How Patient Engagement is making a difference at SickKids

Margaret Keatings is Chief Interprofessional Practice and Chief Nurse Executive at the Hospital for Sick Children in Toronto.

Child and family-centred care, established at SickKids in the early eighties, is a significant strategic priority for the hospital.  It is exciting that, through the leadership of the Health Council of Canada, “patient centred care” is emerging as an area of focus across the health care system, with providers exploring new and more effective ways to ensure optimal health outcomes, improve patient and staff satisfaction, and provide high-quality, cost-effective care.  As innovators in child health, we at SickKids have made great strides in developing a philosophy of family-centred care, whereby the child and family are at the very core of everything we do. 

Our journey was influenced by children and their families.  As identified by key experts at the “National Symposium on Patient Engagement,” the engagement of patients is critical to achieving significant improvements in health care outcomes.  At SickKids we credit much of our success to our extensive engagement of children and families in decision-making at the organizational and patient care levels.  Through focus groups and retreats (that also included over 500 inter-professional staff), children and families significantly influenced our present and future direction.

Children and families participate in key leadership teams at the hospital.  The Children’s Council influences our thinking in many ways and ensures we stay focused on what matters most to the child and their families at all stages of development.  The Children’s Council has contributed to and led key hospital initiatives such as “Meals on Wheels,” where children order what they want and when they want to eat.  They designed our “No Smoking” strategy and have recently provided and influenced a new model of creative arts therapy.

The Family Centred Care Advisory Committee is a partnership between staff, parents and former patients who provide input into key organizational decision, recommend new and innovative programs and provide education to all staff and students.  The stories they share with staff and students influence care, foster empathy, and engage our teams in their commitment to family- centred care.

I believe the approach at SickKids is not relevant only to pediatric populations.  Health care in general should consider a model that moves beyond the “person” and ensures the patient identifies and defines the role of the family/support system they want and need. In order to achieve the best outcomes, patients of all ages need support from those who care most about them, especially when they are ill and most vulnerable.  A broader definition that recognizes that “persons” do not exist in isolation of a family or community, and where their values and beliefs are respected, is required.

Thanks for the opportunity to share!

Key Words: Patient Engagement, Hospital for Sick Children , SickKids

Patient Engagement - Finding Your Degree of Involvement

Miriam Kaufman BSN MD FRCPC is a paediatrician and public educator.  She graduated from Duke University School of Nursing in 1976 and Queen’s University Faculty of Medicine in 1980. Miriam has written a number of books for young people and their parents. She is an Adolescent Health Specialist at the Hospital for Sick Children in Toronto.

It was an honour to be able to attend the Health Council of Canada’s National Symposium on Patient Engagement.  I had many thoughts throughout the day, often starting with comparing the paediatric and adult health care systems.

In paediatrics, doctors, nurses and allied health professionals have long had a different relationship with patients than in the adult care setting.  Long gone are the days of restricted visiting hours, health care providers who only talk to the parents, and drab care settings.  Family-centred care has become embedded in the paediatric system, to the point that adolescent care providers (like me) have to remind our colleagues that it isn’t always appropriate to have the parents in the room, or to honour parents wishes if they ask us to lie to their 17 year old.

Patient engagement is essential, but I do think it is important to remember that different people want to be engaged at different levels and, depending on how they are feeling, maybe not at all.  Some people may just want to get health care, and their providers struggle to help them see this as their disease, with engagement in the process essential for an optimal outcome.  Other patients want to be engaged in their own care, getting advice and making informed decisions.  A much smaller group want to be engaged with the system by sitting on committees, advocating for others, or consulting with health care teams.  Health care institutions must do everything they can to support patient engagement, but it shouldn’t be a requirement for care.  No one should be forced to be more engaged than they feel comfortable.  Highly engaged people help create environments that are respectful of and more comfortable for all patients.

At the conference, we were classified as being either health care consumers or providers, but of course all of us in the room were consumers.  We have all had less than optimal experiences in the health care system, but most of us have had some very positive ones too.  I must confess that I am in the “engaged enough” category when it comes to my own health care.  I try to find good providers, I take responsibility for sorting out their advice and making decisions, I almost always show up on time, and I am engaged in staying as healthy as possible by exercising, eating fairly well and never letting a day go by without chocolate! But I’m not interested in being actively involved in a consumer group or sitting on an advisory board.  I don’t think there is anything wrong with this.

I keep coming back to two of the speakers.  One spoke about the incredible work that Princess Margaret is doing to make their outpatient experience more accessible and efficient for patients.  I loved their ideas and the fact that they came from hours of discussions with current and previous patients.  But the plan they were putting into place was expensive and was being paid for by a private donor.  We don’t have a health care system that can afford some of these amenities.

