Archives: Feature Stories

D’Arcy Duquette, Chair, HQCA Patient and Family Advisory Committee  

This is the third part in a series on the value of patient feedback. The first two installments can be found here and here.

HQCA Executive Director, Charlene McBrien-Morrison recently reflected on Alberta’s journey toward patient centredness and closed her piece by posing this question to the HQCA’s Patient and Family Advisory Committee (PFAC):

How can we (healthcare leaders focused on improving healthcare quality) do a better job of “walking the talk” of patient-centredness by listening to and acting on the voice of those we serve?

Part of my charm is being direct, so I will get straight to our recommendations with one request: Please make the commitment to read this response in its entirety. Stop the flurry of activity. Focus. Prepare to hear our PFAC’s thoughts and take the time to listen. If you can do this, thank you. You are already practicing part of our first recommendation.

1.) Come prepared to listen. No doubt when you decided you needed to engage patients in your work, some thinking had already been done around the task at hand. There may have even been some initial conversations about what solutions could/should look like. Please leave these thoughts at the door. Instead, bring your expertise and knowledge of the situation or desired outcome, and be prepared to provide us with enough context to provide you with valuable input.

If you needed to do some preliminary scoping before engaging us, be willing to revise, or even start from scratch, once you hear our perspective. We like the saying, “Do it right, or do it again.” As patients or people with lived experience, let us help you do it right (or at the very least, better). We are confident we can save you a few “Plan, Do, Study, Act (PDSA)” cycles.

One important note about 1):

If you have already made a decision or cannot bring this openness to the table, please do not engage us for “input” or “feedback”. If you are not going to listen and sincerely consider incorporating our voice into your action plan, you will only create frustration and disappointment (for both sides: patient and leader/provider).

2.) Include experience in your evidence. We hear a lot about evidence-based decision-making. Information or data about our experiences should be part of that evidence, and we applaud the HQCA for including it in their resources like FOCUS on Healthcare. This is part of the Institute for Healthcare Improvement’s (IHI) Triple Aim, however we feel it is often overshadowed by population health/outcomes and cost.

If we compared the Triple Aim to a game of rock-paper-scissors, we think patient experience would be the paper. While an equal-odds contender, it is not immediately clear how it competes in the game. How could paper possibly overcome rock (hard and heavy) or scissors (sharp)? Never underestimate the underdog, though. When wielded by a skilled competitor who sees the potential in paper’s role, paper can be valuable and powerful (able to win the game as cover over rock). As healthcare leaders, you are in a position to use that “paper”, the patient and lived experience, to its maximum impact and benefit.

3.) Make time to lift up and celebrate those that are listening to and acting on their patients’ feedback. The good news stories MATTER. Far too often, leaders reward good work with silence. They only make time to monitor and criticize those that are not doing their jobs. Make sure your focus is on patient-centred successes.

This can and should happen in a variety of ways. Ideas for how to do this could include:

• Establish a way to give credit that is meaningful to the individual or team you want to celebrate. It helps to ask how they prefer to receive these kudos. Some appreciate public recognition and others prefer more private acknowledgement. Either way, personalize it. Make sure you provide a specific example of what you appreciated with respect to patient-centredness and what the resulting benefits were.
• Apply for or nominate individuals or teams for an award. Awards programs like the HQCA’s Patient Experience Awards, RhPAP’s Rhapsody Awards, and Alberta Health Services’ President’s Excellence Awards are just a few examples of formal recognition programs in Alberta that provide opportunities for this. Make time to apply or nominate individuals and teams who are listening to patients and make sure the patient voice can be heard throughout the submission. When we evaluate the Patient Experience Awards submissions, we like to ask, “Where is the patient/client/resident/family?” That helps us make sure the initiatives we are celebrating are truly patient-centred.

Not only do these programs acknowledge the hard work that individuals or teams are doing to deliver patient-centred care, they provide real, local examples to learn from.

Thank you for taking the time to hear a few of our suggestions about how healthcare leaders can “walk the talk” of patient-centredness by listening to and acting on the voice of those you serve. If you have any questions or require additional support, please do not hesitate to ask us. We also want what is best for Albertans with respect to their healthcare.

On the offer to ask us any follow-up questions or share feedback, please feel free to e-mail myself and our team of patient advisors any time at info@hqca-main-branding-nexcess.dev.developmentwebsite.ca. We believe this should always be a two-way conversation.

HQCAMatters is published monthly and presents perspectives on topics or issues relevant to healthcare in Alberta the HQCA considers valuable.

On the five-year anniversary of the release of the HQCA’s Continuity of Patient Care Study, Greg Price’s family reflects on their journey to improve continuity of care for Albertans. 

Five years ago, after the courageous decisions made by the Board and leadership of the Health Quality Council of Alberta (HQCA), the Continuity of Patient Care Study was released. Dr. Tony Fields, Chair of the Board at the time, made this statement in the foreword: “Probing this case lets us look closely at specific problems in the system. More importantly, however, it helps us remember that people are at the centre of the healthcare system.”

For us, Greg’s family, the experience of being invited to work with the wonderful team at the HQCA, to discuss, learn, and to contribute to the development of the report gave us genuine hope. Hope that we would have some answers. Hope that there may be some real action taken to change things. Hope that others would not face the same terrible fate Greg had.

The experience with the HQCA team, and the report, was foundational for us. We were able to become more than “another grieving family”. Our family’s support for positive change is built on the report’s carefully documented investigation, its thirteen recommendations, and its “lessons learned” for patients and families, providers, and the system.

During this five year journey, we have met a great many wonderful people, doing the very best they can to provide care while their work is much harder than it should be. They face many unnecessary challenges because of the lack of a real system of care. Too often, leaders within the various areas of healthcare, or “silos”, pursue their own (or imposed political) priorities. Priorities that do not align with what we consider the goal:

Everyone—providers, patients and families, leadership, policy makers, etc.—contributing their strengths together, to achieve the patient’s best possible care outcome and experience.

Five years ago, the HQCA team included us, and set a unique and new level of collaborative teamwork to identify opportunities and to provide recommendations for improvement. This model reached well beyond the traditional, very strong boundaries that kept people like us on the outside of “the system”. Five years later, we are encouraged by the growing openness of people at all levels to discuss challenges and to develop solutions together with patients and families.

The HQCA and those that have embraced teamwork models that include meaningful patient and family engagement do remarkable and brave work on behalf of Albertans. However, with that courage comes the on-going risk of negative or defensive reactions that stall, or worse, impede progress entirely.

Some of the report’s recommendations have been implemented, including clarity on the intervals that referrals to specialist physicians need to be acknowledged and acted on, one way or the other, and the strengthening of the standards for after hours care (see the College of Physicians & Surgeons of Alberta’s (CPSA) Continuity of Care standard of practice). Leaders worked together to enable radiologists to initiate the next test (which would have saved Greg valuable time) when the need is evident and necessary to insure timely diagnostic work, while keeping the patient’s family doctor informed.

Our family, Greg’s family, will be forever indebted to the people of the HQCA. Their courageous leadership and respect given to us during our very difficult time changed our family’s course for pursuing and supporting change in healthcare. This model of teamwork is setting new expectations for collaboration, accelerating the positive change of continuous improvement in health care, making it the very best it can be for everyone.

To fully accomplish this goal though, we need Albertans to become informed and join us (read more about how on our Health Arrows website). Only by working together can we shift the needle to align completely with this better care goal, for patients and providers alike.

Thank you,

Greg’s Family

HQCAMatters is published monthly and presents perspectives on topics or issues relevant to healthcare in Alberta the HQCA considers valuable.