Integrating the voice of the patient

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Like most hospitals in Canada, Thunder Bay Regional Health Sciences Centre operates within an increasingly challenging healthcare environment: Indeed, we observe a growing population of vulnerable and medically complex patients that no longer require specialized acute care but cannot be discharged home. This exacerbates what are already demanding fiscal pressures. We struggle to address chronic surge capacity. As a young and growing academic health sciences centre, we work together with our system partners to ensure we accomplish our mission and priorities effectively and efficiently. Patients are our partners, and the other health care providers in the system are part of the solution.

Patient and Family Centred Care (PFCC) is the philosophy that guides us. This concept to healthcare provision calls for patients and families to be the focus of all our actions. Many hospitals are embracing the PFCC philosophy, and are involving patients and family members in medical decisions like never before.

What is different at our Hospital is that from the beginning, we have intentionally integrated the voice of the patient at all levels. Patients are members of every program and service council, including the Senior Leadership Council and the Board of Directors. They are at the table, contributing to decisions and plans to tackle the challenges we face.

Patient Family Advisors, volunteers who have experienced care at our Hospital, are intimately involved in discussions at the highest levels. Close to 100 persons volunteer as Patient Family Advisors (PFAs) providing a patient perspective in virtually all areas of the Hospital. Since fully committing to PFCC, PFAs have been involved in over 600 working groups, committees, councils and teams. Some examples include Board Quality, Hiring, CEO selection, Strategic Planning, Accreditation, Staff orientation, Education, Program development, Website development and policy review.

When we have to consider complex issues and weigh the consequences of difficult clinical or financial considerations, a Patient Family Advisor contributes in enriching the discussion and ultimately, the decisions. In this way, we are transparent, accountable to the people we serve, and unfailingly focused on the best outcomes for patients and families.

Ours was one of the first hospitals to include PFA as an active member of the Quality of Care Committee, bringing a unique perspective to discussions regarding critical incidents that have occurred, and the recommendations that result. This is a significant step forward. We had seen the benefit of PFA involvement in other areas, and how it improved outcomes. The PFA active participation adds balance and a valuable perspective, which is particularly important in quality improvement recommendations.

The Quality of Care Information Protection Act (2004) identifies that the patient voice must be represented throughout the care provision process. We not only work with patients and families but, to comply with the Act, we’ve taken that one step further by including a PFA on our Quality of Care Committee. Patients involved in an incident are always part of the review, of course; however the PFA represents ‘all patients voices’ and adds a consistent perspective at the committee level.

Our full integration of volunteer PFAs has been met with surprise from other hospitals. There is often unease because the councils and committees discuss the most critical incidents and highly confidential information. My advice is this: Trust that your volunteer is involved for the right reasons and you will be rewarded with better outcomes. Our PFAs are selected through an application process, and receive the same orientation as Hospital staff. Their commitment to and respect for confidentiality is equal to that of our staff.

We’ve been practicing PFCC for the past eight years, and our Strategic Plan 2020 displays our continued commitment to grow and embed the PFCC philosophy at our Hospital. PFCC is not something that just happens. It’s about making an intentional commitment to a journey with a richer appreciation of what it means to work in collaborative partnership with patients and families. It changes the way you deliver care and services to shape a better organization.

In fact, this year, Accreditation Canada implemented changes to enhance the focus on patient and family centred care. According to their website, Accreditation Canada is now evaluating health care and social services organizations against new requirements that ask organizations to: Partner with patients and families in planning, assessing, and delivering their care; include patient and family representatives on advisory and planning groups, and; monitor and evaluate services and quality with input from patients and families.

In addition, Ontario’s Patients First Legislation provides an action plan that “exemplifies the commitment to put people and patients at the centre of the system by focusing on putting patients’ needs first.” This external endorsement supports all hospitals to enhance PFCC, and validates the work we are doing at Thunder Bay Regional Health Sciences Centre.

Our PFCC commitment has had a tremendously positive effect on the overall patient experience. We know we are leading a trend with other hospitals that are engaging their patient community in enhancing the focus to patient and family centred care.

Thunder Bay Regional Health Sciences Centre has been designated by Accreditation Canada as “Leading Practice” in Patient and Family Centred Care. We are also proud that we received two prestigious awards from the Canadian Patient Safety Institute (CPSI), one as an organization, and one for the work our Patient Family Advisors do. The CPSI is a national organization that monitors patient safety and patient experience across Canada.

Although we are already recognized leaders in PFCC, we view this commitment as an ongoing journey to better the overall experience of care. As we continue on this journey, I am confident we will more successfully adapt our organization to effectively address the challenges we face. Most importantly, we will make improvements that will be observed by our patients and their families.

To learn more about Patient and Family Centred Care or how our Patient Family Advisors make a positive difference, contact PFCC@tbh.net or visit www.tbrhsc.net