I also think that patients feel more engaged when staff are more engaged.  I was with my father at a Toronto hospital last week and was very impressed by how kind and helpful everyone we spoke with was, from busy people who stopped to give us directions, to the person at reception, to the CT technician and on and on.  We both felt comfortable in that environment, and it had nothing to do with the building or the amenities.  It was because there was no feeling that it was their hospital and that we were trespassers.  Rather, we felt that the hospital was shared by all—providers, staff, patients, and that we belonged.

Patients – A Healthcare Resource That Needs More Recognition

Dr. Rob Robson is Principal Advisor at Healthcare System Safety and Accountability.

I see three reasons to strongly promote patient engagement in healthcare initiatives from a quality and safety perspective. The reasons are:

Goodwill

Patients (and families in the broad sense of the word) understand the challenges faced by the healthcare system and want to help us (providers, administrators, managers) fix and improve it.

Knowledge

Patients and their families are as intelligent, perceptive, and observant as are managers and providers and want exactly what we want – high quality, consistent and safe healthcare services.

Determination and self-interest

This answers the question “Who has the strongest interest and commitment to having quality, safe care provided in our system?” The answer, clearly, is the patient.

My first experience in understanding the power of patients and families was as a medical student, when I was part of a group that established a community-controlled primary healthcare clinic in the Point St. Charles area of Montreal. The direct participation of large numbers of patients and residents ensured the creation and management of a service that continues in a robust manner 40 years later. Patients played a key role in defining the range and scope of services, and populated innovative roles such as community health workers that bridged the gap between theory and practice.

My next experience came several years later as a healthcare mediator and conflict engagement practitioner. The willingness of participants (physicians, nurses, administrators and patients) to actively engage in dialogue demonstrated that most individuals want to solve problems at the most direct and non-confrontational level. Very specifically, patients want to understand what is happening, and when they are allowed to participate in dialogue will contribute actively and will promote innovative solutions and resolutions.

My next major learning experience with respect to direct patient and family engagement in the planning and implementation of patient safety initiatives came during several years as the Chief Patient Safety Officer for a large urban health authority. This was manifested at several levels, with patients participating actively in the investigation of adverse events and critical incidents that had led to harm, and others giving freely of their time and energy working on committees, sharing their experiences with health students, and undertaking qualitative research projects of their choosing.

Most recently, I have been a patient myself, undergoing extended (and successful) treatment for breast cancer. Patients provide one another with warmth and human contact, and strong emotional support. They share reliable information about the variations in the journey they are experiencing. While admiring and respecting the devotion of providers (physicians, nurses, technicians, pharmacists, librarians, support staff) to provide safe, quality care in a complex system, I came to rely more and more on fellow patients for an understanding of the experiences I would encounter.

We will make progress in healthcare to the extent that we create spaces at the table for patients and their families and allow them to participate actively alongside all providers who want to do a good job. They will bring endless goodwill, intimate and useful knowledge, and unprecedented determination to the table.

Health Council of Canada launches new interactive website

We’ve re-designed our website and incorporated new tools to ensure you can quickly find the information you need on the performance of the health care system in Canada.

What will you find?

• Now all the information you need from our reports, videos, podcasts, presentations and blog posts is at your fingertips with our in document search.
• You’ll find up to date information on the health care themes we report on, including innovative practices we can all learn from.
• We’ve integrated our social media channels like Facebook and Twitter so you can better share and comment on content with colleagues and friends and we’ve also integrated our blog into the new site.

We also have a new look which is aligned with our renewed vision – a leading voice that informs, inspires and strengthens Canada’s health system.

Thanks to those of you who participated in the development and testing phase of the new website. We are pleased to deliver the results today.  

Visit us often for the latest news and developments at www.healthcouncilcanada.ca and, when you can, tell us what you think about our new site.

Health Council reveals shortlist for Health Innovation Challenge

Students make their case for innovative health practices and policies in Canada

Today we announced the shortlist for the third annual Health Innovation Challenge. In September, we challenged college and university students to find innovative policies or practices in Canadian health care, tell us why the innovations were working, and how they could be applied to the rest of the country.

Over 220 students across Canada submitted essays explaining what they think could change the future of health care in Canada. Several professors incorporated the Challenge into their class curriculum, and as a result entries came from a range of programs including nursing students, medical students, pharmacy students and many others.

                                            

“This challenge is an opportunity for us to hear from the next generation of health leaders about what they see working for the future,” says John G. Abbott, CEO, Health Council of Canada. “Time and time again we hear what is wrong with the health care system. This challenge was about finding what is working so that we can learn from it and possibly share it more broadly in the future.”

