title: The crucial role of clinician engagement in system-wide quality improvement: the Cancer Care Ontario experience.
abstract: In 2004, Cancer Care Ontario's (CCO) role changed from providing direct cancer service to oversight, with a mission to improve the performance of the cancer system by driving quality, accountability and innovation in all cancer-related services. Since then, CCO has built a model for province-wide quality improvement and oversight--the Performance Improvement Cycle--that exemplifies the key elements of the Excellent Care for All Act, 2010. While ensuring that quality of the cancer system is by necessity a continuous process, the approach taken thus far has achieved measurable results and will continue to form the basis of CCO's future work. Clinician engagement has been critical to the success of CCO's approach to quality oversight and improvement. CCO uses a variety of formal and informal clinical engagement structures at each step of the Performance Improvement Cycle, and has developed operational processes to support quality improvement, and educational and mentorship programs to build clinician leadership capacity in that area. An example of sustained quality improvement in system performance is illustrated in a case study of the surgical treatment of prostate cancer. The improvement was achieved with strong collaboration across CCO's surgery and pathology clinical programs, with support from informatics staff.
authors.affiliation: Vice president of clinical programs and quality initiatives, Cancer Care Ontario; co-chair of the CCO Clinical Council; and professor of medicine, health policy, management and evaluation and public health sciences, University of Toronto.
authors.forename: Carol
authors.initials: C
authors.lastname: Sawka
authors.affiliation: Cancer Care Ontario's provincial clinical lead for the Pathology and Laboratory Medicine Program; and professor, Department of Pathology and Molecular Medicine, McMaster University.
authors.forename: Jillian
authors.initials: J
authors.lastname: Ross
authors.affiliation: Cancer Care Ontario's provincial clinical lead for the Pathology and Laboratory Medicine Program; and professor, Department of Pathology and Molecular Medicine, McMaster University.
authors.forename: John
authors.initials: J
authors.lastname: Srigley
authors.affiliation: Cancer Care Ontario's provincial clinical lead for the Surgical Oncology Program; and Professor, Department of Surgery, University of Toronto.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Irish
mesh_terms: D002173:Cancer Care Facilities / Q000592:standards*; D018578:Hospital-Physician Relations; D006801:Humans; D007857:Leadership; D009864:Ontario; D010819:Physician's Role; D058996:Quality Improvement; D012041:Regional Medical Programs / Q000592:standards*