Managing, Measuring & Spreading Improvements in Long Term Care
The second in-person workshop for the 2014-2015 Canadian Foundation for Healthcare Improvement’s (CFHI) Quality Improvement
Collaborative Reducing Antipsychotic Medication Use in Long Term Care: Spreading an Approach from CFHI’s EXTRA Program for
Healthcare Improvement
February 10-11, 2015
Vancouver, British Columbia
List of Faculty and Guest Speakers
Candace Chartier, RN, CHE, MBA, is the Chief Executive Officer of the Ontario Long Term Care
Association. Ms. Chartier began working in the field as a charge nurse at Frost Manor in Lindsay,
Ontario and has experience working in the Acute Care Sector, Rehabilitation, Community Nursing
and the Aeromedical Nursing fields. Since entering the field, she held progressive positions within
OMNI Health Care over her 17 years there, including as a registered nurse, administrator, director
of care, and most recently Chief Operating Officer, before joining OLTCA as Chief Executive Officer.
Ms. Chartier received an executive MBA from the University of Western Ontario’s Richard Ivey
School of Business. She is a strong leader, effective communicator and practiced health care professional who leads and
delivers results on wide ranging and complex projects. She is a strong advocate for long term care and actively involved
with various committees and sits on a number of tables. Her current involvement includes participation on the Health
System Funding Reform Steering Committee; Long Term Care Stakeholder Liaison Committee; Change Committee; Health
Quality Ontario Partnership Table; System Strategy Council; Ontario Health Providers Alliance; Multi Sector Rural Health
Hub Advisory Panel; Nurse Practitioner Advisory Expert Panel; Cancer Care Ontario Advisory Panel; and Long Term Care
Executive Roadmap Committee.
Dennis Cleaver, B.Comm, MHSA, is currently the Executive Director of the Seniors Health Strategic
Clinical Network in Alberta. In this role, he is one of the key leads for the Appropriate Use of
Antipsychotics project. Dennis is a seasoned healthcare professional with a diverse skill set gained
from 30+ years as a Chief Executive Officer or Vice President or consultant in Alberta, British
Columbia and the Northwest Territories.
Mollie Cole, MN, RN, is an Advanced Practice Nurse and is currently the Manager of the Seniors
Health Strategic Clinical Network. In this role, she is one of the key leads for the Appropriate Use of
Antipsychotics project. Mollie has focused most of her 30-year nursing career on the care of older
adults, working as a Clinical Nurse Specialist in both acute care and in Continuing Care and has
worked on provincial teams since the inception of Alberta Health Services in 2007.
Gina De Souza, RN, BScN, MScN, CMQ/OE, CPHQ, LSSBB, is a nurse who is a passionate advocate for
quality of life in older adults. Gina is honoured to work as a Quality Improvement Specialist with
Health Quality Ontario in the development and delivery of curriculum in this fascinating area of
Quality Improvement. Gina has had the privilege of being part of Health Quality Ontario’s Residents
First Initiative at its inception, and other Ministry of Health and Long Term Care funded
Collaboratives spanning clinical topics of falls, continence, pressure ulcers, emergency department
utilization, responsive behaviours, consistency of staff assignment as well as several Lean Six Sigma
Process Improvement projects in the long term care sector. Prior to entering the long term sector,
Gina worked in acute care specialty areas, was a nursing program instructor and geriatric nurse
clinician.
Her long term care experience includes positions of Director of Resident Care, Administrator, Corporate Director of
Quality and Best Practice Coordinator. She has played an active role in numerous quality and risk committees and served
on advisory groups including College of Nurses of Ontario Long Term Care Advisory. Gina was the recipient of the Dorothy
Doyle Leadership Award in 2003. When Gina is not supporting Ontario quality improvement work, she is in her barn
spending quality time with her many hobby farm animals.
Selma Didic, MA, is an improvement analyst with the Canadian Foundation for Healthcare
Improvement (CFHI). Selma has over 6 years experience in designing, conducting and evaluating
qualitative and quantitative research spanning a variety of settings. Selma has published on issues
such as infrastructure development, tourism, and healthcare. Throughout her research experience,
she has applied a variety of methodologies such as sub-group analysis, content analysis,
bibliometric analysis, descriptive analysis, cross-tabulation, statistical significance testing and
regression analysis. Selma’s experience in carrying out research began as an undergraduate
research assistant at the University of Ottawa, and continued in graduate school with her Master’s
project focused on macroeconomic modeling of public investment. In her professional life, she has
held a variety of research-related roles such as an Economist with the Conference Board of Canada,
Policy Officer with Transport Canada and an Evaluation Specialist at CFHI.
