Collins's role in monitoring performance

Concepts of quality assurance and continuous improvement were relatively new to the Canadian health-care system in the mid-1980s. Much of the VCHC's records were kept on cards, as opposed to computers, making it very difficult to develop the type of database that a quality assurance program requires.

While Collins worked to establish a more sophisticated statistical database, he also worked at informal methods of quality assurance. Collins testified:

quite honestly talking to Kim Duncan over a cup of coffee is quality assurance too. In other words, it is happening every day when we are together. (Evidence, page 33,095)

Collins also made sure that the team dealt with negative outcomes as a team. As he described it, following what he called "bad patches", "We drank more coffee, we stayed later, we talked as a team." (Evidence, pages 33,135-33,136)

In addition to this, Collins made sure that the centre conducted annual reviews of its work.