26 Healthcare Quarterly Vol.13 No.1 2010 S Saskatchewan’s Health Quality Council (HQC) was the first of its kind in the country. Launched in 2003, it evolved from the Health Services Utilization and Research Commission, with a mandate to not only measure and report on healthcare but also work with a range of partners to improve the province’s health system. In late 2007, HQC’s board decided to venture beyond narrowly focused quality improvement projects. It was time, the board said, for Saskatchewan to reinvent its healthcare system, using the highest-performing systems in the world as its model. With $5 million in special funding approved by the provincial government in 2008, HQC launched Accelerating Excellence, a multi-level program to rethink, redesign and renew healthcare. To help maintain momentum and show other provinces whether high-performing healthcare can be achieved in Canada, HQC is documenting its journey toward high-performing healthcare. As board member and University of Toronto professor Ross Baker states, “Transparency might embolden some of those who are reluctant, and make it more difficult to drag behind if the overall project is being reported.” This is the first of a series of articles exploring the different elements of Accelerating Excellence. It explores the initiative’s beginnings – with a focus on efforts to engage Saskatchewan’s healthcare leaders in making a better, safer system. ––––––– cottish poet Robbie Burns longed for the gift of seeing ourselves as others see us. Last September, Saskatchewan healthcare administrators and board members partici- pating in a leadership workshop were told to do just that – but with the benefit of a camera, a tool not available in Burns’s time. The task was to have patients create a photographic journal of their journey through a healthcare experience. In Sunrise Health Region, northeast of Regina, the camera showed a perspective staff do not see, or stop noticing – confusing and contradictory signs, a broken front door, a row of doctors’ parking spots sitting empty while the handicapped parking was full and hours of being left alone – including a wait so long it was too late to get a prescription filled. As it turned out, the automatic door had been broken, off and on, for months. Apart from the problem it posed to handicapped, sick and older visitors, the repeated hanging of an out-of-order sign on the front door was not likely to inspire confidence in the system. The photographic journal captured an unfortunate image of healthcare in Sunrise – and a perfect reflection of just how profound a transformation Saskatchewan is aiming to achieve. “Photo journaling lets us see the story through the patient’s lens,” says Suann Laurent, senior vice-president of health services at Sunrise. “You hear the story, but when you actually see it from the patient’s perspective, it’s very different from how people in the health system perceive it.” Handing cameras to patients and asking them to record their visits was an “absolutely fabulous” way to help senior managers at Sunrise understand what patient-centred care really means, says Laurent, and how innovative they will have to be to achieve it, changing not just how they act, but how they think. A new approach to thinking and acting is the whole point of the Quality as a Business Strategy Leadership Learning Collaborative. It is one part of an ambitious plan by HQC to transform healthcare in Saskatchewan. Called Accelerating Excellence, the initiative was launched in 2008. It includes new quality programs for clinicians – Releasing Time to Care for nurses and the Chronic Disease Management Collaborative for primary care teams – and encompasses existing HQC activi- ties, such as its Quality Improvement Consultant program. Supporting all the initiatives is the Quality Insight program, which measures and reports on quality of care. Modelled after the approaches that have led to successful reinventions of health systems in the United States, Sweden and England, Accelerating Excellence promises to give “people working at all levels in our health system … the knowledge and tools to overhaul our system’s current piecemeal collection of disparate parts into a co-ordinated quality-focused system.” Despite an increasing focus on quality in recent years, coordi- Accelerating Excellence in Saskatchewan Jane Coutts Accelerating Excellence Report