Strengthening Ukrainian Healthcare Through Global Collaboration: GMKA Executive Director Completes Training in Quality and Safety at Sunnybrook Hospital

This observership represents a significant step in the development of GMKA’s Quality and Safety (Q&S) program — one of the organization’s core strategic priorities and a system-wide effort to enhance the effectiveness of patient care and improve the safety of healthcare delivery in Ukraine. It not only supports Dr. Huivaniuk in applying Q&S practices within her hospital but also expands GMKA’s capacity to build sustainable quality improvement initiatives across Ukrainian healthcare institutions. In the context of a full-scale war, these efforts are critical: they create new opportunities for hospitals throughout Ukraine to strengthen care delivery, improve patient safety, and implement internationally aligned standards even under extraordinary conditions.

“The Canadian healthcare system is quite distinct from the Ukrainian one,” said Dr. Huivaniuk. “My goal was to understand how it operates and identify practices we could adapt in Ukraine. Through this observership, I gained valuable insight into the structure and impact of Sunnybrook Hospital’s Quality Improvement program, while also deepening my clinical understanding of hepatopancreatobiliary (HPB) surgery under the mentorship of Dr. Julie Hallet, Assistant Professor of Surgery at the University of Toronto.”

Sunnybrook Hospital, a leading academic center affiliated with the University of Toronto, is known for its high patient volume, cutting-edge research, and status as Canada’s largest adult trauma center. During her observership, Dr. Huivaniuk gained firsthand insight into Sunnybrook’s comprehensive approach to quality improvement — emphasizing not just clinical excellence, but also patient-centered care, teamwork, and data-driven processes such as infection control, standardization, and outcome monitoring.

She highlighted the importance of collecting data consistently, monitoring processes, discussing critical cases to prevent future incidents, and preparing educational materials for physicians, residents, interns, nurses, and support staff.

“This directly impacts patient management and the hospital’s overall credibility,” she explained. “There’s also a strong emphasis on soft skills — ensuring the team environment is collaborative and psychologically safe. Each team member has clearly defined responsibilities, regular reporting, and a culture of transparency. Outcomes are accessible to other clinicians, patients, and even external institutions. The QI department is a distinct and robust unit comprising administrators, project managers, scientists, infectious disease experts, and clinical representatives. This is what we at GMKA are working to build in Ukraine.”

Scientific research is also deeply integrated into Sunnybrook’s QI programs, with active involvement from medical students, residents, attending physicians, and master’s-level trainees. This constant engagement supports innovation and fosters leadership in healthcare improvement.

“Ongoing research, learning from errors, asking how we can do better, and participating in international projects — these are all practices we can and should bring back to Ukraine,” Dr. Huivaniuk said. “All it takes is initiative from our medical community. Each of us brings experience and curiosity, and we must include students and interns in the process. Science and quality improvement should be fundamental, not optional.”

GMKA has already built a team of researchers investigating pressing healthcare challenges and generating data to support systemic solutions. Lessons from Canadian colleagues will help refine these efforts.

During her observership, Dr. Huivaniuk worked closely with Dr. Julie Hallet, who specializes in pancreatic, liver, and biliary tract tumors, with a research focus on neuroendocrine tumors — a particularly complex and rare cancer type.

“Working with Dr. Hallet was an incredible opportunity. I gained valuable insights into the management of these diseases and developed a deeper understanding of surgical decision-making in complex cases,” Dr. Huivaniuk shared.

She also took note of the organizational model used by the HPB surgery team, which includes outpatient consultations, operative days, and research responsibilities. Weekly meetings in the HPB department stood out as a model of collaborative care. These meetings bring the entire team together to discuss inpatient cases, complications, treatments, and care plans.

“Surgeons aren’t just operating — they’re actively monitoring patient progress and engaged in research. Residents and interns manage day-to-day care, but once a week, everything is reviewed collectively. A rotating attending physician leads the discussion each week. This kind of structured, team-based approach was new to me, and I found it incredibly effective for professional growth and patient care,” she said.

A particularly impactful takeaway was the active role of radiologists in multidisciplinary boards.

Dr. Huivaniuk believes these weekly meetings could offer a more impactful alternative to the traditional daily ward rounds still prevalent in Ukrainian hospitals.

Within the GMKA Quality and Safety (Q&S) program, our multidisciplinary team continues to disseminate evidence-based clinical and diagnostic protocols, standardized operating procedures, checklists, algorithms, and international guidelines. Partnerships that enable knowledge exchange with international colleagues — such as the observership at Sunnybrook — are critical to strengthening GMKA’s expertise. These insights help us scale and promote best practices across the Ukrainian medical community, even in times of crisis.