#SuperSHIFTER Doug Cochrane, MD is the Board Chair of Interior Health in British Columbia. He served as Board Chair for the British Columbia Patient Safety and Quality Council, from its inception in 2008 until October 2019. He also served as the Provincial Patient Safety and Quality Officer for British Columbia, and is a former Board member and Board Chair of the Canadian Patient Safety Institute. A pediatric neurosurgeon, Cochrane obtained his medical degree at the University of Toronto, and completed a pediatric neurosurgery fellowship at the University of Toronto's Hospital for Sick Children.

What professional accomplishment are you most proud of?

There are two. The first is having the skills, ability and the opportunity to help as many children as I did who had neurosurgical ailments that could be treated effectively with surgery. This was all about decision-making and technical skill, but more importantly supporting families and their kids. The second is the establishment BC Patient Safety & Quality Council (BCPSQC). This came about because a group of care providers and administrators believed that we, health care professionals, have an obligation to improve care for patients, clients and peers, and that we had the knowledge and tools to do it.  Creating an organization that supports this ideal has focused our health system on the "relentless pursuit of quality" so that we can provide the best care we can.

Tell us about your work with the British Columbia Patient Safety and Quality Council.

The BCPSQC is a facilitator of change. It is an active, vibrant and in my opinion (biased as it is) very influential organization that looks to opportunities worldwide – across Canada, to colleagues in the United States, Great Britain, New Zealand, Australia, and elsewhere to help inform how our health care  system can be improved. The Council supports the understanding of issues and provides to partners the support, the best frameworks, and tools to achieve improvement. The Council is singly focused on improving care for patients and, with partners, acts to make health care better. It is also an organization that provides expert advice and confidential reviews for governmental organizations, colleges, and health authorities when requested.

Is there a "personal passion" you are working on now?

My greatest passion at the moment is trying to understand the world view and life experiences of indigenous peoples in the BC interior. The BC Interior has more indigenous people than in other health authorities elsewhere in British Columbia. The Interior has extraordinarily poor and extremely wealthy populations within our First Nations.  Coming to appreciate the indigenous perspective of health has been an eye-opener for me. It has broadened my perspective to health, beyond health care, and certainly beyond the narrow field of neurosurgery. I look forward to this lifelong learning opportunity.

What inspired your work in patient safety?

While I chaired the BCPSQC, I had a number of frontline administrative roles. I was lead surgery at the Children's Hospital in Vancouver and grew through that organization, and numerous reorganizations, that eventually led to the current BC health authority structure. I provided neurosurgical care and was a senior administrator supporting the care that was being delivered by others.  As the Vice-President of Medicine and the Vice-President of Safety and Quality for the Provincial Health Services Authority, I had the unique opportunity to see care being delivered and to be the person responsible for delivering care in the province-wide and diverse health care system that I and others were working to make better.

There was an event where British Columbia and the leadership at the Children's Hospital led the country in openness, transparency, honouring of patients and learning from adverse events. This tragedy, a child's death, occurred following an error in the administration of chemotherapy.  At the time, Lynda Cranston (President & CEO, Children's and Women's Health Centre), David Matheson (VP of Medicine) and Pat Evans (Head of Communications) were so very instrumental in showing me what my responsibilities were as a manager in care delivery – to undertake a comprehensive and respectful investigation; to provide open and ongoing communication with the patient's family; and to make the event known publicly so that others could learn from this experience. I learned that the cornerstone of the organization's responsibility was respectful, open and transparent communication with the family, the commitment to foster learning amongst other care providers and using our experience to develop system changes that would prevent similar events in the future.    

What important lesson have you learned about patient safety?

We can always make it better.  If we have the right mindset and commitment, and if we understand the context and nature of the care we deliver, we can make care better.  We will never have everything perfect, yet, if you made a commitment to improve care, you always can.

What is the best advice you ever received that helped shape your career?

The best things that I have learned in my career – blending both my side of the scalpel and my side of the conversation – have come from families. Families know what is important to them, in comparison to my surgeon's perspective that is focused on the illness or technology. While I had a surgical contribution to make, I also needed to bring realism, in an appropriate and sensitive way, to my discussions with families and my recommendations. What matters to patients and families is the most important question that needs to be asked. If you choose not to ask the question, then the only perspective you will have is your own; too often a perspective that is not relevant to those to whom we are providing care. This philosophy respects the autonomy of the patient supported by respectful and honest realism that defines for care givers, what's important to our patients.

For more insights, email Dr. Doug Cochrane at dcochrane@bcpsqc.ca