Marilyn El Bestawi, RN, BSc, MSHSA, CHE, is a Registered Nurse with a Masters’ degree in Health
Administration. She is a Certified Health Executive with the Canadian College of Health Leaders and
a Certified Long Term Care Administrator. Marilyn completed her 2 year CFHI EXTRA fellowship
where she developed a tool to predict decline in elderly LTC residents to avoid hospitalization.
Marilyn has worked in both community and teaching hospitals throughout her career. Her positions
in Health Care have spanned the range from staff nurse to senior management including a one year
interim Chief Nursing Executive role. Marilyn has been working at University Health Network, in
various contract positions since 2013 and as well does consulting work on staff nurse scheduling for
various organizations.
Lori Mitchell, PhD, is a Researcher with the Winnipeg Regional Health Authority (WRHA) Home Care
Program. Her primary role is to develop, support, and contribute to research, evaluation and quality
improvement activities that assist in evidence based decision-making in the Home Care program. In
addition, her work assists quality of care, program performance, and policy development. Prior to
joining the WRHA, Dr. Mitchell worked for 11 years in academia conducting gerontological and
health services research. Her doctoral training is in Community Health Sciences from the University
of Manitoba and graduate training in Gerontology from the University of Waterloo and Simon
Fraser University.
Kaye Phillips, PhD, is a Senior Director Evaluation, Education and Performance Improvement at the
Canadian Foundation for Healthcare Improvement. Kaye is responsible for overseeing CFHI's EXTRA
program for Healthcare Improvement and a pan-Canadian Collaborative on reducing inappropriate
prescribing of anti-psychotics in long term care. She also leads the design and integration of
strategic evaluation and performance measurement across CFHI's programs.
Kaye brings 10 years of experience working as an applied health services researcher, evaluation
professional and decision support and change management specialist with an interest in quality
improvement and collaborative patient-centered care. Over the course of her career, Kaye has
facilitated organization-wide strategic planning and led the design and implementation of program, corporate and crossregional chronic disease management outcome evaluations, including the North-West Territories Department of Health
and Social Services "Making the Case for Change: Advancing the NWT Chronic Disease Management Strategy" evaluation
and CFHI's Atlantic Healthcare Collaboration cross-case evaluation (in progress). Kaye has also led the design of CFHI's
performance improvement and stakeholder engagement curriculum and e-workshops and serves as a guest faculty across
CFHI’s programs.
Kaye holds a PhD from the University of Toronto's School of Social and Administrative Pharmacy and is an Ontario Training
Center in Health Services and Policy Research fellow and alumna. Her PhD applied network analysis to look at new models
for measuring collaborative research and development for neglected global diseases. Previously Kaye worked as a
research and policy analyst with the Initiative for Drug Equity and Access at the University of Toronto, the Assessment of
Technology in Context lab at Simon Fraser University and with the Institute for Community Health Promotion at the
University of British Columbia.
Joe Puchniak, MSW, CHE, has many years of experience working in the healthcare field at national,
regional, facility and clinical levels, with a continued focus on evidence informed quality
improvement and promoting best practice. He has led and collaborated on numerous quality
improvement projects and initiatives in the field of geriatrics. Joe holds undergraduate degrees (BA
& BSW) from the University of Manitoba, and a graduate degree (MSW) from the University of
Toronto.
Staring on February 17th 2015 Joe will be the Manager of the Special Contracts Unit, Home Care &
Community Mental Health with the Winnipeg Regional Health Authority. Prior to this Joe was a
Client Affairs Manager with CIHI (Canadian Institute for Health Information) working in CIHI's
Western office in Victoria, BC. Before joining CIHI, Joe managed the RAI/MDS assessment system for
Long-Term Care with the Winnipeg Regional Health Authority. He has also worked on the frontlines
of healthcare as a social worker, geriatric mental health clinician and a home care case coordinator. In 2012 Joe
completed his EXTRA Fellowship (Executive Training for Research Application) with CFHI (Canadian Foundation for
Healthcare Improvement) and also achieved his CHE (Certified Health Executive) designation. Joe's work through his
EXTRA Fellowship focused on using health data to better manage antipsychotic medications and improve the quality of
care in nursing homes. This collaborative effort received much positive attention, and is now being spread to healthcare
organizations across the country through this CFHI initiative.
Chris Rauscher is a geriatrician and the Clinical Lead for Seniors Care with the BC Patient Safety and
Quality Council (which includes 48/6 in Clinical Care Management). Chris brings his expertise in
Geriatric Medicine to this role as well as clinical and service development experience from his work
in the hospital, the community and in residential care environments. Chris has supported many
improvement initiatives in British Columbia related to care of patients with complex health
conditions. He supported the early development of 48/6 in Vancouver Coastal Health and acute
care patient length of stay with Fraser Health. He works with the Ministry of Health, the BC Medical
Association and the health authorities to implement the physician Practice Support Program and Shared Care initiatives.
