About Quality and Innovation

Our program exists to make primary care in Canada – and the world – even better than it is.

High quality primary care means providing care that:

  • is timely and available when you need it
  • meets the specific needs, preferences, and values of patients
  • is based on the best research evidence
  • is safe and does not accidentally harm someone
  • is efficient and does not waste scarce healthcare resources
  • helps everyone achieve excellent health regardless of their background or circumstances

Ultimately, we aim to improve the health outcomes and patient experience for those we serve while maintaining costs and ensuring provider wellness.

To read more about our work, download our recent annual report and explore the sections below.

Our vision and strategic plan

Our work focuses on strengthening the “building blocks” of high-performing primary care. First, engaging our leadership to support faculty to dedicate time for QI and build capacity among faculty, learners, and community clinicians to lead QI. Second, building an infrastructure to collect, report, and learn from practice data. Third, supporting our teams to function effectively to deliver front-line care. We strive to involve patients as partners in this work, disseminate our work in scholarly and lay forums, and collaborate with government and other stakeholders to have our work influence policy and practice.

Our strategic plan highlights opportunities for:

  • Leadership — Building capacity in the current and future primary care workforce to improve quality of care.

  • Evidence — Using and generating evidence on how to improve patient experience, improve health outcomes, and reduce cost in primary care.

  • Dialogue — Working in partnership with government, clinicians, and patients to influence policy and practice provincially, nationally, and internationally.

Below is a visual of our workplan:

Q&I Strategic Plan

What is primary care?

Every day, more than 150,000 Ontarians visit a family doctor. Some visit because they feel unwell. Others come for a preventive checkup. Many more come because they have a health condition like diabetes, high blood pressure or depression.

Family doctors listen, examine, diagnose, counsel, write prescriptions, order tests and, in some cases, refer to specialist colleagues for advice. They play a key role co-ordinating care between different health professionals and social services.

It’s not surprising that countries with strong primary care have better health outcomes and spend less on health care.

Who we are

Program Team

Tara KiranDr. Tara Kiran, MD, MSc, CCFP, FCFP 

Tara Kiran is the Fidani Chair in Improvement and Innovation and Vice-Chair Quality and Innovation at the Department of Family and Community Medicine, University of Toronto. Much of her research has focused on evaluating the impact of Ontario’s primary care reforms on quality of care. She has also developed a passion for quality improvement research including initiatives to improve cancer screening rates, measure and reduce care disparities, and support physicians to learn from data. She practices family medicine at the St. Michael’s Hospital Academic Family Health Team where she led the quality improvement program from 2011 to 2018. She is an Associate Scientist in the Centre for Urban Health Solutions at St. Michael’s Hospital and an Adjunct Scientist at ICES. She is also currently an Embedded Clinician Researcher with Health Quality Ontario where she leads a program of research to improve the experience of care for patients transitioning from hospital to home.

Trish O'BrienMs. Patricia O’Brien, RN MScCH

Trish O’Brien is the Manager, Quality and Innovation Program at the Department of Family & Community Medicine, University of Toronto. Trish has been a registered nurse for over thirty years with clinical and research experience in nephrology. Trish caught the quality improvement bug working in nephrology and brought that experience to primary care - first with the Quality Improvement and Innovation Partnership (QIIP) and subsequently with Health Quality Ontario (HQO). Trish has worked in the community, hospital and private industry sectors, and completed certification in quality improvement as an Improvement Advisor (IHI) and in LEAN/Six Sigma (Black Belt), in addition to holding a Master of Science in Community Health degree.

Ms. Dana Arafeh, MHIDana Arafeh

Dana Arafeh is the Patient & Family Engagement Specialist, Quality and Innovation Program at the Department of Family & Community Medicine, University of Toronto. Dana is passionate about involving patients and their families in every aspect of their care. Her goal is to promote patient and family voices as a key driver in all DFCM activities, and look for opportunities for meaningful patient and family engagement. Dana brings a diverse background of skills, including working in paediatrics and mental health at organizations such as SickKids and the Women’s College Hospital, and experiencing managing a national paediatric research network. She also holds a Master’s degree in Health Informatics from the University of Toronto and, as someone living with a chronic condition, serves as a patient partner on multiple projects and committees.

Kirsten EldridgeMs. Kirsten Eldridge, MPH

Kirsten Eldridge is the Quality and Innovation Program Administrative Assistant at the Department of Family & Community Medicine, University of Toronto.


Quality Improvement Program Directors 

Each of our 14 family medicine teaching sites has a QI Program Director who leads the practice and teaching of quality improvement. The Quality and Innovation leadership team meet together with the QI Program Directors eight times a year to discuss how to best advance Quality and Innovation in our department and beyond.


Academic Site


Markham Stouffville Hospital

Dr. Karuna Gupta

Dr. Gina Yip

Michael Garron Health Centre

Dr. Sam Tirkos

Dr. Tia Pham

Mount Sinai Hospital

Dr. Sakina Walji

North York General Hospital

Dr. Tiffany Florindo

Dr. Jennifer Stulberg

Royal Victoria Hospital

Dr. Melissa Witty

Southlake Regional Hospital

Dr. Navsheer Gill

St. Joseph's Health Centre

Dr. Linda Weber

St. Michael's Hospital

Dr. Noor Ramji

Sunnybrook Health Sciences Centre

Dr. Debbie Elman

The Scarborough Hospital

Dr. Susanna Fung

Toronto Western Hospital

Dr. Rory O'Sullivan

Dr. Carly Schenker

Trillium Health Partners

Dr. Ali Damji (Credit Valley)

Dr. Frances Cousins (Summerville)

Women's College Hospital

Dr. Susie Kim


Our work to improve quality

Toronto International Conference on Quality in Primary Care

On November 16, 2019, nearly 150 local and international colleagues came together for the 2nd Toronto International Conference on Quality in Primary Care. The conference theme focused on improving equity in primary care, and speakers from around the world provided insight into the work they were doing in their local contexts to contribute to health equity. View the conference webpage to learn more. 


The Quality Improvement (QI) Program launched a qualitative research project in late 2014 asking the question: What makes primary care teams effective or high-functioning? Learn more about this initiative and read the report. 

Patient Safety

In February 2017, the Quality Program Committee (QPC) supported the use of the IHI Breakthrough Series (BTS) – a Learning Collaborative as the organizing framework for a primary care, patient safety community of practice. Read about the Primary Care Patient Safety Learning Collaborative and access resources.

SPIDER study: Structured Process Informed by Data, Evidence and Research

The DFCM’s Quality and Innovation Program and UTOPIAN have collaborated to work with patients and their health care providers to reduce prescriptions that are less likely to benefit this population. Conversations between clinicians and patients about thoughtful medication choices can improve care for elderly people living with multiple medications. SPIDER, the Structured Process Informed by Data, Evidence and Research will test collaborative ways to have these conversations more often in family practices. 


Over the last decade, our teams have been working to understand and improve gaps in quality in their primary care practices. Explore a selection of innovation reports, commentaries, and research publications that highlight some of our efforts and summarize lessons learned.

View select publications from our faculty.

Contact us

For all general inquiries, questions, feedback, or program inquiries contact: 









Dr. Tara Kiran, MD, MSc, CCFP, FCFP

Fidani Chair, Improvement and Innovation &
Vice Chair, Quality Improvement



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Trish O'Brien

Program Manager



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 Kirsten Eldridge

Program Assistant



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