Cheng (Kim) Li
3^rd Year Medical Student, University of British Columbia
BCPSQC & IHI Scholarship Recipient 2018-2019, Attended Quality Forum 2019

If I were to use one word to summarize my experience attending Quality Forum 2019, it would be “eye-opening.” I want to sincerely thank the IHI Open School Chapter at UBC and the BC Patient Safety & Quality Council for offering this tremendous opportunity to broaden my horizons. The Forum this year started with a heartwarming video message from Adrian Dix, the Minister of Health. He emphasized the importance of team-based care and involving patients as part of the team. In health care, everyone works as a team and their voices should be heard. As a third-year medical student, when I’m in hospital and on the wards, I often felt like a very small, insignificant part of an enormous system. But I was reminded and encouraged that anyone who participates in quality improvement, whether it’s conducting a clinical study or changing an everyday habit, is an important catalyst for change.

At the Forum, I also attended smaller talks and learned about various topics of interest. One presentation that I thought was very interesting was by Dr. Janet Simons (a medical chemist at Lion’s Gate Hospital) about how we can optimize the online settings of Cerner (an electronic medical record) to decrease the number of tests ordered. By just changing what lab panels and sets are available for physicians to order, we can influence the number of lab test orders. This was mainly driven by the realization that unnecessary tests end up being ordered as part of a panel or set (due to the relative ease of pressing one button versus many), which adds to health care expenses. This research offered a refreshing perspective that showed that improvements are not just about the newest technologies. Instead, improvement can mean optimizing the current procedures.

Another talk that highlighted quality improvement initiatives within the current system was by Dr. Karen Dallas, who presented ways to decrease unnecessary packed red blood cell (pRBC) transfusion. She emphasized that often the solution already exists within the system. The answer is not always innovative technology, but looking at existing problems in the system from a different perspective and finding a way to improve the current system. For example, by simply putting a new tick box to order a set for one unit pRBC transfusion, there is a decrease in the ordering of two pRBC transfusions. I was amazed to learn that a simple introduction to the single unit order as the first option has driven behavior change. Additionally, combination intervention was useful and necessary to maintain behavior change. This includes education sessions to encourage discussion on resource stewardship, and getting feedback from the stakeholders to assess the obstacles and challenges to change.

By attending the Quality Forum, I not only explored the multifaceted approaches to improving patient care and reducing health care costs, but also had the opportunity to network with like-minded individuals who share the same passions. I was able to walk away with nuggets of information and advice even outside the setting of talks and sessions. During the lunch session on the second day, I had the opportunity to chat with the emergency medicine program director at VGH and ask questions about elective years, residency and work-life balance. At the end of the Forum, I was not only inspired by the ample amount of exciting research in quality improvement, but also empowered to apply the same principles in my future practice to make a difference.

Katie Maclean
3^rd Year Nursing Student, University of British Columbia Okanagan
BCPSQC & IHI Scholarship Recipient 2018-2019, Attended Quality Forum 2019

As a third-year nursing student at the University of British Columbia Okanagan Campus, I was truly grateful to receive a scholarship to attend the BC Patient Safety & Quality Council’s Quality Forum in Vancouver. I am a part of the IHI Open School Chapter at UBCO, and extremely passionate about improving quality care to patients across all sectors, and attending the Quality Forum was incredible to say the least!

Throughout the entire event, I was inspired by the passion and knowledge being shared among such a diverse group of health care providers. Every presentation I attended encouraged me to better my own community and practice to improve care for all. In particular, I attended a rapid fire session called “Imagine All the People: Engaging Youth and Community for Better Care” which discussed the power of utilizing youth in their own care decisions. One of the speakers, Skye Barbic, who works at Foundry in Vancouver, delivered an exceptional presentation about Foundry’s mission to provide a multitude of services for youth under one roof. I am a part of the youth council at the Foundry centre in Kelowna and took the opportunity to connect with Skye and share what is happening at each location. It’s these little connections and collaborations that have fueled my passion for quality improvement and the valuable insight gained from talking with other like-minded individuals. Every presentation stood out in its own way, and sparked new ideas and incentives for me to take back to my own community.

