AC Completes Largest Survey to Date for Alberta Health Services

July 7, 2017

Organizations ‘see value’ in AC quality platforms ‘even after the survey’

SurveyorsAccreditation Canada (AC) recently completed its largest survey yet for Alberta Health Services (AHS).

The six-day survey, the last in a four-year cycle, involved 30 surveyors who visited 129 sites across Alberta. It covered the entire province, including rural hospitals and facilities in remote areas such as High Level, Fort Vermilion and Horse Lake.

“This is the biggest project we’ve undertaken in Canada,” says Pamela Daw, an Accreditation Associate at AC. She notes that over four years, the AHS surveys have included more than 100 surveyors visiting more than 300 sites. Daw was responsible for logistical preparations for the 2017 AHS survey, ensuring that surveyors had accommodations and transportation in each town/city.

Daw notes that for each AHS survey, there were two AC team leads working together. One AC lead was based in Calgary and the other, in Edmonton, Daw says. Each AC lead was responsible for 15 surveyors.

Alex Rosé, an Accreditation Specialist at AC, says the coordination of surveyors for the 2017 AHS survey began a year and a half before their feet hit the ground.

She notes that there were teleconferences with AHS every week to determine which sites would be surveyed against which standards, and how many surveyors would be needed. Rosé adds that she then had to find surveyors with experience in specific areas of health care, customized to AHS’ needs. “For example, I needed to find six surveyors with experience in Long-Term Care and others with experience in Medicine,” she said.

AC Survey Cycle Brings Value, Ongoing QI to Health System

Linda Tymchuk, Executive Director – Accreditation at AHS, says the four-year survey process has encouraged quality improvement at AHS and a continuous measurement of that improvement. She notes that some staff members who were initially uncertain about accreditation or who didn’t know much about it have now fully embraced the process.

“They have really embraced the standards as a methodology to improve the services they are providing,” Tymchuk says. “They see value in it as an ongoing quality improvement platform, even after the survey.” Tymchuk adds that over four years, AHS’ services were assessed against 38 standards; which are now being developed by AC’s affiliate, Health Standards Organization (HSO).

Tymchuk notes that throughout the cycle, it was a learning process for AHS to figure out how to assess so many sites, services and leadership levels against the standards. “We learned a lot about how to apply the standards across a system,” she said. Tymchuk adds that when dealing with 20 to 30 surveyors per survey and a multitude of sites, the key is ensuring surveyor feedback is returned to the proper unit. This year, surveyors observed and scored 29,038 ratings across Alberta’s health system.”

In a post-survey letter to AC, AHS President and CEO Verna Yiu writes that accreditation is a key component of AHS’ ongoing quality journey. “[Accreditation] supports AHS’ goal of providing a patient-focused, quality health system that is accessible and sustainable for all Albertans.” Dr. Yiu adds that AHS appreciates its partnership with HSO and the “ongoing collaboration to ensure AHS is a leader in quality and patient safety.”

Maura Davies, President of Maura Davies Healthcare Consulting Inc. and a Surveyor Co-Team Lead for AC on the AHS survey, says she was struck by the depth of AHS’ commitment to quality improvement.

“I’ve continued to be impressed by the commitment of AHS to the accreditation process, and their high level of preparation and organization,” Davies says. “Over the years, AHS and AC have developed some approaches that are specific to AHS, allowing a connection of team members and coordination.”

Davies says entire teams of AHS staff mobilized to meet with surveyors during the most recent visit week to walk through, in detail, what is being done in priority areas like Patient- and Family-Centred Care. Davies and others note the value of such meetings, especially given the scale and complexity of province-wide regional surveys.

Regionalization – a cross-Canada trend

The size and scale of the survey is due to the fact that Alberta was the first Canadian province to amalgamate all its regional services into one health system. Others have followed or are following suit.

“Right now, this is the biggest project we’ve undertaken,” Rosé said, adding that Nova Scotia is now amalgamating their regional health services.

Saskatchewan is amalgamating 12 regional health boards into a single authority expected to launch this fall. Manitoba also recently announced plans to centralize some or all services of eight independent organizations into a single ‘shared services’ agency.

Tymchuk says AHS’ collaborative relationship with AC was helpful throughout the four-year survey cycle.

She notes that for a large-scale organization such as AHS, implementing the Qmentum program can be challenging. Tymchuk says that at the beginning of the four-year cycle, AHS’ survey process wasn’t refined.

“I think the collaborative relationship has been very helpful for problem-solving and for establishing the survey process we have now,” she said.

She notes that throughout the cycle, AC surveyors also helped AHS identify Leading Practices. In many cases, Tymchuk says, staff were going about their daily work at different sites without realizing what they were doing was leading the field. “Surveyors identified the Leading Practices and encouraged staff to submit them to Accreditation Canada,” she said. “The staff didn’t really know or appreciate what they were doing was potentially a Leading Practice.”

This article was updated on July 14, 2017.