Sandra Zelinsky is using her experience as a patient to change the philosophy of patient engagement and include patients up-front in decision-making. As a graduate of the Patient and Community Engagement Research (PaCER) program within the Institute for Public Health (IPH) at the University of Calgary, Sandra is using her research skills to advance patient engagement for Alberta’s Strategic Clinical Networks (SCNs). Accreditation Canada and the Canadian Patient Safety Institute are pleased to recognize Sandra Zelinsky as a Patient Safety Champion.
When the Surgery SCN implemented the use of a safe surgery checklist across its 59 hospital sites in Alberta, the approach did NOT include patient input or involvement. Further, the SCN team would audit compliance on use of the checklist, but the impact on patients was not evaluated. Sandra, a patient and community engagement researcher, was asked to join the safe surgery checklist committee and conduct a study engaging patients across the province on behalf of the Surgery SCN.
Patient and community engagement researchers (PaCERs) are individuals living with various health conditions who are trained to design and conduct health research using specific adapted methods of qualitative inquiry. PaCER training includes over 120-hours of classroom sessions and a completion of an internship research study. Sandra and her colleagues used their skills and the specific PaCER methods to engage patients across Alberta in exploring their pre-surgical experiences.
Sandra and her PaCER team found that the surgical patients were feeling anxious and concerned when staff repeatedly asked the same questions, because the patients were not aware about the checklist being used, and thus not engaged in the process. Excluding patients as part of the team when implementing the checklist was causing stress and patients wondered whether their surgical team really knew what was happening. One of the key findings was the idea that “patients want to know.” With this information the committee rewrote policies, adapted procedures and built patient-specific tools to make patients a critical part of the checklist process. On the day of surgery, a member of the surgical team now meets with patients to explain the reason for the checklist and how repeated questions at each step help to keep them safe.
Sandra has supported the development of patient-specific learning tools, such as posters and a “muppet surgery” video podcast to help patients visually understand how the brief, timeout and debrief are the crucial elements of the checklist. Based on patient recommendations, the checklist has been also translated into a number of languages.
“We now have a standard patient-centred approach in place for the SCNs across Alberta where patients are core members of our teams,” says Tracy Wasylak, SCN Senior Program Officer, Alberta Health Services. “Sandra was the patient voice that was instrumental in changing our policies on how to include patients in our processes and is now one of 12 patient engagement researchers in the networks. She is truly a pioneer in actively researching patient engagement and helping us to gather credible data on how to move forward.”
“This project has been exciting to be a part of and the impact has been so rewarding,” says Sandra Zelinsky. “My experience as a patient brought me to the PaCER program, and when you have patients connecting with patients and doing the research, you get different results. We are on a level playing field and people will share and open up as soon as they know you are a patient too. We have the ability to change the way research is being done to affect patient engagement in healthcare.”