Abstract
The Best Practice Spotlight Organization® (BPSO®) Program - spearheaded by the Registered Nurses' Association of Ontario (RNAO) - has fostered a social movement of science to implement evidence-based Best Practice Guidelines (BPGs) across health care organizations since 2003. Now in place at 1,600 health organizations, the program has mobilized more than 150,000 BPSO Champions worldwide to drive continuous quality improvement in care delivery, yielding impactful outcomes for staff, patients, organizations and health systems. In 2019, the BPSO program expanded to include integrated systems of care - starting with four Ontario Health Teams (OHTs) as founding partners - implementing two priority RNAO best practice guidelines: Person- and Family-Centered Care (2015) and Transitions in Care and Services (2023).
Approach: East Toronto Health Partners (ETHP) Ontario Health Team (OHT) was selected as one of the inaugural BPSO OHT candidates, uniting organizations from primary care, home care, rehabilitation, community service sectors and acute care. Cross-sectoral teams, including patient and caregiver partners, collaboratively reviewed BPG recommendations and identified key joint projects to improve care outcomes. ETHP developed e-learning modules and resource toolkits to support these efforts, enhancing communication and continuity of care within the OHT, particularly during care transitions.
The BPSO OHT committee structure was pivotal to its success. The steering committee established relationships across partners' professional practice departments, supported by the OHT's operational and governance frameworks. This structure evolved to include strong community leadership, with community members co-leading BPSO OHT committees and championing evidence-based care initiatives.
RNAO's four-year framework, tailored to meet OHT needs, provides tools for engaging champions, selecting guidelines, identifying practice gaps, coaching, and tracking key performance indicators. This structured approach, guided by RNAO's Leading Change Toolkit (fourth edition) ensured alignment among partners and equipped them with the essential tools for successful BPG implementation.
Results: The BPSO OHT initiative enabled ETHP to shift from quality programs operating "within" organizations to an integrated improvement approach "across" organizations. Frontline providers from several disciplines and sectors have become champions for both evidence-based practice and integrated care. ETHP also undertook three RNAO Advanced Clinical Practice Fellowships, where early-career fellows - mentored by OHT nursing leaders - conducted a qualitative study on care journeys using RNAO's quality improvement methodology. These fellowships deepened fellows' understanding of integrated care, generating insights that benefit the broader community and the OHT. ETHP's 2024 "designation" as a BPSO OHT, after completing RNAO's established milestones over a four-year ""pre-designation"" period, positions ETHP to offer mentorship to other OHTs in earlier stages of their journey.
Implications: The BPSO OHT program advances collaborative approaches to evidence-based care across integrated systems of care by powering frontline providers as champions. The initiative demonstrates that effective implementation of best practices requires adherence to guidelines, along with a commitment to collective action and shared accountability across systems of care. ETHP's experience as a BPSO OHT can guide future efforts to enhance integrated care, promote a culture of continuous improvement, and strengthen resilience in healthcare teams. Collaborative strategies will be crucial for sustaining our workforce and addressing complex population needs.