Open Dialogue

Dr. Joshua Tepper, HQO President and CEO, Speaks with the CAHO Catalyst

Dr. Joshua Tepper, President and CEO of Health Quality Ontario (HQO), chats with the CAHO Catalyst about his vision for HQO; how this independent organization will make its mark on the province; and partnerships in the tireless drive for quality.

Dr. Joshua Tepper, family physician and the President and Chief Executive Officer of Health Quality Ontario (HQO), recently sat down with the Catalyst to discuss what kind of partnerships HQO is looking to develop in its quest for quality, and how this young organization, born out of the Excellent Care for All Act (2010), will make a distinct and lasting impact on the health care system of this province.

 Joshua Tepper
Dr. Joshua Tepper, Health Quality Ontario’s President and Chief Executive Officer. Photograph courtesy of Health Quality Ontario.

HQO is an arm’s-length agency of the provincial government that works in partnership with Ontario’s health care system to support a better experience of care, better outcomes for Ontarians and better value for money. Tepper took the helm in September 2013, leaving his position as inaugural Vice President of Education at Sunnybrook Health Sciences Centre. His experience is extensive and broad: Before Sunnybrook, Tepper was Assistant Deputy Minister in the Health Human Resources Strategy Division of the Ministry of Health and Long-Term Care. He was also the President of the Innercity Family Health Team. He has also been active on a national scale as the Senior Medical Officer for Health Canada, an Adjunct Scientist at the Institute for Clinical Evaluative Sciences, and a Research Consultant for the Canadian Institute of Health Information.

You’re immersed in your first six months on the job. What’s your vision for HQO?

HQO is committed to continually improving the health of Ontarians. I talk specifically about health, not health care, because I think a lot of what determines a person’s health isn’t confined to the health care system. It’s related to education, income, housing, food—all of the social determinants of health. It’s a matter of being willing to lean into the idea of improving the health of Ontarians on an ongoing basis. Quality is an ongoing journey.

What are your goals as incoming President and CEO?

The first goal is to recognize the good work that HQO does. It has been around for about three years, and the component parts that were merged into HQO represent a lot of knowledge and skills. We continue to celebrate and benefit from these strengths.

The second goal is to partner. I really want to make sure that we’re working collaboratively at every opportunity. There’s so much incredible work going on in the province; all sectors in the health care system are engaged in improving quality. We need to be the ‘glue’ and facilitate networks of people engaged in the quality agenda. This will help us learn from each other and then spread and scale the successes. We also need to learn from the failures, which are equally important.

The third goal is to play the role outlined for us in our Minister’s Mandate Letter of being the province’s advisor on quality.

HQO helps health care providers adopt evidence-based standards of care and best practices, and monitors and reports on quality improvement efforts across health care sectors.  Where and how will HQO make its mark, or gain distinction?

HQO needs to help create focus and facilitate the conversations about where the ‘big dot’ indicators are, and what quality means in the system. HQO needs to integrate its skills in defining the evidence, driving change and reporting – but it needs to do so through partnership.

On the subject of moving research evidence into practice, CAHO’s Adopting Research to Improve Care (ARTIC) Program is really exciting. I think it’s something that CAHO should be proud of, along with so much other quality improvement work that CAHO member hospitals undertake—phenomenal work in quality, and ARTIC is yet another great example of this.

ARTIC is devoted to moving research evidence into practice to drive quality improvement and benefit the health care system as a whole.  There’s a great deal of common ground between CAHO and HQO, as you indicate. Looking ahead, what will characterize successful working partnerships with HQO?

There are so many great opportunities to work together. CAHO has expertise, both in specific content areas—clinical areas—but also around the process of quality improvement, that resides. This is too big a province for any one organization alone, such as HQO, to try and be effective. We would want to work with CAHO to be able to leverage that knowledge and expertise. Another thing we need to recognize is the opportunity for spreading and scaling among CAHO hospitals and then beyond CAHO to other hospitals.

CAHO has a presence, beyond the acute care system. Every CAHO hospital, each and every day, interfaces with the rest of the health care system. CAHO hospitals are an important part of integration activities.

As we get a better sense of how to drive and improve quality in the patient’s journey through the health care system, CAHO will help us to determine what the evidence shows us we need to do. CAHO hospitals will be very important participants in spreading and scaling the best of ideas.