Quality improvement as a population health promotion opportunity to reorient the healthcare system

Background A quality improvement (QI) focus in systems strategically investing resources to achieve the Quadruple Aim (i.e., better population health, lower system costs, improved patient care, and an engaged and productive workforce) presents an opportunity to reorient health services towards population health promotion. Setting An interdisciplinary team linked across a large regionalized healthcare system engaged in a (Saskatoon) Region-wide 90-day QI initiative focused on patient safety. Intervention The team worked directly with healthcare teams to link cultural safety, patient-centeredness, and health equity to other dimensions of healthcare quality. The team provided data from health status reports, equity analyses of healthcare utilization, and stakeholder consultations and adapted QI methods, including A3 thinking and Plan-Do-Check-Act (PDCA) cycles. Outcomes Throughout the 90 days, use of the terms "health equity" and "cultural safety" increased among healthcare teams and in region-wide communications. Within the year following the initiative, the Region made public and ongoing commitments to address health inequities. Implications System-wide QI initiatives present opportunities to promote population health approaches, shift perspectives and language, and ultimately influence organizational culture. Learnings are relevant to health promotion practitioners attempting to engage healthcare partners, and for health systems strategically investing for improved population health.