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UWI TODAY
– SUNDAY 3 JUNE, 2018
MEDICAL SCIENCES
Defining and achieving quality in health care
remains a challenge to health systems locally, regionally
and internationally, as “quality” carries different
meanings for different people. The UWI Faculty of
Medical Sciences held its second healthcare quality
symposium recently, on April 21 at the University Inn
and Conference Centre.
The one-day symposium involved 60 participants
including health professionals, health administrators,
educators, and students. They discussed best practice
models to improve and sustain high quality health
care, and heard interesting panel discussions on quality
in health systems, health education, patient care and
diagnostic services.
Dr Vishwanath Partapsingh, Acting Chief Medical
Officer at the Ministry of Health, attended. Dr Edwin
Bolastig who is Health Systems and Services Advisor
for the Pan American Health Organization, spoke on
behalf of the Director General of the World Health
Organization, Dr Tedros Adhanom Ghebreyesus.
Dr Joshua Tepper, CEO of Health Quality
Ontario (HQO), gave an impassioned and inspiring
presentation on delivering quality healthcare across
a vast geographic area to a diverse population with
socioeconomic challenges. He said in Ontario this is
mandated by a government bill called “Excellent Care
for All”, requiring accessible, appropriate, effective,
equitable and safe health care for all citizens.
Dr Tepper highlighted the approaches taken by
Ontario’s HQO to realise this goal through nine key
activities: (1) Create the conversation (a culture of
quality); (2) Public Reporting; (3) Provider Reporting;
(4) Quality Improvement Plans; (5) Quality Standards;
(6) Patient Engagement; (7) Skill Building; (8) Large
Scale Improvement; and (9) Clinical Engagement.
Davlin Thomas, CEO of the North Central
Regional Health Authority (NCRHA), spoke on
“Improving Quality at the Edge of Chaos”.Through the
lens of disruptive innovation, complexitymanagement
and health systems theory, he provided recent
examples of improvements in service quality at the
NCRHA, such as significantly reduced waiting times
for emergency care and the Walk-The-Talk initiative.
The latter, he said, empowers communities to take
ownership of their health issues.
Dr Henry Bailey of the Arthur Lok Jack Global
School of Business gave an insightful presentation on
his research in patient-reported outcomes, and how
tools such as the EQ-5D can aid clinical decision-
making through patient involvement in health care. He
also highlighted the shift in the use of patient-reported
outcomes from population studies towards collecting
this type of data as part of healthcare delivery in oder
to improve quality of care.
The important issue of monitoring the quality
of medicines was given focus by Dr Rian Extavour
of The UWI School of Pharmacy, in particular post-
marketing surveillance of the quality of medical
products. She highlighted the global prevalence of
HEALTHCARE QUALITY SYMPOSIUM
Models of Best Practice
B Y R I A N M A R I E E X T A V O U R & R A H U L N A I D U
substandard and/or falsified medical products and
practical approaches used to monitor the quality of
medical products, which were pivoted on prevention,
detection, response.
Quality in health education
Professor Joseph Branday, who is Director of
Medical Education at UWI’s Mona campus, traced
the history of medical education in the Caribbean and
highlighted the development of accreditation systems
and standards. He described quality assurance in
education as a continuous process of reviewing how
students are taught and assessed, whereas accreditation,
he said, is intermittent and focuses on evaluation of
the product offered. The participants were reminded
that robust quality improvement systems may facilitate
both global recognition and local relevance.
DrWilliam Smith and Dr ShivaughnMarchan led
the audience through the steps involved in acquiring
and maintaining accreditation for the postgraduate
residency at the School of Dentistry. The School is
the only non-US dental school to be accredited by
The American Dental Association’s Commission for
Accreditation for this programme, offered by NYU-
Langone.
To describe the need for quality in optometry
and eye care, Dr Subash Sharma pointed out the
approaches applied in the areas of patient services,
and research at the Unit of Optometry, including the
National Eye Study of T&T. The latter grew out of a
collaboration with the Ministry of Health and Anglia
Ruskin University in order to identify areas for quality
improvement and is used to guide policy and practice.
Quality in patient & diagnostic services
Dr Steve Weaver, Director of The School of
Nursing (UWI, Mona) outlined the importance
of policies, practice guidelines, leadership and
management in quality improvement for clinical
practice in the Caribbean. This principle was echoed
during the presentation by Professor Chief Patrick
Akpaka, Clinical Microbiologist, who emphasized
the need for laboratory services that produce results
that are accurate, reliable and timely to support
optimum patient care. Dr Michael Morris of the
School of Veterinary Medicine discussed services of
veterinarians at his School who support small animal
health, milk and meat production and aquaculture.
Participants left the symposium satisfied, and
called for more forums to discuss and plan quality
improvement in healthcare.
Opportunities for supporting quality improvement
initiatives in healthcare are available with the recent
establishment of the Caribbean Centre for Health
System Research and Development at the Faculty
of Medical Sciences. The mandate of this Centre
includes the strengthening of health systems through
the conduct of research relevant to the needs of
the Ministry of Health and the Regional Health
Authorities, and communicating the findings to
them in a format that facilitates uptake in policies,
programming and practice.
In order to understand areas for improvement,
benchmarks and objective measures or indicators are
needed to assess all levels of care, particularly patient
engagement. Unless we know where our weaknesses
lie, how can we develop our strengths?
From left, Dr Joshua Tepper, Dr Rian Extavour, Professor Rahul Naidu and Professor Michael Branday at the health care quality symposium
held on April 21 at the University Inn and Conference Centre, St Augustine.
PHOTO: DEXTER SUPERVILLE
