It’s eight am at Kingston General Hospital (KGH) and 100 first-year resident physicians are taking their seats at staff orientation. While many of the young physicians may be anticipating hearing from senior health-care leaders at KGH, the first person to take the podium is not a medical professional at all, at least not in the traditional sense.
“Hello, my name is Anndale McTavish. I am the patient and I am the reason that you’re here,” she says. McTavish is a former patient who underwent treatment for colon cancer at KGH in 2009. She is also the co-chair of KGH’s Patient and Family Advisory Council and one of the hospital’s nearly 50 Patient Experience Advisors. She and her fellow advisors are on a mission to ensure that each patient who enters KGH has a better experience than the last.
“At KGH we put patients first so that’s why I speak to new physicians before anyone else,” says McTavish. “I want to remind them that they are paramount to my safety and care.”
McTavish and KGH’s Patient Experience Advisors are a key part of the hospital’s five-year strategic plan to transform patient care by partnering with patients and their families. To make that transformation a reality, Patient Experience Advisors work closely with staff in planning and decision-making activities that affect patient care. And that has health care leaders in Canada – and as far away as the UK – paying attention.
“The transformation of our hospital was fuelled by an unexpected source – our patients,” says KGH President and CEO Leslee Thompson. “Our Patient Experience Advisors are so deeply involved in all of our processes and planning that it tends to surprise people. But our perspective is that once you start to look at the world through the patient’s eyes, you look at yourself differently. At KGH, we are learning that our approach is not ‘normal’ but we’ve just done what feels right.”
It’s that collaborative approach with patients that was a major factor in the hospital’s recent win of the 2012 National Research Corporation (NRC) Picker Innovative Best Practice Award for Patient-Centred Care in Canada.
How is KGH partnering with patients to achieve its aim of Outstanding Care, Always? It began in 2010 when the hospital took a decided turn in its approach. Instead of ‘doing for the patient’ or ‘doing to the patient’, they made it their mantra to ‘work with the patient’ and always ask: ‘What would the patient think?’
To truly be able to answer that, KGH needed patients and their honest opinions – no matter how hard to hear. Daryl Bell, Lead of the Patient and Family Centred Care Initiative at KGH reached out to former patients and their family members who had expressed concerns about their care while at KGH. “I asked them if they’d like to help us make a difference in the experience of the next patient. To shift culture, we knew we’d need to understand first-hand what the patient experience is like – not what we think it’s like or hope it’s like but what it’s actually like from the patients themselves,” says Bell.
With that, the Patient and Family Advisory Council was formed. Started with just three members back in 2010, the Council is now 12 strong while KGH’s Patient Experience Advisors number nearly 50. Combined, they volunteer 350 hours per month and currently partner with staff on 260 initiatives to influence change.
That patient partnership is readily visible at KGH. Walk into just about any meeting room in the hospital and expect to see former patients or their family members sitting side-by-side with nurses, physicians, program managers and even the CEO. Their role is to provide no-holds barred commentary on instances in which the system succeeds and where it fails. That input which, among other things, includes collaborating with health-care practitioners to develop or improve hospital programs and making suggestions for how the hospital should be designed for accessibility is taken very seriously.
It’s that respect for her contribution that spurs on Patient Experience Advisor Karen Nicole Smith, a renal patient at KGH, who at age 40 has been dealing with chronic kidney disease for 22 years. She has been volunteering with the Regional Renal Program Steering Committee since 2011. “The doctors really listen to what I say and tell me how important what I’m saying is so I know I’m making a difference and that feels amazing. Sharing my experiences and making things better for future patients makes me feel as though living with chronic illness hasn’t been for naught.”
Smith isn’t alone in that sentiment. Many of her fellow advisors’ suggestions are already making a difference in the lives of KGH’s patients and their families. Some of the unique initiatives resulting from the input of Patient Experience Advisors include: changes to patient menus, participation in recruitment interviews to ensure potential candidates are patient-centred and the implementation of bedside shift change reports that make the patient and their family a part of daily care plans.
Down the road, more initiatives are planned. By year’s end, each program area will have completed a patient and family feedback forum. These involve patients and their families returning to a unit to share their patient experience with staff – be it positive or negative. “Staff will hear what went well and what didn’t so they know what to remedy or what they should continue doing,” says Bell.
KGH knows they’re onto something special. Since the Patient and Family Advisory Council was founded, 54 organizations – including The Change Foundation and the Patient Association of Canada – have called on KGH to learn more about their process.
The interest doesn’t end there. Health Minister Deb Matthews requested a private meeting with the Patient and Family Advisory Council during a recent visit. And this month, Thompson and McTavish will speak about KGH’s approach to enhancing the patient experience at The Kings Fund Transforming Patient Experience Annual Conference in the UK.
“We’re on a journey of profound change and we’re very proud of what we’ve accomplished so far,” says Thompson. “But we recognize that we still have a long way to go.”
Still, the positive feedback and recognition are signs that KGH is moving in the right direction. “We’ve had one visiting hospital CEO say; ‘I can’t believe you’re doing this. This is scary!’” says Bell. “And in the same breath ask: ‘How can our hospital do the same thing?’ People want to see what we’re doing here at KGH and how our strategy is coming to life. These days we’re getting so many requests to find out how we do what we do, that it just makes me grin.”
Patients are grinning too. “My dream hospital is a place in which staff and patients are partners in an environment of compassion,” says McTavish. “Now that our voice is being heard loud and clear at KGH, we’re one step closer to that dream.”
For more information about KGH’s strategy for achieving Outstanding Care, Always and KGH’s Patient and Family Advisory Council, visit: www.kgh.on.ca and click on ‘About KGH’.