Working with the IHF Sector in Ontario

1. The Canadian Association of Radiologists Working with the IHF Sector in Ontario An Overview of CAR and MAP Initiatives September 20, 2013

2. PresentationOutline • CAR Overview • CAR Accreditation Programs • Practical Resources • Quality Initiatives • Advocacy • Looking Ahead • Contact Info • Q & A Period

3. Our Mission • To promote the highest standards in patient-centered imaging • To promote lifelong learning & research • To promote safe, efficient & quality healthcare for Canadians

4. Who We Are • Radiologists – Canadian and international – and affiliates • national authority and political voice of radiologists • preferred source of best practice information for radiologists, government, industry, healthcare authorities and the public

5. What We Do • PROMOTES QUALITY IMPROVEMENT: • Clinical Practice Guidelines • Referral Guidelines • Advisories and Position Statements • Accreditation Programs • PROMOTES CONTINUING EDUCATION AND LIFELONG LEARNING: • CPD Events • Annual Scientific Meeting • CARJ, including the Self-Assessment Program

6. Strategic Objectives • With the theme of quality improvement in mind, the CAR has adopted overall strategic objectives for the Association, based around the areas of: • Quality Assurance & Patient Safety • Advocacy • Membership Engagement

7. Our Provincial Partners • Provincial Radiological Societies • Provincial partners have taken an active role in promoting radiology and has contributed to the advancement of technology, research and patient care in medical imaging on a provincial level: • Separately incorporated • Mandates & activities are different • Both the CAR and provincial radiologic societies exist to support the improvement of image quality and patient care in radiology.

8. Promoting a Culture of Quality Improvement • The CAR aims to provide Radiologists with tools and resources to improve the quality of radiology services across Canada. This is accomplished through: • Accreditation Programs • Practical Resources • Quality Initiatives

9. CAR Accreditation Programs

10. Accreditation Programs PROGRAMS INCLUDE: • Mammography Accreditation Program • Bone Mineral Densitometry Accreditation Program …in final stages of development • Future programs may include: CT, MRI, Ultrasound, Etc.

11. MAP Overview WHY IS MAP ACCREDITATION IMPORTANT? • To ensure that patients have access to the highest quality of mammography, conducted safely. • To ensure that radiologists are reading from optimal diagnostic quality images. • To ensure that images are available “which provide necessary and sufficient diagnostic information to provide an accurate diagnosis.” (Ref. Board of the Faculty of Clinical Radiology of the RCR, 31 Oct 2008) Centres that meet the criteria and achieve accreditation are acknowledged publically on the CAR website (www.car.ca)

12. MAP Overview In 1993, the CAR accredited its first units through the MAP: Currently, the MAP has accredited just under 600 mammography units, in approximately 450 centres across Canada.

13. MAP Overview These variables are assessed through the following 3 stages of the accreditation program:

14. MAP Overview • TRANSITION FROM CR TO DR • Advise your MAP coordinator, no earlier than two weeks prior to the installation, and no later than two weeks after the installation of the new unit. The written notification will be accepted via email, fax, or regular mail, and must contain: • The facility’s MAP identification number • The exact installation date of the new equipment • The type of equipment being installed (i.e. DR) • The make, model, and serial number of the new equipment • The list of units that are being replaced by the new equipment • The date the physicist will be inspecting the new equipment

15. MAP Overview TRANSITION FROM CR TO DR Accreditation questions should be directed to: José Gauthier Coordinator of Quality Assurance, Ontario (613) 860-3111, ext. 206 mjgauthier@car.ca Transition questions should be directed to: The Ontario Breast Screening Program screening@cancercare.on.ca

16. Practical Resources

17. Practical Resources CAR Guide to Peer Review Systems CAR Guide to Maximizing the Effectiveness of Clinical Audits AND

18. Practical Resources Lifecycle of Medical Imaging Technology Guidance (due to be released in 2013)

19. Practical Resources Radiation Protection Primer

20. Practical Resources Referral Guidelines Practice Guidelines AND

21. Practical Resources • Ultrasound – Prostate (2013) • Ultrasound – Vascular (2013) • Breast Imaging (awaiting publication) • Technical standards for BMD Reporting (awaiting publication)

22. Practical Resources • WAIT TIME BENCHMARKS • (www.waittimealliance.ca) • In 2005, the CAR partnered with the WTA and began reviewing the MRI and CT benchmarks that had been released that year. • Objective: both the consistency of data tracking and reporting across Canada and, ultimately, equal access to quality imaging care for all Canadians will be enhanced. • These benchmarks are planned to be released in 2013.

23. Quality Initiatives

24. Quality Initiatives • 1) Clinical Decision Support Initiatives • developed in order to observe behavioural change and compliance with best practice guidelines in diagnostic imaging among physicians at a local hospital. • supplied by the CAR • funded by Health Canada

25. Quality Initiatives 2) Medical Imaging Team Day For the past two years, the CAR has partnered with five other organizations to hold an Awareness event on Parliament Hill called Medical Imaging Team Day. Outcomes: 2012 - Paper on the Appropriate use of Medical Imaging in Canada and website were launched: www.imagingteam.ca 2013 - Patient resource brochure called Medical Imaging: The Inside Story. This is a guide for patients from their medical imaging team.

26. Quality Initiatives • 3) Collaborations • Canadian Breast Cancer Screening Initiative (CBCSI) • Pan-Canadian Lung Cancer Screening Network (PCLCN) • Osteoporosis Canada (OC) • Canadian Heart Rhythm Society (CHRS) • Society of Obstetricians and Gynecologists of Canada (SOGC)

27. Advocacy BREAST DENSITY AWARENESS ACT • CAR presented to the Senate Standing Committee on Social Affairs, Science and Technology, in May 2013. Ministries of Health • Health Canada and MOHLTC Appropriateness • CAR guidelines were integrated into a CPOE system for diagnostic imaging with attendant CCDS. • Most effective way of implementing guidelines to ensure that DI resources are used most appropriately and effectively.

28. Looking Ahead

29. Looking Ahead • CAR Initiatives Scheduled for 2013 & 2014: • Launch of the BMD Accreditation Program • Continued involvement in national CPG pilot projects • Work continues on Lifecycle of Equipment project • Collaboration on radiation dose assessment projects • Work that continues on 2nd phase of WTA

30. Who Can You Contact? GENERAL INQUIRIES: Andrea Nelson Director, Quality Assurance anelson@car.ca MAP INQUIRIES: José Gauthier Coordinator, Quality Assurance mjgauthier@car.ca

31. Questions?