Over the past three years, Lisa Stewart has fundamentally changed Vancouver Coastal Health (VCH)’s approach to embedding quality improvement into daily practice at the point of care. The key to her success? Launching communications channels that break down hierarchy, inspiring staff to provide the best possible quality of care and celebrating people who make a difference.
When VCH began implementing Releasing Time to Care, some units within the organization thrived while others struggled. So Lisa developed a strategy to engage, inspire and connect clinicians and staff: team-based quality improvement, or TBQI, as it came to be known, is a framework that supports individuals, teams and sites to embed quality improvement through protected time for meetings, huddles and leadership rounds.
Fifty-five TBQI teams are now empowered to identify, action, evaluate and sustain improvement opportunities, with an average of one new team joining each month. They span Richmond Hospital and almost all of Vancouver General Hospital, and the program is expanding into the GF Strong Rehabilitation Centre and Lions Gate Hospital as well as community and long-term care sites.
Lisa and her team have trained over 60 clinical quality leaders, delivered hundreds of education sessions and facilitated over 120 TBQI conversations with senior leadership and clinical teams. Hundreds of improvement projects have been developed through the program, including trauma checklists, an equipment repair guide for staff, pre-printed orders, admit kits, handover processes and sepsis management.
Members from one TBQI team helped with communication activities for alerting staff about an infusion pump that was unintentionally delivering fluids. Nurses developed meaningful messaging for their colleagues to guide them on what to do in the event of an over-infusion. Two weeks later, their messaging helped a nurse identify and record an over-infusing pump, which ultimately led to identifying the contributing factors.
Lisa’s approach to engaging staff in improvement is key. Whether it is celebrating their stories, validating experiences, providing a supportive hug or jumping in to help, she finds value in each and every conversation.
And when someone goes above and beyond, Lisa makes sure to celebrate and recognize them. She launched the “I Made A Difference” campaign to highlight staff who demonstrate the best possible care to patients, families or coworkers. The campaign has grown in each of its four years to include hundreds of examples of how staff go above and beyond. It has no boundaries – physicians, nurses, allied health professionals, housekeeping staff, Starbucks baristas and leaders have been celebrated. It has spread across VCH as well as to other health authorities.
Through resilience, perseverance, dedication and commitment, Lisa has transformed how quality improvement happens across VCH. Small changes with big impact have occurred and been celebrated and her approach to engaging staff has transformed the culture around quality improvement.