Another incredibly moving presentation was the rapid fire session “Compassion at the End of Life” – specifically, the presentation “Improving the End-of-Life Experience Through Lasting Memories and Compassion.” During this presentation, two nurses from Kelowna General Hospital, Robyn Goplen and Sybil Hoiss, presented their project for which they started a keepsake initiative in the KGH ICU. This program provides families and patients with the opportunity to make jewelry with an imprint or special message to remember their loved one by. I speak not only for myself, but the entire room when I describe the compassion felt from the stories of those they cared for and who took part in the program. The cherry on top was when an audience member stood up and showed one of the necklaces she was wearing that she made from this exact program when her son had died. It’s projects like these that remind me how lucky I am to be a health care provider, and of the lasting impact we make on the lives of others. That, to me, is the best reward that any career can offer.

Lastly, I have to say that the integration of Indigenous peoples in the Quality Forum was incredibly moving. From the heartbreaking stories of the burden Indigenous peoples have suffered within the health care system, to their perspectives on how we can better their experiences, minorities and cultural difference need to be addressed within society today. We need to open the conversation in order to provide effective and culturally safe care. During the Quality Forum, I realized I had a lack of knowledge regarding present treatment of Indigenous peoples. I had no idea of the stigmatization that is still occurring today and the hardship that Indigenous peoples fight against everyday. I believe in the importance of fighting the stigma around Indigenous peoples and I hope that their collaboration with the BC Patient Safety & Quality Council will lead to better treatment and care for all, and a greater understanding of their cultural needs. From my experience at this conference, I am empowered to help minorities and those from different cultures receive exceptional care, and advocate for my patients when they don’t have a voice.

I cannot thank BCPSQC enough for providing me with one of the best experiences of my life. The knowledge, passion, creativity and connections that I made and learned at this conference will propel me through my final years in nursing school, and aid me in my career as a health care provider to actively work on bettering the care of my patients. Thank you to all the amazing presenters and staff that made this event possible, and I cannot wait to see the quality improvements to come.

Jamie Park
2^nd Year Pharmacy Student, University of British Columbia
BCPSQC & IHI Scholarship Recipient 2018-2019, Attended Quality Forum 2019

As a pharmacy student, we learn a lot about clinical practice, pathophysiology and pharmacology of medications. However, there is a lack of opportunities for pharmacy students to learn more about innovative and interprofessional quality improvement projects that are occurring in British Columbia.

This year, I had the honour of attending Quality Forum 2019 through the BCPSQC & BC IHI Open School Chapters Quality Improvement Scholarship. It was a unique and enlightening experience where I got to learn more about various health topics and meet like-minded individuals with different backgrounds in health care.

In particular, I loved the Randomized Coffee Trial, which was an opportunity to connect with an assigned partner and learn about each other’s passions, contributions to health care, and ideas for change. My partner was a senior analyst at BC Emergency Health Services. It was very interesting to learn about her career path and the current projects that she is involved with. As a health care professional student, it was fascinating to learn about the emergency department and what their workflow was like. She emphasized the importance of interdisciplinary collaboration since her work involved a lot of interactions with physicians. Later on, I got to know her on a personal level when we talked about our shared interest in travelling. Quality Forum 2019 provided a great medium for students like myself to meet and connect with inspiring mentors.

As a future practicing pharmacist, I plan to include clinical research as a key part of my practice. I would particularly like to combine my interests in health outcomes research with my desire to improve health care services to patients through technology. Quality Forum 2019 had a storyboard reception with over 100 posters on various topics such as improvement capability, population health and clinical practice. I was surprised to see so many quality improvement projects in the field of eHealth. The poster that was most memorable was “Innovation in Real Time Data Collection For Releasing Time to Care.” There are many health apps that are currently available for health care professionals to use. However, we are not exposed to the app development process or how we can further improve future apps to ensure that they help improve current workflows. I was able to learn about the step-by-step process through this poster. The project was about an evidence-based, continuous quality improvement program that was developed in consultation with front-line staff to ensure that the app was indeed useful and relevant to the app users. With the development of this app, there have been major improvements such as reduced time to clean and tabulate data. It was enlightening to learn about the process of app development and the importance of constant communication and feedback between staff and developers. As well, I was able to get inspiration for future research poster projects. As I went through the numerous posters, I jotted down notes about how to make research posters visually appealing and easy to follow. Quality Forum 2019 allowed undergraduate students interested in research to explore various areas of innovative health topics and also connect with researchers or students with the same interests.

Once again, I would like to thank the BC IHI Open School Chapters and the BC Patient Safety & Quality Council for providing me an amazing opportunity to not only recognize the incredible work that is currently being done to improve care in British Columbia, but also to share my perspectives to achieve better patient care. I highly recommend that students attend next year’s Quality Forum to meet passionate and experienced individuals who strive to improve quality of care and to learn about various quality improvement projects that are occurring in British Columbia. I hope to attend the conference again in the near future as well!

