(From Connexion Newsletter Spring/Summer 2024)

It’s one thing for a family doctor to want to improve the quality of care, but tackling change in a busy family practice can seem burdensome. Fresh off a one-year Physician Quality Improvement project, Dr. Shauna Tsuchiya remarked how manageable — and rejuvenating — the process has been.

“I really recommend it,” Dr. Tsuchiya says. “It helps with burnout. And I tell people this all the time, I think when you can be part of change then that prevents me from burning out, because I can be part of the solution, and I have the tools to be part of the solution.”

The Physician Quality Improvement initiative (PQI) is a program of the Specialist Services Committee, a partnership of Doctors of BC and the BC government, that works in collaboration with health authorities across the province. PQI provides hands-on training and learning projects to help physicians with quality improvements in health care.

Dr. Shauna Tsuchiya, who shares a community primary care practice in Kamloops, worked in a dyad, which sees a physician pair with an administrative partner for their projects. Dr. Tsuchiya reached out to the Thompson Region Division of Family Practice since her project intended to focus on her community practice, and was paired with Chelsea Brookes, Member Integration Lead. Chelsea was the first non-Interior Health partner in the program, which up to that point had focused on hospital-based participants.

Over the course of a year, Chelsea and Dr. Tsuchiya worked together through two in-person training sessions and several virtual sessions. The goal: To develop a customized patient-experience questionnaire for Dr. Tsuchiya’s patients to provide actionable feedback.

Dr. Tsuchiya says that developing a project charter at the outset of the PQI work was important to establishing guidelines in the dyad for addressing communication styles, conflict resolution, scheduling, and decision-making.

“I think it’s an amazing opportunity to work in a dyad partnership,” she says. “You know how you work, and how decisions are made in your world, but that doesn’t necessarily mean that’s how it happens in the other areas of health care. You really learn how you can help each other.”

“To embed a project in an organization requires buy-in,” Brookes says. “People work to their skills. For example, I was able to work on the survey and poster, and Shauna could focus on the clinical aspect.”

The pair also worked with an out-of-town patient partner (who is not a patient with Dr. Tsuchiya’s clinic) to give the perspective of patients.

“We developed a patient-experience survey,” Brookes says. “For example, we asked ‘Do patients feel safe? Do they feel respected? Do they feel heard?’ Things like that. We had a lot of a-ha moments using the PQI tools.”

Dr. Tsuchiya says they were careful not to go into topics that she doesn’t have the ability to change, like office layout. Otherwise, the questionnaire is flexible, and can be modified to probe different subjects such as cultural safety, or appointment booking.

The next step for Dr. Tsuchiya is to launch the questionnaire within her practice to patients. Action and evaluation are the goals, not perfection.

“We planned for continuous improvement. You can change it after each iteration. You can get some feedback and say ‘OK, I can make these changes now’ or wait and get more data,” she says. “You get that flexibility to really make changes on the fly.

“It doesn’t need to be perfect, just start, and change as you go, and those are all QI cycles.”

Dr. Tsuchiya says that working with Chelsea and the Division allowed Interior Health to see the partnerships and the role that divisions of family practice plays.

“When you’re in acute care, so many people have no idea, they’ve never heard of the divisions of family practice and have no idea what they do. And I think it allowed us a little bit to showcase just how awesome the Division is, and what can be done,” she says.

Follow up: Contact Chelsea Brookes if you are interested in creating your own patient experience questionnaire, or if you would like more information about the next Physician Quality Improvement cohort.
Email: cbrookes@thompsondivision.ca