Grant: Operating Grant: SPOR iCT Rewarding Success - Travel Awards - Manitoba

Two of Manitoba's priorities for our health system are improved clinical and financial efficiencies through redesigned care delivery, and improved performance management using measures of efficiency and effectiveness. Meeting these priorities is challenging due to a lack of measures of health outcomes and delivery, a poor understanding of how and where resources are spent, and the difficulties in implementing change in a complex system. We are proposing to determine the effectiveness of a new way of selecting, collecting, analyzing, reporting and acting upon measures of health system performance.While this can be broadly applied to all of healthcare, we have chosen to focus our work on provincial orthopaedic care as it provides both acute and elective care, there exists sex and gender differences in access and utilization, and because the learning's can be scaled broadly. We will start by measuring total resources expended provincially on the delivery of orthopaedic care, and then develop a full understanding of how this care is delivered. We will then measure care delivery in the following areas: access, appropriateness, effectiveness, safety, and care experience. Patients and the existing multidisciplinary provincial orthopedic executive will participate in the selection of the measures; the committee will then use this data provincially to improve care efficiency and effectiveness by identifying cost discrepancies, optimizing how orthopaedic care is delivered, and assessing the clinical and fiscal value of the various components of orthopaedic care. The data will also be provided to the provincial orthopaedics standards committee for review and inclusion in physician quality reports. To determine the effectiveness of this process, we will compare these measures before and after they are reviewed and acted upon. To understand why and how change occurs, we will observe the committee's decision making process, and perform interviews with key participants.