Wayne Park
3^rd Year Sciences, University of British Columbia
BCPSQC & IHI Scholarship Recipient 2018-2019, Attended Quality Forum 2019

I am beyond grateful to have received support from the UBC IHI Open School Chapter and the BC Patient Safety & Quality Council to attend Quality Forum 2019, which was an eye-opening experience for an aspiring health care provider like myself. The two-day conference showcased important initiatives that others are actively working on, inspiring audiences with their genuine passion in their work. The interdisciplinary nature of the conference allowed attendees to hear stories from varying perspectives, and I felt inspired after hearing patients’ lived experiences with their engagement in quality improvement initiatives.

One session particularly resonated with me, and it was Andrea MacNeill’s illuminating talk about contributing to health care from an environmentally sustainable perspective. As an undergraduate student pursuing a sciences degree with a focus on earth and ocean sciences, I have found little overlap between my volunteer work and passion for patient care and my sustainability values. There is often a misconception that environmental stewardship requires a compromise in patient care. However, listening to Dr. MacNeill’s talk taught me how such a compromise does not exist, once we can collectively recognize climate change as being a global health threat, increasing the burden of disease. Prevention of disease is the first step providers should advocate for, and I am keen to support sustainable health care through effective research that supports the prevention of disease.

Attending this year’s Quality Forum has affirmed my motivation to become an advocate for patient rights and quality improvement, and I am more than excited to see how I can become further involved in QI as a provider in the future. At the end of the day, all of the attendees were united by our motivation to improve the quality of patient care, and I am eager to apply these patient-centred concepts annd values into my work. I left the conference feeling a renewed sense of inspiration towards the future of health care and hope to take the lessons and experiences I’ve gained to contribute to an impactful future in health care. Thank you to the UBC IHI Open School Chapter and the BC Patient Safety & Quality Council for this invaluable opportunity to attend the conference, and I hope to be able to attend this conference again in the future from the perspective of a provider.

Victoria Rea
4th Year Biomedical Studies, University of Northern British Columbia
BCPSQC & IHI Scholarship Recipient 2018-2019, Attended IHI National Forum 2018

I would like to thank the BC Patient Safety & Quality Council and the BC IHI Open School Chapters for the generous scholarship that allowed me to attend the 2018 IHI National Forum in Orlando, Florida from December 9-12, 2018. I was ecstatic to learn that I was the recipient of this scholarship, as I am passionate about leadership and health care improvement, and I would not have been able to attend the forum otherwise. Being an undergraduate student at the University of Northern British Columbia, attending this conference was the opportunity of a lifetime as I was surrounded by individuals that I look up to, and was able to have a voice for northern BC at the conference. I am a fourth-year biomedical studies major at UNBC, and have been in the process of applying to medical school. Among other lessons, this conference reignited my passion for health care improvement and leadership, in a time in my life that I needed it most.

At the National Forum, I attended many workshop sessions that taught me lessons that I can bring back to the Prince George UNBC IHI Open School Chapter. On the first day of the conference, I attended the pre-conference keynote with Dr. Zubin Damania, also known as Z-Dogg MD online. There was not a dry eye in the audience as he spoke about burnout, his work in quality improvement, and how one of the largest determinants of health is where a patient was born and raised. After Dr. Damania’s eye opening keynote, I made my way to the presenter and student reception where I had appetizers, and was able to network and meet new people involved with quality improvement and the IHI. The second day of the conference involved a keynote by Derek Feeley and Jason Leitch, and workshops called “How to Co-Design an Environment Where Staff can Thrive,” “Activating Global Health Change Agents for Health Equity,” “Engaging students as Catalysts in Improvement Work,” and a second keynote called “Women in Action Paving a Way for Better Care.”

Some major points at each of these workshops was learning how to close the “know-do gap,” the value of a patient-centred value system in QI work, the need to refocus existing resources already available instead of starting improvement interventions from scratch, and creating an environment where students can work so that they feel appreciated and motivated. Learning about how to create an environment that students can be involved in without feeling taken advantage of or underappreciated was of great importance to me as our UNBC IHI Open School Chapter grows. Personally, I have been in a negative working environment before, and I want the UNBC IHI Open School Chapter to reflect a safe space where all involved are appreciated, respected and motivated.

