The final day of Canada’s Forum on Patient Safety and Quality Improvement focused on collaboration and partnerships, and finding practical solutions for cultural change. Some 300 participants attending the Forum proceedings in Edmonton, Alberta were joined by a virtual audience of more than 2,000 visitors from some 611 sites in 17 countries. The Forum was moderated by Stephen Lewis, who provided succinct summaries and witty commentary throughout the two-day program.
During the opening keynote address, Vickie Kaminski (President and CEO, Alberta Health Services) provided insight on successful collaboration and partnerships, using her experiences in healthcare to illustrate the benefits and downfalls of each approach. Collaboration is used when you want to see results; key to successful partnerships are shared risk, resources, rewards, vision and values. Vickie says to be successful in both collaborations and partnerships you need system thinking and system problem-solving. She stated that you need an equal voice at the table and that actions should come out of every meeting that everyone can agree to, otherwise you should not meet again.
Marian Walsh (Bridgepoint Active Healthcare) provided a perspective on the future state and treating the new patient. As a hospital focused on patients with chronic diseases and complex conditions, Bridgepoint is looking at ways to improve better outcomes for this patient group. Bridgepoint is leading research and looking at strategies to obtain clarity and evidence on safe care, address lack of coordination and integration of care providers and on transitions of care, adverse events in polypharmacy, and the role of patients and families in care management.
In the closing keynote, Dr. Nikhil Joshi provided lessons learned from a physician turned patient. After being diagnosed with cancer, Dr. Joshi’s experience as a patient led him to quickly change his practice to embrace and advocate for patient engagement. Having patients and families as active partners and team members is the new norm in healthcare planning and delivery.
Dr. Nikhil Joshi
Five breakout sessions provided an opportunity for participants to develop practical actions from one of four perspectives: patient voice, leadership, communication or measurement. The lively discussions and innovative solutions underscored engagement, accountability, ownership and empowerment as key components for change.
In the Changing Culture session, experts Christina Krause and Marlies van Dijk (British Columbia Patient Safety & Quality Council) talked about strength-based leadership, opening the session with a speed networking exercise for participants to share with each other their superpower and what strengths they bring to the table. Culture is more than the way we do things around here; culture connects to clinical outcomes. Concepts covered that are central to culture included your power distance index, adaptive leadership, innovation and ideas, along with liberating structures in action. Groups discussed ways change your culture to be more grassroots-driven; how to measure meaningful cultural change; strategies to build and maintain a just and trusting culture; combating a culture of fear; how to keep a culture supportive of change on the agenda.
Making Change Stick session, Marguerite Rowe (Vancouver Island Health Authority) used the analogy of a sticky note and the steps of tacking, taping, and then gluing to make change stick. The presentation reinforced the power of habits, change, culture, leadership, and family partnerships. People will embrace change if they understand the why behind the change. Actions developed focused on accountability and sustainability strategies; change fatigue, adapting/adjusting to new habits; and best practices for making change stick.
Dr. David Chaulk (Alberta Children’s Hospital) led the
Strategies on Innovative Risk Taking session. Healthcare is risk adverse; it suggests a potential dangerous outcome. Dr. Chaulk encouraged participants to try to think of it as change management. Participants were asked to come up with actions to address how to incorporate innovative risk taking while meeting all quality and regulatory requirements; including patients and families and frontline staff as collaborators in innovative change; how to ensure that a culture of innovative risk-taking is fostered; and to share their experience with risk models they are using.
Eleanor Rivoire (Kingston General Hospital) led the session on
Meaningful Patient Involvement. Kingston General have identified eight winning conditions for meaningful patient engagement as their formula for success, including: strategy (plan/principles/action plans), leadership support, organizational champions, partners (patient experience advisors), a performance improvement mindset, infrastructure (functional/organizational), sustainability, and patient-centred leadership. Participants discussed ways to better educate patients about the system and its way of working; what survey tools work best to get specific information without overloading patients; skills and attributes beneficial to patient engagement across the system; barriers to meaningful patient engagement; and staff engagement to enable patient engagement.
The Using Adult Learning Principles to Create Change, led by Dr. Dennis Kendel (Family Physician) and Laurel Taylor (Performance Improvement, Alberta Health Services), was a brainstorming session to come up with actions on how to use learning to create change. The groups addressed issues such as frustration and fatigue with ongoing change; techniques that appeal to all learning styles; creative strategies to support implementation of change; ensuring change sticks in work environments and systems with high turnover; and sustaining change over the long term.
During the lunch break, a news conference was held to recognize two major Canadian healthcare organizations contributing patient safety alerts to a publicly available, web-based platform developed by the Canadian Patient Safety Institute (CPSI). Alberta Health Services (AHS) and the Health Quality Council of Alberta (HQCA) are contributing information to
Global Patient Safety Alerts, making both organizations part of a global repository for learning from potential risks for patient harm. Hugh Macleod (CEO, CPSI) invited provinces and healthcare organizations across the country and internationally to become part of the Global Patient Safety Alerts family.
The Forum poster competition winners were announced, recognizing Target Zero: A multi-disciplinary approach to pressure ulcer prevention (Judy Neves-Saccomanno/Jenny Poongavanum/Nadine Moniz, University of Alberta Hospital, AHS) for most creative design;
The House the e-Sim Built: Innovative Strategies to test for Patient Safety (Bobbi Johal/Sue Barnes, AHS) for greatest improvement achieved; and
Continuity of Patient Care (Health Quality Council of Alberta honouring “Greg’s story”) for best example of patient and family partnership. CPSI also acknowledged the virtual posters submitted;
to view the virtual posters.
Strategies to test for Patient Safety
poster winners for greatest improvement achieved
Target Zero: A multi-disciplinary approach to pressure ulcer prevention, poster winners for most creative design
Health Quality Council of Alberta poster winners for best example of a patient and family partnership (Greg’s story)
In his closing remarks, Hugh MacLeod shared his hopes as a patient and for a safer healthcare system. He challenged participants to build a better future and to create a spark with their power and passion to move the agenda forward. His closing words, reflected a call to action for patient engagement: ‘patients are ready to see you now – are you ready to see them?’
Presentations and Breakout Sessions Canada’s Forum are available to view online and for you to use in your educational sessions and workshops.
Click here to view archived presentations from the Forum broadcast and pre-conference proceedings.