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Vancouver Orthopaedic Foot and Ankle Programme Wins the 3M Health Care Quality Team Award |
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Vancouver Orthopaedic Foot and Ankle Programme Wins the 3M Health Care Quality Team Award
Alastair S. E. Younger, M.D, FRCSC
Clinical Associate Professor,
Division of Lower Extremity Reconstruction,
University of British Columbia, Department of Orthopaedics
Surgeon Team Lead
BC Foot and Ankle Clinic at Providence Health Care
Vancouver, BC
Colin D. Meakin, B.H.K., M.Sc.
UBC Orthopaedic Research Coordinator
B.C. Foot and Ankle Clinic
St. Paul's Hospital
Vancouver, BC
The Foot and Ankle surgical programme at St. Paul’s Hospital in Vancouver was recently awarded the 3M Health Care Quality Team Award for Canada for their work with surgical pathways. This health care accolade recognizes successful, sustainable quality improvement projects that exhibit high levels of innovation and exemplary teamwork. The award was presented by the Canadian College of Health Service Executives (CCHSE) and 3M Health Care in Quebec City on May 30, 2004. Twenty-five health care teams from across Canada applied this year. Judging was conducted by distinguished health service executives, management scholars and corporate executives appointed by the College. The selection criteria demanded that the winner demonstrate significant improvements in efficiency in a hospital programme for the community through a quality teamwork strategy while improving the level of patient satisfaction.
Description of the Foot and Ankle Pathway Initiative
The team predicted that good preoperative education and a thorough clinical assessment could help prevent unnecessary cancellations or long hospital stays while reducing anxiety levels for the patients and hospital staff alike. They also believed that enabling the patient to play a role on the team, expecting them to submit their own health information and preparing them for discharge prior to preoperative workup, would improve patient compliance with postoperative care. All of this would maximize surgical outcomes and reduce the reliance of patients on the medical system during their recovery period.
A multi-disciplinary clinical pathway was developed incorporating standard guidelines to streamline the entire surgical process and decrease variation in practice. At the heart of this surgical pathway was the “only ask them once” (OATO) principle where each health care provider (physiotherapy, nursing, anesthesia and surgery) built on previously acquired patient information at each step of the process. This ensured that patients were not asked repeated questions, allowing the different health care providers to spend less time retrieving information and more time addressing concerns that really mattered to the patient during their meetings. The patients were educated by a number of different providers and methods using consistent information, increasing the potential that essential knowledge would be retained by each patient. The pathway used a common documentation system allowing the team to track patient outcomes and manage variances when they occurred.
A pre pathway trial of 40 patients was compared to three post pathway annual audits of 20 patients, measuring the impact of the pathway and ensuring that the goals and objectives were being met. Postoperative pain control, day of discharge, patient satisfaction and other indicators were monitored and showed significant improvements.
The Foot and Ankle surgical pathways initiative now provides a model of best clinical practice for other surgical services and the lessons learned are being spread throughout the Vancouver health care region in a variety of ways. These achievements highlight how a surgical hospital can apply the “Quality Improvement Model” and become more efficient and cost effective while improving patient outcomes and levels of satisfaction. For further information about this initiative, please contact Dr. Alastair Younger:
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or visit this link: http://www.cchse.org/AwardsRecipients.htm.
Legend for Photo
On hand to accept the award at the May 30 ceremony were (front row from l to r): (Providence Health Care): Colin Meakin; Betty Ann Chorpita; Dianne Doyle; Dr. Alastair Younger (back row from l to r): Andrew Stephen (3M); Peter McCaw (3M); Donna Towers (Chair, CCHSE); Gary Mandziuk (3M); Kevin Higgins (3M).
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Dernière mise à jour : ( 21-03-2007 )
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