To conclude the first day of the conference, a moving keynote was delivered by Maureen Bisognano, Dr. Celine Gounder, Dr. Mona Hanna-Attisha and Vania Deonizio, where each person explained their experiences being a woman in medicine and quality improvement; again, many tears were shed hearing the inspirational stories from these women. Specifically, the “Dancin’ Power” movement was explained by founder and executive director Vania Deonizio; this is a quality improvement effort where Vania incorporated dancing into the everyday lives of those who might benefit from artistic expression in long-term hospital care. I was so intrigued by the movement, as I was a competitive figure skater growing up, and I am currently in the process of researching to see if this could be viable in the University Hospital of Northern BC in Prince George. Ultimately, the first day of the IHI National Forum was a success.

The second day of the IHI National Forum was a moving keynote by Gregory Boyle, where he talked about his improvement work through his company, Homeboy Industries. I have never been in the presence of somebody as wise, well-spoken and passionate as Gregory, as he told us his emotional stories about quality improvement by working with marginalized populations as he helped reintegrate gang members and previously incarcerated individuals back into society through Homeboy Industries. After the keynote, I moved into a full day of workshops where I attended sessions that taught me how to leave the forum with a sticky message, activate leaders as agents for change, and prepare personally and professionally for end-of-life conversations, followed by a final keynote by Dr. Don Berwick. I was interested in learning about how to recruit leaders to act as change agents as I thought that this could be directly related to the IHI UNBC Chapter, aiding in recruitment and chapter sustainability. Specifically, I learned how unleashing intrinsic motivation, and finding a way to do this for chapter members at an individual level, is a way to ensure that motivation and action are maintained. Lastly, Dr. Berwick’s keynote was also a takeaway from the National Forum. He talked further about closing the health gap among marginalized populations, as previously mentioned by Dr. Damania, and further expressed health issues in the United States regarding how where we grow up heavily determines our health outcomes for the rest of our lives.

In all, I learned valuable lessons from the keynote speakers and the multiple workshops that I attended. I was able to network and connect with like-minded individuals who offered to provide support when I need it in the future. Furthermore, I am taking many valuable lessons back to the UNBC IHI Chapter in regards to student recruitment, creating a positive environment that encourages QI interest and motivation at an individual level, and ultimately creating an environment where we can thrive while creating changes in the health system. I left the IHI National Forum more inspired than I have ever been. I have been reminded that with proper support, we can make a change in the health system that needs improvement, and I am motivated to help make these changes happen. I would like to thank the BC Patient Safety & Quality Council and the BC IHI Open School Chapters for providing me with the outstanding opportunity to attend the IHI National Forum, as it was an experience that I will never forget. I would also like to thank the Institute for Healthcare Improvement for hosting such an incredible conference. Lastly, I would like to thank my peers in the UNBC IHI Chapter for informing me of the conference and scholarship opportunity, and for providing a platform that can truly help create change in the North.

Vivian Tsang
3^rd Year Medical Student, University of British Columbia
BCPSQC & IHI Scholarship Recipient 2018-2019, Storyboard Presenter at Quality Forum 2019

What I appreciate most about the BCPSQC Quality Forum is the unique coming-together of health professionals from various clinical, research and geographical areas across BC to facilitate the sharing of ideas and experiences from the past year. Such interdisciplinary intersections contribute to the success of the Forum in bringing together teams who are conducting similar projects in order to form networks and connections to expand research horizons. Sharing pitfalls and strengths of past interventions also helps to expedite ongoing and upcoming projects.

Having attended the event previously when in my undergraduate years, attending the sessions this year as a medical student allowed me to appreciate the connections between clinical medicine and research. Many of the workshop presenters were physicians who had lectured me in the past or whom I had shadowed in clinic. This contributed to a more nuanced understanding of the significance of their research projects and the difference it made both for patients and the health care system. At the front lines of medical care, clinicians shared their fondness for quality improvement projects because it allows them to see the direct effects of their efforts. Their motivation is further propagated by their team of staff who benefit from increased efficiency and improved patient and systems outcomes.

