Earlier this month, I attended the National Health Leadership Conference in St. John's with several CPSI staff. CPSI was proud to be a Gold level sponsor of the event, which was presented by HealthCareCAN and the Canadian College of Health Leaders. We distributed patient safety messaging to attendees from our booth, and our team spent time engaging with the NHLC audience via social media – in fact, we reached over a million people online during the short time we spent there!
While I was looking forward to spending my time at the conference connecting with healthcare leaders from across the country and around the world, and I was delighted to have the opportunity to present a breakfast session, the truly outstanding moment for me was during the Great Canadian Healthcare Debate.
Designed to identify the health care system's most pressing need, this year's Debate explored three important issues: mental health, Indigenous health and seniors' health. The first runner up, with 26% of the vote following the debate, was a resolution debated by Jan Byrd, Patient Safety Improvement Lead for the Canadian Patient Safety Institute!
I was so filled with pride.
Jan told the story of Brian Sinclair, a 45 year old Indigenous man from Winnipeg, who died of complications from a treatable bladder infection after being ignored for 34 hours in an Emergency Department waiting room. "No medical staff ever spoke with Brian during that 34-hour waiting period," Jan said to the audience of healthcare professionals, "even when strangers and non-medical staff tried to get the nurses to help. Had he received the care he needed, he would not have died."
This was a preventable patient safety incident due to several breakdowns in communication and low health literacy for both Brian and those charged with his care. Complex patients and those with low health literacy levels are at the greatest risk of experiencing harm. "Lower levels of education, low income, homelessness, unemployment, minority status, English as a second language, and older age are all related to poorer overall health status and lower health literacy levels," Jan stated. As a result, these people face delayed diagnoses, greater use of emergency care, a poorer ability to manage their own care at home, and – of course – higher mortality rates.
So, what can we do about this? We know that social determinants help create health gaps, but can plainly see that health services themselves often increase those inequities, rather than mitigating them. As Jan declared in the Debate, "Low health literacy is not a patient problem!" If healthcare providers and leaders can't communicate health information in a way patients understand, then we have the health literacy problem.
"The stigma surrounding low health literacy is real," Jan concluded, "and the healthcare systems that overestimate and assume strong understanding in our patients lead to incredible risk. We must find another way. This is a shared responsibility between patients and the health system. We can take ownership to explore together how to improve communication and power structures, and finally move forward."
Jan argued for social and political change that would address the patient safety incidents experienced by Indigenous persons, the poor and poorly-educated, and for us all. She suggested CPSI could help create the space to talk about patient safety, health literacy and Indigenous health, across Canada. Her presentation was a call to action for Canadian healthcare leaders and Indigenous communities to co-develop a meaningful consultation process, strengthening health literacy and patient engagement as critical conditions for patient safety.
Jan took a respectable second place in the Great Canadian Healthcare Debate to universal mental health care, presented by Nicholas Watters, Director of the Knowledge Exchange Centre at the Mental Health Commission of Canada. Third place went to Dr. Anwar Haq, Executive Director of Covenant Network of Excellence in Seniors' Health and Wellness, who pressed healthcare leaders to commit to changing the culture in the healthcare system by actively involve family caregivers in care settings.
"The spirited and substantive debate that health leaders engaged in was the kind that legislators should be having in legislature across Canada and in the House of Commons" said Paul-Émile Cloutier of HealthCareCAN. "All three final motions debated were extremely well developed and intertwined with each other remarkably well so that whatever progress is made on one issue impacts the others."
I couldn't agree more. I expect to hear back from many of the people touched by this topic, and I know that CPSI will help lead the way to promote health literacy as a way of keeping patients safe.
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Yours in patient safety,