Patient Declaration of Values: Perspective from other side of the bed

Every Ontario hospital is required by the Excellent Care for All Act to have a patient declaration of values or rights and responsibilities. Bridgepoint Health – a complex chronic care and rehabilitation centre in the heart of Toronto’s Riverdale community – has both. But when they developed the Bridgepoint Patient Declaration of Values, they made a conscious choice to exclusively consult patients, not staff.

“A hospital’s patient declaration of values is intended to be about understanding what’s important to our patients,” explains Monica Jacobs, Bridgepoint’s Director of Patient Relations and Risk Management. “So we wanted it to be really and truly patient-driven. We spent six months consulting exclusively with patients, continually revising and refining each value until it reflected the voices of the entire Bridgepoint patient population. This was very different from the typical approach.”

The core question patients were asked during consultations was: What behaviours and values matter most to you? Ten themes emerged:
•    Voice / communication
•    Being informed
•    Engagement and participation
•    Giving consent
•    Quality care
•    Courtesy and respect
•    Confidentiality
•    Privacy
•    Independence
•    Social and other practices

Each theme is expanded with specific statements that clearly set expectations around the conduct patients would prefer from staff. Further validating the patient-exclusive approach to consultations, the themes echo the results of the recently released study The face of chronic disease: Understanding the patient population at Bridgepoint Health, led by Kerry Kuluski, Research Scientist at the Bridgepoint Collaboratory for Research and Innovation. The consultations and the study involved interviews with distinct groups of patients, reflecting a representative cross-section of inpatients and outpatients.

“It’s interesting that, although the timing and process of patient interviews were completely separate, the findings and feedback corroborate,” notes Peter Allatt, Bridgepoint’s Clinical Ethicist – who led the Declaration of Values consultations, working closely with Cassandra Mackey, Bridgepoint’s Patient Relations and Quality Coordinator.  “The Declaration of Values puts us on the other side of the bed,” says Allatt. “When staff read the document, we want them to ask themselves: Is there anything in here I wouldn’t want if I were a patient?”

While Allatt notes there are frequent, daily examples of staff delivering on the Bridgepoint Patient Declaration of Values – regularly confirmed by patient feedback surveys – Bridgepoint continues to take steps to educate staff about what the document means to them. It’s on the agenda at every new staff orientation session, has been profiled in Bridgepoint’s internal newsletter, and was the topic of a recent ethics lunch at the hospital.

“In April 2013, Bridgepoint is moving to a new state-of-the-art facility, and we’re already working to ensure that the declaration of values moves with us,” says Allatt. “We’ll be doing in-services across the hospital in the next few months, reinforcing positive behaviours by recognizing those who live out our patients’ values, and transparently sharing the results of our patient satisfaction surveys.”

You can download a copy of Bridgepoint’s Patient Declaration of Values at