Holland Bloorview Kids Rehabilitation Hospital is the recipient of the 2017 Innovation in Patient Safety Education Award in the Power of an Organization category. Recognizing an untapped potential, Holland Bloorview is providing the knowledge and skills to ensure that clients and families have an equally knowledgeable voice in patient safety to effectively partner with clinicians in advancing high quality safe care. This capacity-building model has extended beyond the organization, and is now being leveraged at a national level.

(Left to right): Sonia Pagura, Senior Director, Quality, Safety and Performance; Alifa Khan, Family Leader and Vice-Chair of the Family Leadership Accreditation Group (FLAG); Laura Oxenham-Murphy, Manager of Quality; Elena Garisto, Quality Coordinator; Carol Damp Lowery, Accreditation Coordinator; Diane Savage, Vice President, Programs and Services; and Julia Hanigsberg, President and CEO. (Missing from the photo: Adrienne Zarem, Family Leader and Chair of FLAG; and Nick Joachimides, Manager of Patient Safety)

The Quality, Safety and Performance team at Holland Bloorview partnered with the Patient Safety Education Program – Canada (PSEP – Canada) to revise the PSEP – Canada training program for the specific needs of clients and families. Over a six-month planning process, this initiative included participation of a team of hospital leads, a family leader from Holland Bloorview, PSEP – Canada Master Facilitators and representatives from the Canadian Patient Safety Institute, who reviewed and revised the program for youth and families. The program offers a mechanism to train children, youth and families in patient safety, while providing the knowledge and skills to teach other children, youth and families using generative language and solution-focused coaching in how to better partner with clinicians and influence the system from the patient and family perspective.

As a result of the training, two of Holland Bloorview's family leaders are influencing change in hospital standards. Adrienne Zarem is co-chair of one of the Health Standards Organization (HSO) Committees and was a patient surveyor for Accreditation Canada's survey of the Nova Scotia Health Authority. As well, Alifa Kahn is working in partnership with the HSO Primary Care Technical Committee and has also been asked to become a patient surveyor for Accreditation Canada. Holland Bloorview's Master Facilitator and family leaders will also join the faculty and panel for the planning and delivery of the first pan-national PSEP – Canada program, Patient safety training for Patient and Family Leaders.

"When I think of what PSEP – Canada has provided, not only is it equalizing the knowledge field of patient safety to allow conversations to happen in a different way, it also allows for our family leaders to have skills that they can apply to a broader system level," says Sonia Pagura, Senior Director, Quality, Safety and Performance.  "Our family leaders who have completed the program and are now part of provincial and national initiatives and committees, and contributing in ways that is perhaps outside of the lens of experience of the system. They are armed with knowledge of what a system-like safety initiative is, what it should look like, and how they can contribute that knowledge, while overlaying the patient experience."

Holland Bloorview's family leaders have also been appointed executive sponsors of key organizational initiatives (e.g.  integrated coordinated care plans), have provided input on the roles of clients and families in the hospital's pandemic plan from a systemic perspective, participated in the development of the new strategic plan 'No Boundaries',  and provided input on the evolution of client and family quality and safety and the elements required to make it a success. The next phase of innovation is to have family leaders co-design incident reporting systems and patient safety incidents for clients and families to enable families to enter incidents themselves as full partners in safety. 

The strategic imperative of training clients and families has now resulted in the co-design of an education program with family, youth and child leaders as part of the planning committee that will  build capacity and provide training to more than 200 family leaders at Holland Bloorview. A youth will help lead the child learning initiative, two youths will help lead the youth learning initiative, and several family leaders will help to train families in the family leader initiative. In addition, the training will be attached to a significant improvement initiative.

"Not only do we want to train, but we also want to attach that knowledge to a safety improvement initiative where our family members lead and staff partner with them," says Sonia Pagura. "The roles are now reversing, before you would have a family leader be a part of an initiative. Now, we are asking families to lead the initiatives and have staff partner with them in an equal role. This peer-to-peer training model not only aims to help build capacity amongst patients and families to make our health system better and safer, but it also represents a cultural shift in patient safety that acknowledges the importance of the patient and family voice in quality improvement."

Sonia Pagura credits Holland Bloorview's President and CEO Julia Hanigsberg and Vice President of Programs and Services Diane Savage for their foundational belief and support in the co-creation and design of the training program, and entrusting the Quality and Safety Performance team to lead this journey. In addition to senior leadership support, staff's commitment to these efforts has anchored the culture of client and family involvement at Holland Bloorview.