Ensuring that the patient is at the centre of the decision-making process has become a way of life at Kingston General Hospital (KGH). Today, the hospital has 61 active patient and family advisors partnering with staff on a number of safety initiatives. For this, Accreditation Canada and the Canadian Patient Safety Institute are pleased to recognize Kingston General Hospital as the organization recipient of the 2014
Patient Safety Champion Award.
KGH Lead, Patient- and Family-Centred Care, says that the development of the Patient- and Family-Centred Care program is bigger than any one individual safety initiative, but rather a change in the way the hospital looks at patient safety. It all began in 2010 when KGH was facing significant financial trouble and had been placed under supervision by the Ontario government. It was an ideal time for the hospital to create a new model of care aimed at improving both the patient experience and staff morale.
KGH Patient Experience Advisors Marla Rosen and Barb Girard speak with staff at a program council meeting
That year, KGH created a Patient and Family Advisory Council and recruited their first 26 Patient Experience Advisors.
Now there are more than 60 passionate advisors who contributed more than 5,000 volunteer hours last year.
“Having patients and families present at the table has enhanced our conversations and brought a perspective that had been sorely lacking,” says Daryl Bell. “Once you start doing it, it only makes sense that of course you should be doing it this way. Looking back, it is humbling to realize the time we spent doing ‘to’ and ‘for’ patients, and not ‘with’ them.”
KGH wanted to move patient engagement beyond the typical patient focus groups to a wider and richer experience with patients and families. This includes partnering patients and families with staff from the moment a project or decision-making process begins through to its completion. Their goal is to ensure that the patient perspective is included in all decisions that impact the patient, including patient safety initiatives.
At least one, but preferably two or more Patient Experience Advisors have been included as full members of on a number working groups and committees that have focused on patient safety. This included work to reduce specimen collection errors, reduce patient falls, improve hand hygiene rates, and improve patient identification practices including the wearing of ID bands among other. Patients are even involved in efforts to improve the hospital’s safe reporting practices.
To make this engagement possible, Patient Experience Advisors are recruited regardless of whether they have had a positive or difficult experience with KGH and are brought up to speed as any other team member at the hospital would be. This includes orientation and all the training necessary to actively contribute to the team such as a Continuous Improvement Cycles and Lean Methodology.
KGH has recognized that communication between healthcare workers and patients and families is also key to safety... KGH has identified five basic standards to support front-line staff in making that partnership and improving patient communications at the bedside. They include that all staff, volunteers and physicians wear name badges at chest level so that the patients understand who they are speaking to; purposeful rounding so that every patient is seen at least every hour by a staff member; effective communication where staff identify themselves when they go into a patient’s room and explain what they are doing; a whiteboard is placed at the end of every patient’s bed that is updated with key information such as staff names at every shift change; and a feedback forum where staff and physicians sit down with selected patients/families after discharge to find out what the patient experience was really like. KGH staff are then able to looks at what contributed to or took away from a great patient experience and begin a continuous improvement cycle to work on things that need improvement and spread what is working well. Through all of this KGH also encourages its patients to become active participants in their care. This allows patients to contribute in ways that will help improve safety in the hospital such as reminding hospital staff to wash their hands when they enter a room if they have forgotten, or ask questions about their care if they are unclear.
“It is impossible to measure the impact that partnering with patients and families has made on our decisions and on our culture,” adds Daryl Bell. “Ultimately, by partnering with patients and families we can help determine if the care we provide is safe and that we have the information needed to make well-informed decisions. We could not have transformed our organization without the passion of our patient and family advisors to make for a better and safer patient experience.”