which a physician and a clinical/administrative manager share management responsibilities within a client program or service unit.” – (Ann Langley, Ph.D., October 2011). The gap between the co-management behaviours expected by managers, the difficulty in moving toward common goals in managing activities, and the lack of management skills are some of the problems (among others) that slow down “attempts to overcome heroic and romantic conceptions of leadership based on a single individual.” At the CHU de Québec — Université Laval, physicians feel ill-equipped because of their lack of management training and skills, as well as their lack of knowledge and understanding of the administrative process and organizational hierarchy. This is also true of administrative managers, who have scarce knowledge of the medical hierarchy and lack the tools, operating structure, and follow-up mechanism for project co-management. The EXTRA project will serve to strengthen medical-administrative co-management at the CHU de Québec - Université Laval. Targeted co-management team: medical and administrative managers in gastroenterology.

Vitalité Health Network

“Enhanced quality of care by improved practice support for nurse practitioners in primary health care”

Nicole D. LaBrie – Regional Manager, Chronic Conditions, Primary Health Care, Vitalité Health Network
Véronique Landry – Professor, Nursing, Vitalité Health Network
Shelley Robichaud – Director, Primary Health Care, Vitalité Health Network
Nicole Brideau – Nurse Practitioner, Primary Health Care, Vitalité Health Network

The project takes a collaborative approach, with the members (managers, nurse practitioners in primary care (NP-PHC), professors, and professionals) working together to put in place a process and tools for improving the quality of nursing interventions by NP-PHCs. These activities will help managers support NP-PHCs in their work and thus promote best practices while ensuring safe, competent care and the assistance and resources required to fill and/or remedy gaps, as needed.

Finally, with this project, the EXTRA team hopes to improve patient and family care and to foster greater reflexivity in nurse practitioners in order to promote their professional development.

Centre intégré de santé et de services sociaux (CISSS) de la Montérégie-Est

“Establishing a service offer and a centre of expertise in crisis intervention throughout Montérégie-Est in accordance with the needs of the population and in collaboration with local partners.”

Robert James Borris – Assistant director, mental health and addiction programs, CISSS de la Montérégie- Est
Annie Mongrain – Head of crisis services, mental health programs, CISSS de la Montérégie-Est, mental health and addiction programs, CISSS de la Montérégie- Est
Andréanne Audet – Project manager, mental health and addiction programs, CISSS de la Montérégie- Est
Christine Lobe – Care partnership and client experience advisor, Quality, assessment, performance and ethics, CISSS de la Montérégie- Est

Designing an offer of community crisis intervention services adapted to the emerging needs of the population and the socio-health and cultural context is an organizational priority for the CISSS de la Montérégie-Est.

Based on best practices and influenced by the experiences of stakeholders, improvements to our service offer are expected to be made in accordance with the following four pillars:

A service offer and intervention methods in line with the needs of users and the new realities of the community
A positive client experience for patients and their loved ones
A positive employee experience
A permanent centre of expertise based on best practices

Each component will be supported by a cross-cutting framework for measuring the performance and satisfaction of the main stakeholders concerned (patients, employees, or community partners).

CISSS de Chaudière-Appalaches

“Democratizing learning and innovation: a pillar for excellence in care and services”

Patrick Simard – Interim president-CEO, general administration, CISSS de Chaudière-Appalaches
Stéphanie Simoneau – Director of housing, support for elderly autonomy program – SAPA, CISSS de Chaudière-Appalaches
Karine Dumont – Senior advisor, development of the university mission, university research and education – DREU, CISSS de Chaudière-Appalaches
Mélanie Dostaler – Assistant to the director, technical services – DST, CISSS de Chaudière-Appalaches

The premise of our improvement project is to bring about an organizational culture of learning by democratizing access to the best knowledge in order to accelerate its application in clinical, administrative, and management practices, while also promoting innovation in our technological and/or real estate solutions. In recent years, the CISSS de Chaudière-Appalaches (CISSSCA) has set up control rooms, which are tools supporting the organizational performance measurement and management system. These rooms are connected to the processes that the organization has put in place to better manage its portfolio of organizational projects. Our main objective is to improve these processes in order to achieve a better balance between the four pillars of the performance of CISSSCA’s Vrai Nord by putting greater focus on the “learning-innovation” dimension. Improving the management of this dimension will serve as a common thread, helping to more intensively share and mobilize the best available knowledge and promoting the co-construction of innovations by all participants in care and services. The project aims to adopt the means, in the context of SAPA control rooms, to better define and measure learning and innovation in an integrated, coordinated and sustained way, in order to continuously improve these elements and create real value.

CHU de Québec - Université Laval and CIUSSS de la Capitale-Nationale

“Continuum of integrated outpatient care and services - complex pediatric clienteles”

Caroline Drolet – Director, mother/child unit, Centre hospitalier universitaire de Québec
Marie-Josée Laprise – Coordinator, pediatric services, Centre hospitalier universitaire de Québec
Marie-Christine Laroche – Assistant to the director, DSM, Centre hospitalier universitaire de Québec
Mireille Ouellet – Assistant director, DITSADP youth component, CIUSSS de la Capitale Nationale

This innovative project aims to develop a model of integrated outpatient care for pediatric clients with a complex clinical care profile requiring multidisciplinary care and health services. This model of integrated outpatient care aims to break down silos between institutions, promote clinical cooperation and service integration, and decrease hospitalization episodes. Consistent with the premises of the management model set forth by the MSSS, we will promote the integration and coordination of care and services by eliminating breaks in the continuity between transition points. We want to ensure that integrated services revolve around the child, and to prioritize evolving family needs and the maintenance of family dynamics in our decision-making, by bringing children’s care closer to home. This will transform the hospitalization experience into an outpatient one, thanks to the values of diligence, compassion, and collaboration that will guide our decisions throughout our process.

CISSS de la Montérégie-Ouest

“Ensuring that no one with a complex mental health issue has to suffer alone.”

Patrick Dubois – Assistant director, quality, assessment, performance and ethics, CISSS de la Montérégie-Ouest
Martin Tétreault – Assistant director, mental health and addiction programs, CISSS de la Montérégie-Ouest
Lyne Daoust – Director, critical and specialized care programs, CISSS de la Montérégie-Ouest
Martin Turcotte – Head of addiction services, CISSS de la Montérégie-Ouest

The EXTRA team aims to develop adapted, integrated, and preventive services for "heavy users" of emergency services through an approach that promotes the recovery of the person in their natural environment and with the increased involvement of their loved ones.

In this way, the person and the various resources will be part of a single integrated network in which all parties interact to create a coherent trajectory from the standpoint of the service user's experience.

Implementing an intervention plan tailored to the complex needs of patients will ensure the fluidity and continuity of care within the community consistent with the life project of the person living with the issues.

It would be interesting to explore a new interdisciplinary team model, which, in a 24/7 context, could assist patients in planning their discharge from the hospital to an adapted resource or home. The objective is to accelerate patients’ return to their own environment after long, repetitive hospital stays.

With this project, we hope to improve the service offer in the community in order to provide effective and efficient services for these people who are often caught in the “revolving door” syndrome.