Patient-centred leadership: A call to action

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When I arrived at Kingston General Hospital (KGH) four years ago, I was faced with a number of big challenges including the reality that very few of our practices, processes and policies actually involved patients. So, I started to ask some questions: If we know that patient-centred care is the right way forward, what needs to happen to make it part of the DNA of our organization? What does it take to engage with patients in a meaningful way? What does patient-centred leadership look like? And, what can I do personally to model it?

In a recent issue of Health Affairs dedicated to the topic of patient engagement, editor-in-chief, Susan Dentzer referred to the concept of patient engagement as the “blockbuster drug of the century”.  Patient-centred care and patient engagement are getting lots of attention these days. There are many great examples of how patients are helping to shape new models of care and health care policies that affect them. Social media is becoming an equalizing force. It is amazing how rich social media conversations can be, and how fast knowledge can travel from one person to a whole population with a click of a button. On a broader scale, patients and patient groups are advocating for vital changes in the health care system using social media and other innovative ways to amplify their voice.  What was once taken as the gospel from health-care providers and decision-makers is now open for public interpretation and debate. Health care no longer happens behind closed doors.

I think that patient engagement is becoming the most disruptive innovation in health care that we will see over the next decade. New approaches to patient engagement are upsetting the traditional balance of power between patients, care providers and decision-makers. This shift is welcomed by some, and resisted by others, but the reality is that it is happening and all of us as leaders need to think about how to do things in new ways. I’m excited about the possibilities of partnering with patients. By shifting from a culture of “doing to and for patients” to a culture of “doing with patients,” a new era of health care is emerging.

Driving patient engagement deep into the day-to-day life of an organization is not an easy feat. It requires a daily commitment of staff, physicians, volunteers, students, patients and families to think about working together in new ways. At KGH, we started down this path by asking what would be different if patients ran our hospital.  We tried to put a patient lens on everything we did, and then the light bulb went on. If we were to truly transform the patient and family experience, patients would have to be part of the journey in very tangible and meaningful ways. So, we made the bold decision to involve patients in any and every decision in our organization that has an impact on the patient experience. It’s bold because once you start down this path, nothing stays the same – for staff or for patients.

With more than 50 patient experience advisors now on board at KGH, our patients and families have become a powerful force of positive change. Our patient advisors have been instrumental in policy changes such as eliminating visiting hours, shaping our models of care, participating in hiring panels for new staff, and taking part in staff and physician orientations. They are active participants on improvement teams to help tackle issues such as wait times, infection rates and hospital wayfinding. We have even started to “peoplize” our numbers, turning statistics into patient impact statements and stories that are effective drivers of change. Today, patient engagement touches nearly every aspect of our day-to-day business.

So, what can you do as an individual leader to foster patient engagement and patient-centred care in your own organization? One of the things we know is that checklists build transparency, reliability, teamwork and better outcomes for patients.  I’ve put together a Patient-Centred Leadership Checklist that I am starting to use myself, and I hope that it may be helpful for others as well.

  1. Does the decision I am making have a material impact on the experience of patients? If so, was a patient at the table to help shape it? If not, what steps will I take to fix this?
  2. What have I done to give a voice to the patient if they are not there to do so themselves?
  3. Have I “peoplized” the numbers I am looking at today?
  4. What have I learned from a patient today?
  5. What story have I shared about something that made a positive difference to the experience of patients in my organization today?

Engaging patients has been nothing short of transformative for me in my role as President & CEO, and for our organization. My ask of each of you reading this today is to give the Patient-Centred Leadership Checklist a try, and see for yourself what it feels like to work this way.  I challenge you to join me, and the many others who are already part of the movement to bring patient engagement into the mainstream of health care. Help shake up the status quo and be part of the biggest disruptive change that health care will ever see.

To learn more about what we are doing at KGH please check out www.KGHConnect.ca, or follow me on Twitter (@Leslee _KGH). We would also like to learn from you, and I encourage you to register for our upcoming Knowledge Exchange conference: “Transforming the Patient Experience” May 9 and 10, 2013.  (Visit kgh.on.ca for details.)