I had the privilege of attending Breakfast with the Chiefs on November 28th hosted by Anton Hart and the Longwoods Publishing team. It was not lost on me that the speaker was a diagnostician by training. Dr. Joshua Tepper MD is the new CEO and President of Health Quality Ontario. He is a smart, talented physician leader with the right diagnosis for our patient named “quality”.

In his first seven weeks on the job, Dr. Tepper has taken the time to complete a thorough history and physical exam and his findings are key to developing the right care plan for quality.

1. EHR; we must leverage our investment in electronic health record technologies to better link providers patients and families in much more meaningful ways.
2. Data; we must convert the data we have into meaningful information and powerful knowledge to provide our clinicians, managers, patients and the public with real-time feedback that makes a difference in the pursuit of high-quality care.
3. Social determinants of health; in their absence our best medical advice and compliance with that advice is null and void. If our patients are struggling to find food and shelter, health and quality has a completely different definition.
4. Patient engagement; we must do better in involving our patients and families in the design, delivery and improvement of care.
5. Coordination of quality improvement initiatives and resources. No matter where you are in Ontario, quality and quality improvement in healthcare is alive and well. Learning what's working and what's not working from each other now is key to our collective success if we are to prevent harm tomorrow and improve the quality of care well into the future.
6. Culture; quality needs to become everyone’s number one priority in healthcare. Each of us must become competent in quality improvement science and collectively we must embrace a culture of quality improvement.

In addition to these astute clinical findings, Dr. Tepper suggested our patient requires four important lines of investigation to assist in the development of a care plan that will benefit the patient and minimize the chance of harm. For each investigation, we must replace the word “or” with “and”. Specifically we need:

1. quality improvement and accountability;
2. rapid cycle evaluation and research;
3. reduction in unnecessary variation and local autonomy to meet for local needs;
4. innovation and scale / spread of best practices.

Dr. Tepper and his team at Health Quality Ontario are on the right path. As healthcare leaders we should all join his care team and help implement the care plan. If we do, the patient known as “quality” may return to full health and wellness. Personally, I look forward to doing by part, I hope you do too.

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