Assessing patient pathways to improve integrated, people-centred care: the Quebec MSSS experience
Bibliographic record
Abstract
Background: The Ministere de la Sante et des Services Sociaux of Quebec (MSSS) pioneered an innovative patient pathway accreditation initiative with Accreditation Canada to advance integrated care by unifying standards across patient pathways, and organizational and professional boundaries to enable high-quality services that meet the needs of people and communities.Citizens, community and service organizations, and policy makers with an interest in evaluating its programs and services and promoting continuous improvement and the development of integrated, people-centred care. Approach: The Quebec MSSS is the government department responsible for overseeing public health and social services in the province of Quebec, Canada. The MSSS has a broad mandate, including the planning, coordination, funding, and evaluation of health and social services across the province.The MSSS serves 8.7 million, and growing, residents of Quebec and is structured to provide comprehensive, integrated, and high-quality services to all residents, ensuring that the system is responsive to the needs of the population. A province-wide patient pathway accreditation cycle was co-designed with Quebec MSSS and Accreditation Canada to meet its unique and integrated structure and to uphold quality and safety through assessment.Quebec's health and social services system is characterized by a high degree of integration on three levels. The The Ministere de la Sante et des Services Sociaux of Quebec (MSSS) is the government entity responsible for developing and implementing health and social services policies in the province. It establishes strategic orientations, policies and allocates resources. On the other hand, the new Sante et des Services Sociaux of Quebec agency was created to operationalize the orientations and policies of the MSSS, and to supervise health and social services establissements. The latter are organizations that provide direct health care and social services to users. Each establissement reports to Sante et des Services Sociaux of Quebec , and may include one or more hospitals, local community service centers, long-term care hospitals, rehabilitation services, mental health and addiction services, and others. Results: 30 public establishments took part in the first patient pathway accreditation cycle between 208 and 2023. The accreditation process engages with senior management, service providers, clinical teams, patients, and family caregivers in each public establishment. Over 00,000 stakeholders expressed their perceptions of quality and safety through 5 surveys in areas such as governance, staff mobilization, quality of life at work, patient safety culture and patient experience.The Quebec accreditation program is based on more than 50 co-designed quality standards from Accreditation Canada. The program covers a 0-year period organized in two five-year cycles (208-2023 and 2023-2027), including areas of focus such asleadership, governance, public health, infection prevention and control, medication management, telehealth and the evaluation of programs and services along a patient pathway, including at transitions of care and coordination of services. Qualitative and quantitative assessment methods are used to understand integrated, quality and safety practices aligned to national and international quality standards. ImplicationsThe patient pathway assessment aims to develop a culture of continuous improvement for the benefit of patients, family care givers, and communities. A co-designed accreditation program that meets specific structural and population needs enables a clear understanding of strengths and weaknesses along a patient pathway, the ability to unify practices and standards across professions and organizations. Learn how gaining a better understanding of patient pathways has helped to illustrate gaps in transitions of care, resulting in more informed decision-making at the organizational and ministry levels. Learn how to build patient safety and quality into an everyday practice by mapping your own jurisdiction patient pathway journey.The second phase of implementation occurs 2024-2027. Improvements will be applied to continue to co-design an assessment program that meets the needs of Quebec and of its residents.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.008 | 0.003 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.009 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".