Clinicians often spot opportunities for improvement in their day-to-day practice. They usually become apparent after concerns are shared with colleagues in a hallway or cafeteria, or due to a clinician’s own drive to experience job satisfaction. But how does one turn an idea into action in our exceedingly complex health care system? 

In partnership with six health authorities, the BC Ministry of Health, and Doctors of BC, the Physician Quality Improvement (PQI) initiative funds training for physicians to develop the skills to bring their quality improvement ideas to life. In addition, participating physicians receive funding and support to design, plan, and implement their projects, usually with involvement from multidisciplinary teams. The training is provided by quality improvement experts over a 10-month period (on average), mostly in a group setting. The size of each project’s team varies depending on the scope of the project. 

A joint steering committee composed of senior health authority administrators, Specialist Services Committee representatives, patient representatives, and clinically active physicians leads the overall direction of the initiative. Dedicated PQI staff provide support to participating physicians in each health authority. 

The PQI initiative began in 2015 and has trained and supported over 500 physicians per year. Program graduates report enhanced understanding of quality improvement and improved skill development, enabling them to effect change in their workplace. PQI’s renewed annual budget based on the 2019 Physician Master Agreement is $10.5 million. 

Examples of past PQI projects include reducing patient wait times to receive radiation therapy, improving sepsis care for inpatients in the acute medical wards, and decreasing unnecessary urine cultures in the emergency department. 

Last year, a PQI Summit brought over 400 health care attendees from across the province to celebrate the work of the initiative, encourage connections, and spark action—with inspiration from keynote speaker, Dr Don Berwick, president emeritus of the Institute of Health Care Improvement. 

How to get involved 

Throughout the year, PQI teams in each health authority hold 1- to 2-day information and introductory learning sessions. Attending one of these sessions is not a requirement in every health authority, but attending physicians find the sessions useful to learn quality improvement methodology and have their questions answered. 

At the beginning of each year there is an intake process in each health authority where physicians submit their proposals to the steering committee and participate in a round of interviews. The steering committee then selects which projects to fund based on a diverse set of criteria. The criteria differ in each health authority, but some noteworthy factors for consideration are:

• Desire to bring improvement, big or small, to the health care system.
• Desire to learn quality improvement concepts.
• The project’s strategic alignment with health authority priorities.

The selected physicians are notified that their project has been accepted in early fall.

PQI is one of nine initiatives supported by the Specialist Services Committee. If you have questions, contact sscbc@doctorsofbc.ca. To learn more about the Specialist Services Committee’s work, go to www.sscbc.ca. 
—Gordon Hoag, MD
Provincial PQI Physician Lead

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This article is the opinion of the Specialist Services Committee and has not been peer reviewed by the BCMJ Editorial Board.