Women’s College Hospital is on the journey to becoming a Learning Health System (LHS). This is a model in which we will foster a culture of curiosity and engagement where everyone at the organization is continuously asking thoughtful questions about our current processes, delivery, and outcomes, to determine if and where we are adding value and then to assess how we can work together to effect improvements.
What is a Learning Health System?
Did you know that on average, it takes about 17 years for research findings to be implemented into clinical practice? A learning health system involves the use of feedback and data to make improvements to patient care in real-time – not years from now.
An LHS embodies the integration between research, clinical care, operations, and the community where everyone is engaging in research and quality improvement. This fosters continual improvement and learning across all programs, centers, and institutes, with the aim of impacting positive change for the best possible patient care.
The four building blocks to a learning health system are that:
- It is patient-centered, focusing on individuals, families, and communities;
- It is data and evidence driven;
- It is fully supported and enabled by the organizational structure; and
- It takes place within a culture of ongoing rapid learning and continual improvement.
To achieve a learning health system, an entire organization – people, patients, and infrastructure – all need to be aligned.
LHS Seminar Series
Another great way to learn about an LHS is by attending one of our monthly virtual seminars! This is an opportunity for speakers from across the globe to share their experience with an LHS, the value-add, and how it has influenced the way they conduct their work.
For information about upcoming seminars, please visit our events page.
The role of the LHS Steering Committee is to support the execution of the vision, goals, and mandate of WCH in building a Learning Health System (LHS). Meetings occur every 4-6 weeks, between September to June.
Vision
To foster a culture of curiosity and engagement where everyone in WCH is continuously asking questions about our current processes, delivery, and outcomes, to determine if and where we’re adding value and then to assess how we can work together to effect improvements.
Goals
- Develop a consensus and common vision of LHS across WCH through engagement from various partners and community members;
- Build the Learning Health System Collaboratory, which will serve to plan, implement, evaluate and sustain the LHS model; and
- Establish the building blocks for an LHS, including hospital infrastructure and change management processes.
Membership
- Chairs
- Dr. Rulan S. Parekh MD, MSc (Vice-President, Academics; Staff Nephrologist; Professor, Department of Medicine, Institute of Health Policy, Management and Evaluation, University of Toronto)
- Dr. David Urbach MD, MSc (Head, Department of Medicine; Medical Director, Perioperative Services)
- Soumia Meiyappan (Manager, Learning Health System Collaboratory, Academics)
- Members
- Dr. Onil Bhattacharyya MD, PhD (Family Physician; Frigon Blau Chair in Family Medicine Research; Director of the Institute for Health Systems Solutions and Virtual Care)
- Dr. Noah Ivers MD, PhD (Family Physician and Clinician Scientist; Canada Research Chair, Implementation of Evidence-based Practice)
- Dr. Geetha Mukerji MD, MSc (Corporate Medical Information Officer; Staff Endocrinologist)
- Theresa Kay (Director, Professional Practice)
- Celia Laur (Implementation Scientist and Health Services Researcher)
- Chandra Farrer (Quality Manager, Quality, Safety and Patient Experience)
- Elaine Goulbourne (Clinical Director, Primary Care and the Peter Gilgan Centre for Women’s Cancers)
- Sandra Grgas (Clinical Director, Specialized Medicine & Mental Health)
- Sandra Robinson(Clinical Director, Perioperative Services)
- Brenda Chin (Manager, Organizational & Talent Development)
- Anne Forsyth (Director, Clinical Applications & Decision Support)
Note: Two experience advisors will be engaging community members with lived experience on this Steering Committee and are in the process of identifying these partners. Please see our page on Patient and Community Engagement for more details.
A timeline of the Learning Health System development at WCH over the next 5 years (2023-2028).
We invited two Experience Advisors (EAs) to join our LHS Steering Committee. The role of the EAs on this Committee has been a combination of providing feedback and input on ideas and projects and partnering with staff Committee members as an equal Committee member.
Our approach with building an LHS at WCH is to start small, and then build out. In the next few months, we will develop “pilot” projects, which are ways of testing out different ideas and will certainly benefit from EA input, especially as we come up with these ideas and think about how they can be rolled out. For example, one pilot idea could be to look at patient questionnaires (known as patient-reported outcome measures, or “PROMs”) that could be used across different departments at the hospital.
The impact our EAs have had on our work towards building an LHS at WCH is already evident – one key area is around the notion of survey fatigue that we need to consider as we investigate PROMs. As patients move across WCH, they may receive the same if not similar surveys, which can be overwhelming. Our EAs have shared that there are several surveys out there and that they often seem perfunctory – highlighting the apparent disconnect between the questionnaire and the care they have received. They are helping us think of ways to ensure we do not create any additional burden for patients by organically integrating these into patient flow. They have also highlighted the importance of communicating to patients what we are doing with this information and how it is connected to their care and informing care delivery. This exercise has also brought to light the other surveys are out there in the WCH landscape and how we can work with others within WCH to approach this work from an organization-level.
We are confident that connecting with and involving our EAs in an ongoing manner will continue to make an impact on how we develop our LHS at WCH.
Below you will find a list of helpful resources that describe national and international examples of LHS’ in development and stories of successful LHS implementations.
- The Learning Health Care Project
- The Learning Health System Collaboratory at the University of Michigan
- Institute for Better Health, Trillium Health Partners (Ontario)
- LHS Toolkit from Newcastle University
The Learning Health System (LHS) toolkit was developed by The International Network for Activating Learning Health Systems (INACT-LHS).
Please refer to this resource as a guide for developing and implementing an LHS initiative at WCH.