Patient Safety Champion Awards

December 13, 2016

Framing

• About the Champion Awards

• Purpose of webinar: celebrate and inspire• Take at least one practical idea to implement

• Agenda• Johanna Trimble, Michael Garron Hospital

• Q&A

• Alifa Kahn and Adrienne Zarem, Charles Pharand

• Q&A

• Montreal Children’s Hospital, Lyndhurst Spinal

Cord Rehabilitation Team

• Q&A

Your Questions

• What did you learn form this initiative that has

the most impact in helping to keep patients

safe?

• How to get started?

• How to team up with patients for patient

safety?

• How to spread to other departments?

• How to engage management and patients?

• Looking for

• Innovative ways to partner

• Best practices

• Transferable initiatives

Partner Organizations

In partnership with

Ed Kry Cathy Litwin

Candy Garossino

Joanna Price

Sonya Green-Hache Amir Karmali

Thank YOU Judging Panel

Moderator

Cathy Litwin

Member, Patients for Patient Safety Canada

Johanna Trimble

Community Engagement Advisory Network

Vancouver Coastal Health

Volunteer Champion Award Johanna Trimble, PFPSC

Webinar, December 13, 2016

BC Polypharmacy Risk Reduction Initiative& Fraser Health Authority Polypharmacy Risk Program

Faculty, Call for Less Antipsychotics in Residential Care

Lecturing the 1st Year Medical Students at UBC in Community Geriatrics (involving the family in care)

UBC Life Sciences Lecture HallNote students listening with rapt attention : )

Public member helping with the development of the Rxisk.org website tools:

Interaction Checker shown below

Development team for medstopper.com (physician version) and the upcoming public version of the tool.

Preventing

Overdiagnosi

s

Conference,

Oxford, UK

2014

Workshop

presenter

with Dr. Dee

Mangin and

Dr. Claes

Lundgren

Provincial appointment to the BC Patient Safety and Quality Council

“How do you

remain outsiders when you work within?”Sir Liam DonaldsonPatient Safety Envoy, W.H.O.

We never forget why we’re doing this work.

To honour those we love who have suffered harms and to make meaning for ourselves from what could be seen as an arbitrary tragedy. To make sure this doesn’t happen to anyone else.

Why we need to do this work.

A picnic in the garden with Fervid

Dedicated to Fervid Trimble 1917 – 2008

Michael Garron Hospital

Partnering with Patients for Quality & Safety at MGH

Canadian Patient Safety Institute Webinar

December 13, 2016Mari Iromoto, Director Quality & Innovation

1

23

Michael Garron Hospital at a glance

LeanProcess Improvement

Methods

24

A philosophy of partnering with patients

Boardroo

m

Planning &

Projects

Bedside

Board Quality CommitteePatient Experience Panel

Choosing Wisely Committee

Medical Quality & Patient Safety Committee

Research Ethics Board

Unit Patient Experience Panels

Strategic Plan Task Forces

Quality Improvement Plan

Patient Centred Care Plan

Mobility Strategy

Hiring Panels My Story

Patient Stories & Videos

Care Planning

Bedside Shift Exchange

Discharge Planning

Care Rounds

25

A culture of embedding the patient voice

Patient

VideosPost-

Discharge

Phone

Calls

Patient

RelationsPatient

Satisfaction

Surveys

Social MediaLeadership

Rounding

26

Partners In Care

My

Story

Care

Rounds

IDEAL Patient

Discharge

Bedside Shift

Exchange

Patie

nt

Vide

os

Post-

Discharg

e

Phone

Calls

Patient

RelationsPatient

Satisfacti

on

Surveys

Social

MediaLeadershi

p

Rounding

Patient

Stories

10Units Create Discharge Plans with Patients

and Families

27

Partners In Continuous Improvement

My

Story

Care

Rounds

IDEAL Patient

Discharge

Mobility

Strategy

Family

Presenc

e Policy

Patient Rights &

Responsibilities

Mock Room

Design

Strategic

Planning

Bedside Shift

Exchange

Patie

nt

Vide

os

Post-

Discharg

e

Phone

Calls

Patient

RelationsPatient

Satisfacti

on

Surveys

Social

MediaLeadershi

p

Rounding

Patient

Stories

Infusion

Pump

Satisfactio

n

ED

Redesign

20Projects

Co-Designed By

Patient Experience

Panel

Mobility

Infection Control

Advance Care Planning

Family Presence

Quality Improvement

Patient Rights &

Responsibilities

28

Thank You!

Mari IromotoDirector, Quality, Operational Excellence, Privacy &

Innovation

mirom@tegh.on.ca

@mari_iromoto[ ]

Alifa Kahn and Adrienne Zarem

Family Leaders

Holland Bloorview Kids Rehabilitation Hospital

Adrienne Zarem Alifa Khan

Charles Pharand

Volunteer Ambassador

Bruyère Continuing Care’s Saint-Vincent Hospital

Charles Pharand

Montreal Children’s Hospital

The Three Musketeers (L to R): Drs. Samara Zavalkoff, Nadine Korah, and Sasha Dubrovsky

Overview

1. What sparked the project

2. The project

3. Lesson learned through partnership

We Should Talk | Montreal Children’s Hospital

Physicians for patient safety

Samara Zavalkoff | Nadine Korah | Sasha Dubrovsky

We Should Talk | Montreal Children’s Hospital

The Problem

Not everyone at the Montreal Children’s

Hospital communicates when a concern

arises, thereby compromising safe care.

