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Friday, March 9, 2012

OP-ED: Turning what we know into action

The below is an op-ed by Dr. Jack Kitts, Chair of the Health Council of Canada and CEO of the Ottawa Hospital. It was published last week in several local papers.

Looking beyond 2014, it’s time to start thinking about the new direction the Canadian health care system could take, and to take advantage of the rare opportunity to be able to decide what kind of health care system we want. The conversations already underway are too important to not include the very people who benefit most from health care: the patient. To transform the health care system, and for the good of Canadians, patients need to be involved in the design, planning, and delivery of their own health care.

In our review of the current health accords, the Health Council of Canada has found that where specific objectives and concrete targets were set, governments and the health system made the most progress. The patient experience is measurable, and in future, should inform the establishment of key system performance objectives. This sends a signal that the time has come for those at all levels of the health care system, including service delivery and policy settings, to recognize patients as partners. And moreso now than ever, Canadians expect to be involved. Too often, decisions are made for patients, rather than with patients. In a recent report, we found that less than half of Canadians feel involved and are actively participating in their health care. We also found that patients who are engaged are happier with their care, and feel better about their health. So why wouldn’t we encourage more patient engagement?

Patient engagement is a continuum of involvement. On one end, the provider merely informs patients of what will happen and how they will be cared for. That’s all too often where we are today, and where we have been in the past. But the role of the patient should not be to passively receive care. The relationship needs to get onto the other end of the spectrum, where there is a two-way exchange of information, patients are empowered, providers are willing to listen to them, and decisions are made as a team. We have evidence that shows engaged patients tend to have better health outcomes, and we believe that the health care system could have better results if patients were actively involved in its design and continuous improvement.

To raise awareness about the potential of patient engagement, and to spark a national dialogue to build support for patient engagement in health system transformation, the Health Council of Canada hosted a symposium in October, 2011. The over 160 people who attended collectively represented the Canadian health care system: patients, federal and provincial government representatives, regional health authorities, local health integration networks, health system administrators, health care providers, and researchers. We heard many perspectives. Patients told us what it is like to navigate the often intimidating and confusing Canadian health care system. Health care providers gave us an insider’s view on this same system, and planners and administrators told us how they’re working to make patient-centred care a reality.

We also heard  of many examples where patient engagement is being done well across Canada. For example, the Patients as Partners program is both a policy and a philosophy of the British Columbia Ministry of Health. Their unofficial motto is “nothing about me without me.” For the health care system to change, we must learn from one another, share what others are doing well, and, more importantly, not be afraid to ask them how they did it. The ideas for change are out there. By sharing what we learn from others who are also actively involved in health care, and putting that knowledge into practice, we can start to turn ideas and experience into action, and a better reality.

For the Health Council of Canada, our work didn’t end with the symposium. We recently released Turning what we know into action, our commentary on what we heard throughout the symposium. The proceedings report is also available online at We will keep what we learned in October fresh in our minds, and embed it into all that we do. Patient engagement at all levels happens when we ask ourselves, “Is this the right thing to do so that patients and their caregivers have a voice?” We hope governments and health care providers take that message to heart. And we also hope that patients take it upon themselves to be more involved in their own care.

Dr. Jack Kitts

Dr. Kitts is the Chair of the Health Council of Canada and is the CEO of the Ottawa Hospital.

Key Words: Patient Engagement, National Symposium, Patients as Partners

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