Quality Improvement : Health Equity and Preventative Care

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A Quality Improvement Plan (QIP) outlines change concepts and sets targets to improve health outcomes for clients and community. COVID-19 has worsened existing health inequities for racialized and vulnerable populations. Intentional and integrated planning is critical because the pandemic has significantly affected how people find and access care. Across the healthcare system, delays in care have resulted in missed routine preventative care, postponed surgeries, and inadequate management of complex and chronic diseases.

In 2021–2022 the Ontario Ministry of Health asked Ontario Health Teams (OHTs) to submit collaborative Quality Improvement Plans (cQIPs) outlining how they plan to deliver higher-quality, more integrated care to communities. The East Toronto Health Partners have worked over the past eight months with clients, community members, and provider organizations to create their cQIPs. The ministry has asked OHTs to focus their improvement work around a core set of priorities aligned to health system COVID-19 recovery and revitalization. The cQIPs identify barriers and improvement opportunities related to cancer screening, alternate levels of care, and mental health and substance use.

The East Toronto Community Health Centre (ETCHC) Network brings together SRCHC, East End Community Health Centre (EECHC), Flemingdon Health Centre (FHC), and Access Alliance. Community Health Centres in East Toronto have a long history of working together in an integrated and collaborative way. The ETCHC Network shares a number of programs where staff are co-located to support fully integrated and comprehensive rehabilitation and chronic disease management. Examples include diabetes education, self-management programming, community-based pulmonary rehabilitation, and physiotherapy.

During the COVID-19 pandemic, ETCHC Network worked on a range of projects that responded to the crisis at a population level. We also continued to align our quality improvement work to focus on health equity, health promotion, and access to routine screening and preventative care. A key part of this work was continuing to provide access to in-person clinical visits—in East Toronto, approximately 12% of visits were in person, but at SRCHC, 47% of clinical encounters were in person.

In 2022, the ETCHC Network will focus on increasing cancer screening rates, sharing data to support a Quality Improvement culture, and improving how it collects point-of-care socio-demographic data from clients and service users. This work will help the ETCHC Network identify health inequities and work to implement and evaluate solutions to reduce these inequities. It will also help inform planning and advocacy at a systems level. This quality improvement focus also aligns with Ontario Health’s priorities of reducing health inequities, transforming care, and promoting service excellence.