Dr. Shyr Chui first heard about the concept of quality improvement (QI) when he was a young radiologist in his early days with the United Kingdom’s National Health Service. His thirst for knowledge made him want to hear more, but back then opportunities for physicians to learn about quality were few and far between.
He began seeking out information on QI methodology, which aligned well with his natural curiosity and ability to think outside the box. Decades later, the impact of these early learnings has profoundly impacted the entire quality improvement culture at Northern Health (NH) – and health care teams across northern BC are all the better for it.
“Dr. Chui’s passionate advocacy for a quality, patient-focused approach, and ability to engage and connect with all team members make him a true exemplar of quality culture,” says Laura Parmar, a Regional Physician Quality Improvement Coach at NH. “He is frequently described as down-to-earth, relatable and wise, and appreciated for his ability to focus on learning and improvement, be vulnerable and accountable, and have an openness to new ideas no matter where they come from.”
When Dr. Chui first joined NH, the concept of QI was in its infancy. Undeterred, he took a humble and honest approach to learning and brought staff and physicians along with him.
As Regional Medical Lead of Diagnostic Imaging from 2014-19, he helped transform the culture of Regional radiology from siloed, sometimes distrustful teams often hampered by the challenges of rural and remote work that strained limited resources, space, equipment and staff. He introduced a Joy in Work initiative into his own department, inspired by work at the Institute of Healthcare Improvement (IHI), engaging the team, generating change ideas and measuring their impact on joy in work in the department.
“The Joy in Work initiative spawned an elaborate and successful department-wide bake off competition,” says Laura. “This innovative and outside-the-box approach to workplace dissatisfaction is credited with changing the culture of the department and creating trusting and lasting relationships that have improved provider satisfaction and quality of care.”
Dr. Chui also connected with the Physician Quality Improvement (PQI) program in its earliest days, and championed the idea of regional PQI coaches like Laura, unique among PQI programs in BC. He served as co-chair of the Northern Health/Specialist Services Committee Physician Quality Improvement Initiative during the uncertain days of the pandemic, and has supported numerous QI projects, often using innovative and untraditional methods.
For example, he convinced Northern Health leadership to forego outside mediation and instead allow him to lead a Think Tank approach to resolving a dispute between emergency and imaging departments in Dawson Creek. This person-centred, solutions-focused approach included personally inviting all involved stakeholders to come together with QI coaches, generate a shared understanding of the problem, and work together to create change ideas.
“These individual conversations did more to develop our understanding of the nuances of the conflict and challenge than any data collection or graphical analysis ever could! The relationships formed by a single phone call developed a level of trust that allowed people to confidently show up and know that their views were valued,” Laura says. “He truly exemplifies what it means to engage in the human side of change and he does it with more passion and skill than anyone I have ever worked with.”
Dr. Chui’s innovations don’t end there. He also hosts NH’s Qualitycast North podcast, believed to be the only QI podcast of its kind. Working in partnership with NH Communications, it celebrates the health authority’s QI successes in a fun way. It has been downloaded over 1,500 times in over 20 different countries.
It’s these personal touches that make Dr. Chui’s approach so successful, says Laura. She recalls hearing about the impact he had on changing the culture of morbidity and mortality rounds at the University Hospital of Northern British Columbia. Rounds are necessary but can often fall into a session of “blame and shame” among care providers. Dr. Chui’s approach was to be a mentor, talking about problems with compassion and looking to solutions rather than placing blame.
“Shyr creates a culture where it is OK to admit our mistakes. He brings the human elements to the work and is always saying, ‘it’s OK, how do we make it better?’ ” says one physician colleague.
Adds Laura: “His willingness to admit and talk about his own mistakes and shortcomings dramatically influenced the culture and created psychological safety that allowed others to do the same. His openness and vulnerability make him a true leader.”