He also has been working, for many years, on improvements in care and support for people living with dementia. In
addition, his recent interests include approaches for in-patient physician care, transitions in care, and polypharmacy in the
elderly.
Ben Rideout, MHA, is a Quality Leader, Clinical Improvement, with the BC Patient Safety & Quality
Council. Ben has been a member of the BC Patient Safety & Quality Council since April 2014. As a
Quality Leader in Clinical Improvement, he supports a variety of initiatives including Clinical Care
Management and CLeAR (Call for Less Antipsychotics in Residential Care). Through his previous
roles at Island Health, Ben was involved in numerous improvement initiatives and developed an
enthusiasm for quality improvement. He has always been passionate about numbers and has a
specific interest in helping turn data into knowledge to support quality improvement. Ben holds a
Master of Health Administration from Dalhousie University and a Bachelor of Business Administration, with a joint major
in Business and Geography, from Simon Fraser University.
Duncan Robertson, FRCP, FRCPE, FRCPC, FACP, is a consulting geriatrician at the Veterans’ Health
Centre and Lodge at Broadmead in Victoria, British Columbia. Duncan commutes weekly to Alberta,
serving as Senior Medical Director of the Alberta Seniors’ Health Strategic Clinical Network. As a
clinician and Professor of Medicine at the Universities of Toronto, Saskatchewan, Alberta and British
Columbia, he participated in developing Specialized Geriatric services in 11 cities in 4 provinces. In
Toronto he was also Director of the Regional Geriatric Program of Metropolitan Toronto. As a
clinician he continues to support specialized geriatric services in AHS Central Zone, in person and by
video consultation. Duncan also has a long history of leadership positions in professional
organizations including the Canadian Association on Gerontology, Canadian Geriatrics Society and
the British Columbia Medical Association Geriatrics and Palliative Care Committee.
Duncan migrated to Canada in 1966. After three years in rural General Practice followed by training as a specialist in
Internal Medicine at Western University, he returned to Oxford for further training in Gerontology and Geriatrics. In 1981,
Duncan became one of the first Canadian physicians recognized by the Royal College of Physicians and Surgeons of
Canada as a Specialist in Geriatric Medicine. He was awarded the Distinguished Service Award by the Canadian Geriatrics
Society and the Queen Elizabeth II Diamond Jubilee Medal for services to Gerontology.
Stephen Samis is the Vice-President of Programs with the Canadian Foundation for Healthcare
Improvement (CFHI). He has a strong reputation in health research and policy, population health
and evidence-informed policy development to improve Canada’s health systems and ultimately the
health of Canadians. Stephen applies more than 15 years’ experience in research, policy
development, knowledge exchange, partnership development and advocacy in the health sector.
Prior to CFHI he was director of Health Policy at the Heart and Stroke Foundation of Canada and he
managed Research and Analysis at the Canadian Institute for Health Information. Before moving to Ottawa in 2000, he
was a health research and policy consultant in British Columbia, where, among other things, he co-authored BC’s
Framework for Action on HIV/AIDS (1998). Stephen holds a Master’s degree in Sociology from Simon Fraser University in
British Columbia and began his career in health policy and research as coordinator, research projects at AIDS Vancouver
Island in Victoria, BC.
Marie W. Schall, MA, is a Director with the Institute for Healthcare Improvement (IHI). Marie leads
innovation and improvement projects and is a member of the operations team for IHI’s Triple Aimrelated activities and programs. Ms. Schall also leads the development and application of IHI’s
strategy for spread and scale-up of improvements and is currently supporting the 100 Million
Healthier Lives Initiative. Marie is currently leading the formation of a Disability Competent Care
Learning Community for health plans as part of a contract with The Lewin Group and the CMS
Medicare-Medicaid Coordination Office (MMCO). Prior to joining IHI in 1995, Ms. Schall designed
and led improvement projects for PRONJ (the New Jersey Quality Improvement Organization) and was Director of
Research for the Health Research and Educational Trust of New Jersey, a non-profit affiliate of the New Jersey Hospital
Association.
Lisa Schilling, RN, MPH, is national vice president, Healthcare Performance Improvement and
Director of Kaiser Permanente’s Center for Health System Performance. Lisa leads the enterprisewide strategy to develop and implement clinical and operational performance improvement
systems. As part of the Care Management Institute, Lisa also leads the planning to adopt Kaiser
Permanente’s total health strategy in care delivery starting with obesity prevention and treatment
and behaviour change models for member wellness. A leader with more than 20 years’ experience,
Lisa has been a nurse and leader of the surgical critical care service line and community health
improvement leader at Fletcher Allen Healthcare, in Burlington, Vermont.
