Patient safety issues highlighted in innovative stage play

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Researchers at York University’s Faculty of Health have come up with a pioneering way to convey their evidence-based research on what can happen when health-care mistakes are made – they are putting on a play about it.

Seeing the Forest is inspired by a true story about what happens when a patient is not heard. As part of Canadian Patient Safety Week programming, the play runs from November 1 to 5, and is being performed as part of a symposium at various health care sites across the Greater Toronto Area.

York Professors Deborah Tregunno and Liane Ginsburg of the Faculty’s School of Nursing, are leaders in the field of patient safety culture. They collaborated with their colleague, Professor Gail Mitchell, who has experience with conveying research findings through the arts. This dramatic approach presents research from their studies conducted in four provinces, in cooperation with the Canadian Patient Safety Institute.

The play’s development was financially supported by the York’s Faculty of Health Inter-professional (IPE) Education Fund. IPE programming is shared with the health-care community through the Faculty’s innovative Health Leadership & Learning Network (HLLN).

Written by professional playwright Julia Gray, Seeing the Forest is being performed during National Patient Safety Week in collaboration with six organizations, including the Central Community Care Access Centre, the Centre for Addiction and Mental Health, Credit Valley Hospital, North York General Hospital, Sunnybrook Hospital, and Unionville Home Society.

“By dramatizing research using the arts, the findings become more meaningful,” says Mitchell. “The play presents the complexity of real life from the perspective of the patient and health care professionals. The impact is much stronger than it would be if you were just reading words off the page of a research report.”

The key character in the play, the patient whose name is Healther, goes to the hospital for routine surgery and tries to communicate specific concerns to different health care providers, yet things go awry. Research suggests that 2.9 per cent – 16.6 per cent of patients in acute care hospitals experience one or more adverse events, and therefore the circumstances depicted in the play are quite possible.

“Health-care providers work hard to keep patients safe every day,” says Tregunno. “However, there are often systemic issues that contribute to errors. This play is valuable because it strikes an emotional chord and engages people in conversations about improving safety. ”

“Productivity, efficiencies and throughputs are emphasized in the health care system, but equally important is the part where you keep vigilant and attentive to what you’re doing and the relationship with the individuals — which can be difficult when we’re asking health-care providers to do more and more,” Tregunno says.

The play was first performed on Oct. 15 at a Research Day at University Health Network. “The audience was completely captivated by the play,” says Debra Bournes, RN, PhD, Director of Nursing, New Knowledge and Innovation at UHN. “The content was very realistic and sent a powerful message that mistakes can and do happen when we get too comfortable and familiar with caring for patients with similar conditions who are undergoing ‘routine’ procedures.”

Queried after the play, 97 per cent of the UHN nurses that provided feedback on the play indicated that they would “do something different after seeing this play.”

As healthcare becomes more complex, the job of keeping patients safe is becoming more difficult, the researchers say. The York professors focus their research on patient safety beyond traditional clinical safety concerns, addressing the systemic and cultural aspects of patient safety.

“Patient safety literature currently calls for more checklists, more accountability and more protocols, but this play shows that when the system is set up like a machine, checklists are not enough,” Mitchell adds. “It illustrates that we as health care providers need to dialogue and work together differently. We need to promote health care that is based more on meaningful interaction.”

“This play is a great example of the innovative and interdisciplinary approaches to health care led by York University’s Faculty of Health,” says Professor Lesley Beagrie, Associate Dean, Professional & Global Programs. “Instead of tailoring health care programs to individual silos within the health profession, we aim to keep the focus on the end user – the patient. Patient Safety Week reminds us of the vital need for inter-professional health professionals to work together so that the focus remains patient centered. This same approach is at the core of what the Health Leadership & Learning Network aims to do. “

HLLN at York is a catalyst for fresh thinking about health and health care, with programs addressing the educational needs of various audiences. Dedicated to providing the insights to manage complex adaptive systems and institutional change, health care professionals interested in further educational opportunities are invited to learn more at www.hlln.ca.