What's on the quality agenda? Acknowledging progress, respecting the challenges

While many quality improvement and performance measurement initiatives are under way in Canada and beyond, there are challenges to be met around effectively coordinating the national quality agenda, sharing expertise and reducing duplication. An important first step has been recognizing the vital connection between quality and efficiency.While many provinces and territories have embraced the quality challenge, the national quality agenda remains less than coordinated. Reaching agreement on goals must be done in full collaboration with the provinces and territories, respecting their unique priorities while also providing the benefits of a national measurement and performance system and broader-level strategies.Workplace culture affects the ability to deliver safe care. Creating an integrated culture of quality results in measurable improvements in staff satisfaction and patient outcomes. However, this process requires long-term commitments from governments, boards, chief executive officers (CEOs) and staff, and involvement at all levels in design, initiation and implementation.There is frustration with the extensive and growing number of bodies to whom health organizations must submit data. This duplication could be reduced through consistent definitions, measurement priorities and reporting mechanisms, as well as national agreement on core performance measures. Ongoing collaboration at many levels is increasing the sharing of information and aligning of definitions in this regard.