The Health Council of Canada’s work reporting on the progress of health care renewal in Canada presents innovative practices to decision-makers at all levels. The Challenge is a way to involve future health leaders in identifying practices and policies that hold potential. While the entry topics varied greatly, several broad themes emerged throughout, like innovations in wait times, Northern and rural health care, Aboriginal health, pharmaceuticals management, and determinants of health.

                                                                                                   

Winners will receive $1,000 and the chance to apply for a summer internship at the Health Council of Canada office in Toronto, Ontario. Their work will also be featured on the Health Council’s social media platforms, as well as in the quarterly e-newsletter.

Winners will be announced March 26, 2012.

Full Shortlist

Health Policy

Group Shortlist:

·         University of Alberta (Edmonton, AB) – Austin Ojala, Gagan Gandoke, Peter Lok, Expanded role for pharmacists in health promotion

·         Western University (London, ON) – Alvin Li, Sonia Thomas, Organ donation strategy: Reimbursement and job-protection policy

Individual Shortlist:

·         University of Toronto (Toronto, ON) – Galina Gheihman, Ontario’s remote drug dispensing policy as an innovation to improve prescription medication access in remote, rural and Northern communities

·         Dalhousie University (Halifax, NS), Laura Stymiest, People Assessing Their Health (PATH) & Community Driven Health Impact Assessment (CDHIA): an innovative public policy initiative

Health Practice

Group Shortlist:

·         McMaster University (Hamilton, ON) – Aaron Lau, Yi Ki Tse, NPSTAT - A novel nurse practitioner acute care model in the community for Canada's current and future aging population

·         University of Saskatchewan (Saskatoon, SK) – Alexander Dyck, Ingrid Wirth, Social Paediatrics in Canada: More than Medicine

·         Langara College (Vancouver, BC) – Kathleen Adam, Katarzyna Hunc, The Extended Care Paramedic Program: An innovative approach to sustainable patient-centred care

Individual Shortlist:

·         St. Francis Xavier University (Antigonish, NS) – Elizabeth Gallivan, Bridging the osteoporosis treatment gap

·         Simon Fraser University (Burnaby, BC) – Laura Kadowaki, PRISMA: A health care and knowledge translation success

·         St. Francis Xavier University (Antigonish, NS) – Erika Kall, Homeless At-Risk Prenatal Program: Innovative service delivery model reduces health inequities

Key Words: Health Council of Canada, Innovative Practices

                                                                                                                   

Health Council hosting town hall in Vancouver

In a few weeks we’re hosting a town hall on patient engagement in Vancouver. Check out the event listing below – we hope you can make it!

Patient Engagement Town Hall

Join the Health Council of Canada as well as patients, health care practitioners, and government leaders as they discuss how patient engagement can be successfully used as a means of improving the health care system. Discussion will focus on the benefits and need to shift from provider-focused to patient-centred care. “Patients as Partners” will deliver a presentation about transforming how patients in British Columbia work with physician and other health care providers, their communities, and health system administrators to manage their care. An open question and answer session will follow.

Thursday, February 23, 2012

7:00 p.m. – 8:30 p.m. (PT)  
Fairmont Hotel, 900 W Georgia St., Vancouver
www.healthcouncilcanada.ca

For more information or to arrange an interview please contact:

Yeena Peng, Manager, Media Relations, Health Council of Canada
ypeng@healthcouncilcanada.ca, O: 416-480-7100, C: 416-407-2635

College and Association of Registered Nurses Response to Alberta Joining the Health Council of Canada

Dianne Dyer is the President of the College and Association of Registered Nurses of Alberta.

As professionals, registered nurses value decisions based on sound evidence and ongoing monitoring and evaluation of outcomes.  If progress towards a goal is not measured, the goal may be achieved but the benefits may not be recorded to inform practices.   The Health Council of Canada plays a key role in providing information to inform the decisions made by governments.  That is one of the reasons Alberta’s registered nurses and nurse practitioners are very pleased that the Alberta government has chosen to join the Council.    

With Alberta as a member of the Council, there will be valuable opportunities to measure both provincial and national progress towards identified health outcomes.  The Council will gain increased access to Alberta data, leading to more comprehensive national monitoring, reporting and benchmarking.

 

As a Council member, Alberta will have a new forum for sharing innovative ideas and for collaboration to address health issues that impact all Canadians.    Like every jurisdiction in Canada, Alberta is unique, and Council membership provides a chance to showcase provincial innovations which may contribute to solutions for other jurisdictions in areas such as primary health care and health technologies.  The Council’s focus on areas such as the state of home care and its integration with primary, acute and long-term care and health human resource planning will improve accountability and promote resolution of these issues.

 

We are very pleased with our government’s decision to join the Council and become an active partner at the national level in renewal of our health system.

Key Words: Alberta, Health Council of Canada, Health Accord