“nothing about me without me!” patient participation in...
TRANSCRIPT
“Nothing about me without
me!”
Patient participation in
healthcare redesignJune, 2014
Margot Wilson, RN, MSN Director, Chronic Disease Management Strategy
Providence Health Care
Delia Cooper Patient Representative
Patient Voices Network
BackgroundJoint partnership between Providence Health Care and the Shared Care
Committee, in collaboration with Vancouver Coastal Health
Mission to improve care for patients with complex chronic conditions by:
• Simplifying the patient journey
• Improving outcomes
• Reducing costs
• Strengthening relationships
Focus Groups
•Family physicians
•Specialists
•Patients
Need for improved
•Communication
•Access to specialists
•Collaboration and relationships
Context
A Force to be Reckoned With
ImportantPowerfulMust not be ignored
Starting out
• Will it change the dynamic?
• Where will we find the patients?
• Will the patient voice be heard?
• What are our expectations of the patient
representatives?
IPAC/Deloitte Public Sector Leadership Award
Added Value
Understanding what is really important to the patient
• Ability to book appointments directly with specialist
• What patients want to be accountable for in their health
care journey
• What is important for the specialty area to know about
the patient before they arrive
Ability to change practice immediately
Rapid Access to Consultative Expertise
•Telephone advice line for family physicians and Nurse
Practitioners
Notification of Family Physician•On admission to hospital
Impact on Change
What we have learned
Principles
• Include patients from the beginning
• Include patients as full team members
• Set out ground rules at start of meeting
• Include more than one patient for support
• Ensure clear expectations from both sides
• Use a facilitator
• Keeps conversation on track
• Ensures all voices are heard
• Ensure follow through on suggestions to the best extent you can
• Give regular updates on progress
• Do a process evaluation after a few meetings to get feedback on how
things are going.
Logistics
• Provide instructions to get to the meeting room
• Provide refreshments and food (with travel time it could be several
hours)
• When providing food – check for allergies – patients might have
some restrictions
• Consider the timing of meetings to avoid rush hour
• Provide parking
• Provide reimbursement for all costs
• Use of flip charts for keeping the points visible
Feedback from a patient representative
“Just having us in the room makes
everyone aware of the focus of it, not
just the duties and administration, but
more about what is best for the patient.”
PVN Patient Representative
Excellence in Quality Award 2013
Levels of Patient Participation and Engagement
• Individual
• Organizational
• System
Patient and Family Engagement at the Organizational
Level
Importance of Patient Participation at the Organizational Level and in
the Patient as Partners|Patient Voices Network
For Patients:
• Positive contribution
• Greater understanding
• Problem-solving in setting where real
change is possible
• Opinions are considered in focus
groups and surveys
• Educational experiences – Webinars or
Conferences
• Briefing and debriefing teleconferences
are enlightening
• Stimulating and gratifying experience
For the Health Care System:
• Includes all stakeholders in
change process
• Patient-centered perspective
• No vested interests
• Greater harmony in problem
solving process
• Expedience frequently a priority
• Cost effective
Importance of Patient Participation at the Organizational Level and in
the Patient as Partners|Patient Voices Network
Successes in the Shared Care Program from the Patient Perspective
Communication in all areas:
• Referrals to specialists
• Clarity for patients
• Consults
• Support for complex chronic diseases (RACE)
• System acknowledgement of patient realities
• Hospital communications
Highlights from the Patient Perspective
• Canadian Medical Association’s Multi-stakeholder Summit – “The
Referral and Consultation Process” - Ottawa, December, 2011
• Health Council of Canada’s National Symposium – “Advancing
Integrated Health Care: Practices that Work” – Toronto, October,
2012
• Shared Care Partners for Patients – “Collaboration in Action:
Showcasing Shared Care in BC” – Vancouver, October, 2012
• Institute for Healthcare Improvement Forum – “Defining
Moments” – Orlando, Florida, December, 2012
• National Health Leaders Conference – 2012, 2013 presentations
• Ethel Johns Research Nursing Forum – “Minding the Gap” –
Vancouver, February, 2013
Patients as Partners|Patient Voices Network and the
Shared Care Program
Learnings from the Patient Perspective:
•Patient as Partners|Patient Voices Network
- tremendous background support
- briefings, debriefings
- participation only to the level that the patient is
comfortable
• Shared Care Committee
- welcoming
- appreciative
- very supportive
- exciting opportunities
System Redesign Engagement Practice Support Programs
Patient and Family Participation
PVN Videos
• The patient perspectivehttp://www.youtube.com/watch?v=QiHFLKGHL9w
• The healthcare provider perspectivehttp://www.youtube.com/watch?v=uxTNnkWlqys
What are people are saying?