Of particular interest was Dr. Andrea MacNeill’s session on the environmental impacts of surgery. Dr. MacNeill is a general surgeon specializing in sarcoma with a special interest in reducing the environmental impacts of surgery. This emerging area of research has great potential to improve health as well as the financial and environmental expenditures of the health care system. It has been proven that pollution from healthcare activities as a whole generates as much disability as medical error. Her studies have shown that single-use items consume more carbon than reusables even when factoring in laundering considerations. In addressing the fact that North America’s largest greenhouse gas emissions are rooted in anesthetic gases, Dr. MacNeil collaborated with colleagues in anesthesia to make the simple switch from using desflurane to sevoflurane in operations to help decrease CO2 emissions. These examples of quality improvement work demonstrate not only the rigour of research in the field but also illustrate the opportunities to include seemingly unrelated areas of research interest in a full-time clinical career.

During the storyboard session, I had the opportunity to present my research on non-contact opioid monitoring devices for people who use drugs. This work was completed in collaboration with the BC Centre for Disease Control under Dr. Jane Buxton. The fentanyl crisis in Vancouver and other parts of the world has itself been an incentive for the development of smartphone applications among both private and public organizations. With increasing numbers of these smartphone applications that promise to prevent and recognize opioid overdose, there have been no measures thus far to evaluate the acceptability and accessibility of these devices for the population who will be using them. My project compiled data from the BC Harm Reduction Survey along with key informant interviews to gather answers to this issue.

Being able to present as well as enjoy the workshops offered a delicate balance of learning and contributing to the research community. I want to thank the BC Patient Safety & Quality Council as well as the BC IHI Open School Chapters for the opportunity to be sponsored to attend this incredible conference and look forward to attending similar events in the coming years.

Kevala Van Volkenburg
4^th Year Health Sciences Student, University of Northern BC
BCPSQC & IHI Scholarship Recipient 2018-2019, Attended Quality Forum 2019

I am an undergraduate student at the University of Northern British Columbia (UNBC) and a member of the IHI Open School Chapter at UNBC. I was honoured to have received a scholarship to the Quality Forum this year. Coming from the North, it can be very expensive to travel to anywhere warmer – like Vancouver – to attend amazing and useful events such as this one. This scholarship facilitated this eye-opening experience for me. My first day at the Forum I felt a little lost – there were so many doctors, nurses, health care managers and allied health professionals. There was no need for me to be nervous, though. Everyone was warm, welcoming and interested in the same things as me. Despite feeling a little out of place at the beginning, I connected and had engaging conversations with everyone I met. Before this conference I had no idea how many people had dedicated themselves to improving the health care system and patient care. Also, the presenters showed outstanding work focused on improving issues they saw where they worked. Even prior to the presentations, I was inspired by the fact that so many people had successfully implemented projects and research in quality improvement. I attended several sessions, from publishing quality improvement projects to projects in end-of-life care.

One of the talks that touched me was Chris Pointon’s presentation on the #hellomynameis campaign. It was started by Kate Granger, his wife of 15 years who was a doctor herself and was diagnosed with cancer. Like many of us, Kate wanted to know about her treatment and her care, including understanding the who, what, when, where and how. Not a difficult request, right? On one of her trips to the emergency room, almost no one took the time to introduce themselves. The only exception was the porter. After this experience Kate started the #hellomynameis campaign to remind health care professionals to introduce themselves to their patients. Kate and Chris worked tirelessly to share her campaign and passion for patient-centred care. After Kate passed away from her disease, Chris continued their work.

After the talk, he told the Quality Forum audience that we are the largest group of people he had ever presented to and we all took a picture with our #hellomynameis signs. I hope that Chris’ talk impacts many others and encourages them to spread #hellomynameis to the world. I will make sure to be conscious about introducing myself to my patients and my colleagues.

One rapid-fire talk I attended was about end-of-life care. Before this conference I volunteered in the dementia facility in my hometown and saw the great job the team was doing. However, as I learned in this presentation, there is always room for improvement. This acute care ward team wanted to improve the family and patient experience when a loved one is passing away. They made a cart which included coffee, tea, candles and other things the family might need. This helped families make the most of their time with their loved ones before they passed. They also found a local pendant maker that could imprint fingerprints or etch heartbeats into a necklace or bracelet. Even though this seems like such a little thing, it meant so much to everyone involved. The team had countless success stories from patients and during the question and answer period, participants from the program stood up and shared how much these efforts changed their hospital experience. I found it amazing that such a little thing could make such a huge difference.

Quality Forum 2019 helped me deepen my perspective about quality improvement. I had always thought that to improve the health care system we need to think big and do big projects. Since the Forum I have realized that even small changes can make a huge difference to so many people. The Quality Forum was an eye-opening experience for me and I would recommend it to anyone, from health care professionals to patients to students.