Prior to joining Kaiser Permanente, Lisa was the National Director of critical care services at VHA Inc., with her work
focusing on improving delivery system performance. Lisa has served on the editorial board of the Joint Commission
Journal for Quality and Safety and has authored several publications on related topics. A current AHA senior fellow, Lisa
has been an AHA Fellow, graduate of the Intermountain Advanced Training Program and the Harvard Business School
Executive Leadership program. Her education includes degrees in biology from the University of Vermont, nursing from
Castleton State College, and Masters in Public Health, Administration, and Health Outcomes from UNC Chapel Hill.
Cynthia Sinclair, RN, is the Personal Care Home Manager with East Gate Lodge in Manitoba. Cynthia
is a registered nurse and currently completing her B.N. Cynthia has an Adult Education Certificate
from the University of Manitoba and is also a Certified Diabetes Educator. Cynthia is a recent
graduate of the Executive Training for Research Application Fellowship Program where her
intervention project focused on using data collected with the MDS tool to improve quality care in
the PCH sector and to inform decision-making and strategic planning at both the program and
facility level.
Cynthia's nursing career has spanned across several sectors, from acute care, to community to long
term care. Cynthia has been in a management role for the past 18+ years. After 2 years abroad as a
Managing Director of a LTC facility in England, Cynthia returned to Winnipeg and joined the WRHA
in 2000 as Manager of Community Nursing Services, and successfully transitioned the VON nurses to the WRHA.
After decentralization of the nursing unit, Cynthia became the Manager of Centralized Nursing Services, responsible for
the Manitoba Ostomy Program, the Manitoba Home Nutrition Program and the Community IV Program. During this
tenure she successfully led a re-design of the IV Program to a new service model. Cynthia is the Manager of Initiatives
with the WRHA PCH Program. The PCH Program spans the entire city of Winnipeg and includes 39 personal care homes.
She is responsible for Quality Improvement and Accreditation, as well as various region-wide projects.
Trevor Strome, MSc, PMP, is the Informatics and Process Improvement Lead for the Winnipeg
Regional Health Authority Emergency Program and is responsible for developing and implementing
innovative analytics tools for use in healthcare quality improvement initiatives. He is also Assistant
Professor with the Department of Emergency Medicine, Faculty of Medicine, University of
Manitoba, where he participates on clinical and operations research projects and teaches statistics,
informatics, and quality improvement to Emergency Medicine Residents as well as Emergency
nursing staff.
Having obtained undergraduate training in computer science and neuroscience, and graduate
training in Epidemiology, Trevor has broad experience in health informatics implementation, healthcare quality
improvement, and healthcare analytics development. In addition to a Project Management Professional (PMP)
certification, Trevor has achieved certifications in Lean and Six Sigma. Trevor has been involved in the successful
commercialization of health informatics technology, including an Emergency Medical Services data system launched in
cooperation with the University of Alberta and other commercial partners. Trevor has co-authored three book chapters
and numerous articles on healthcare topics. Trevor is also the author of the book Healthcare Analytics for Quality and
Performance Improvement (http://HealthcareAnalyticsBook.com) which is published by John Wiley & Sons, Inc.
Terrence Sullivan, PhD, Professor, Department of Health Policy University of Toronto and
independent board chair of the Canadian Agency for Drugs and Technologies in Health (CADTH).
Terry also chairs the board of Public Health Ontario (the Ontario Agency for Health Protection and
Promotion) and is a lead faculty and Quality Improvement Advisor for the Canadian Foundation for
Healthcare Improvement. From 2001 to March 2011, Terry occupied successively responsible
positions at Cancer Care Ontario (CCO), the final seven years as President and CEO during which
period the entire organization transformed its business model to performance measurement and
improvement of cancer services.
Evelyn Williams, MD, MHSc, CMD, FCFP, is the head of the division of Long Term Care with
Sunnybrook Health Science Centre and President of the Ontario Long Term Care Physicians. Evelyn
has an economics degree from Simon Fraser University, medical degree from UBC, and Masters of
Health Administration from the University of Toronto (2004). She has been a practicing family
physician in Toronto since 1981, and has been active in medical administration in the Veterans'
Centre of Sunnybrook hospital since 1995. Administrative areas of interest include physician
performance management and quality improvement. She has served as an inspector for the
Medical Review Committee for the College of Physicians and Surgeons, and is currently a peer
assessor for their quality management program. She is also assistant professor in the Department
of Family and Community Medicine, University of Toronto, and is co-developer of the new Ontario
Long Term Care Medical Director Curriculum.