“This is my first QI involvement. I feel like this is a way of capturing much of the frustrations I experience in my day to day work and to do something positive about it. I really enjoyed this process because it is a collaborative approach in identifying system level issues." Dr. Lawrence Chow 
In fall 2018, VCH adopted the Interdisciplinary Learning Review, a system process review which helps to identify system-level opportunities for improvement. The ILR approach utilizes a systems-level lens to identify, learn, understand and share opportunities for improvement through a process of examining patient journeys. The goal is to make these improvement opportunities thoroughly understandable, measurable and actionable.
Over the past 3 years, this new collaborative approach has fostered a culture of learning across disciplines and specialities at VCH. It has brought together point-of-care clinicians from all parts of the organization to have conversations on how to provide the best possible care for the patient/client and their family, elevating the traditional chart review processes to a more meaningful mechanism that utilizes frontline expertise in a truly multidisciplinary, no-blame setting.
The process begins with a conversation with physician leads and operations teams to decide on a cohort of interest. Then, cases are identified and reviewed independently by a physician and a frontline care provider. All patient information is entered and stored into a central registry that has the ability to generate data. Once the review is complete, a group of health-care providers from all disciplines come together to discuss and gain consensus on the system opportunities for improvement identified, which is essential to ensuring confidence in the data obtained through this process. The data is then used to drive meaningful change.
At VCH, our ILR journey started with mortality reviews in 2018 and have since expanded to mental health, community and stroke and rehab programs. To date, we have trained close to 80 physicians from across all three communities of care.
For more information on the program, please contact Dr. Roderick Tukker - Roderick.Tukker@vch.ca
Written by Nicky Huang