Multi-disciplinary team, including family advisors

We Should Talk | Montreal Children’s Hospital

The Vision

Inspire 100% of staff and patients to

effectively communicate with the goal of

eliminating preventable harm

We Should Talk | Montreal Children’s Hospital

Raise awareness and

measure performance

Our Strategy

Inpatients We Should talk Dashboard

2014-15 Target vs 2014-15 vs target

73% 0%

41% 13%

87% -1%

14% 0%

44% -3%

219Nb of selected cases :

Ytd result diff %Reference result

Listening to patients/families

Encouraged to ask questions

Treated with courtesy/respect

Know how to report safety concerns

Comfortable speaking up

Cumulative result comparison

(Year to date)

37%

77%

0%

5%

1%

41%

14%

86%

55%

73%

0% 20% 40% 60% 80% 100%

Comfortablespeaking up

Know how toreport safety

concerns

Treated withcourtesy/respect

Encouraged toask questions

Listening topatients/families

Always/Yes sometimes

Quarter

Q1 Q2

Q3 Q4

Year

2013-2014

2014-2015

2015-2016

82%69%

81%63% 69% 78% 74% 67%

0%

25%

50%

75%

100%

62%41% 41% 40%

51% 55% 58% 53%

0%

25%

50%

75%

100%

92% 80% 91% 86% 78% 91% 86% 86%

0%

25%

50%

75%

100%

16% 15% 12% 15% 12% 15% 16% 12%

0%

25%

50%

75%

100%

44% 39%50% 42%

28%

0%

25%

50%

75%

100%

Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

2014-2015 2015-2016

Unit

ACU B06N

B06S B07N B08

B09 K1589 N/A

Summary Listening to patients/families

Encouraged to ask questions

Treated with courtesy/respect

Know how to report safety concerns

Comfortable speaking up

Average % of "Always"

OCT 2015 JAN 2016 MAY AUG 2017

Inpatients We Should talk Dashboard

2014-15 Target vs 2014-15 vs target

73% 0%

41% 13%

87% -1%

14% 0%

44% -3%

219Nb of selected cases :

Ytd result diff %Reference result

Listening to patients/families

Encouraged to ask questions

Treated with courtesy/respect

Know how to report safety concerns

Comfortable speaking up

Cumulative result comparison

(Year to date)

37%

77%

0%

5%

1%

41%

14%

86%

55%

73%

0% 20% 40% 60% 80% 100%

Comfortablespeaking up

Know how toreport safety

concerns

Treated withcourtesy/respect

Encouraged toask questions

Listening topatients/families

Always/Yes sometimes

Quarter

Q1 Q2

Q3 Q4

Year

2013-2014

2014-2015

2015-2016

82%69%

81%63% 69% 78% 74% 67%

0%

25%

50%

75%

100%

62%41% 41% 40%

51% 55% 58% 53%

0%

25%

50%

75%

100%

92% 80% 91% 86% 78% 91% 86% 86%

0%

25%

50%

75%

100%

16% 15% 12% 15% 12% 15% 16% 12%

0%

25%

50%

75%

100%

44% 39%50% 42%

28%

0%

25%

50%

75%

100%

Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

2014-2015 2015-2016

Unit

ACU B06N

B06S B07N B08

B09 K1589 N/A

Summary Listening to patients/families

Encouraged to ask questions

Treated with courtesy/respect

Know how to report safety concerns

Comfortable speaking up

Average % of "Always"

OCT 2015 JAN 2016 MAY AUG 2017

Campaign Visible to >80% in the MCH

Reached >850 000 via social media

1/3 families encouraged by campaign to communicate

1/2 staff report lanyards help cue to action

When something’s not right, we need to listen.

When something’s not right, tell us, we are

listening.Data to drive vital behaviors

AWARENESS

INTERNAL>80%

EXTERNAL

>18000

DATA DRIVEN CONTINUOUS IMPROVEMENT

COMMUNICATION WITH PATIENT

UP BY 10-15%

SAFETY CULTURE

NO CHANGE

EDUCATION

MUTUAL LEARNING MINDSET LEAN SIX SIGMA UNIT BASED ROUNDS

QUALITY PROGRAM

UNIT-BASED CONTINUOUS QUALITY

IMPROVEMENT

LEAN MANAGEMENT

SYSTEM

EXECUTIVE WALK

ROUNDS

QUALITY

DASHBOARDS

COMMUNICATION IS KEY TO A LEARNING ORGANIZATION, IN WHICH PARTNERSHIP LEADS TO QUALITY CARE AND POSITIVE EXPERIENCES FOR STAFF AND

PATIENTS/FAMILIES

A HOSPITAL WHERE KIDS CAN BE KIDS, PARENTS ARE PARTNERS, AND STAFF ARE

SMILING

We Should Talk | Montreal Children’s Hospital

• Value of learning together

• Focus on vision

• Slow down to go fast

• Scope creep (ex. research)

• Sustainability planning

Lessons learned through partnership

We Should Talk | Montreal Children’s Hospital

Quotes from Aaron Fima (family advisor)

“Dedicated and bright people at the MCH;

really want to make a difference”

“Family advisor is crucial to help improve

patient safety and keep healthcare providers

focused on what matters most”

Lyndhurst Spinal Cord

Rehabilitation Team

Sandra Mills and Heather Flett

Implementation of the Patient-Oriented Discharge Strategy (PODS) in SCI Rehab

47

Heather Flett Sandra Mills Advanced Practice Leader Patient and Family Educator

Canadian Patient Safety Institute

Champion Award Webinar

December 13, 2016

SCI Rehab PODS Pilot

• 1 of 8 pilot hospitals in OpenLab Early Adopter Initiative

• Between January 2, 2015 – March 31, 2015:

Built a project team including 2 Patient Advisors

Conducted patient & staff focus groups/interviews

Pre-pilot survey of patients discharged in February

Adapted PODS template and process to SCI rehab

Staff education

Pilot implementation

Evaluation

48

Aims of SCI Rehab PODS:

• Consolidate rehab learning

• Identify outstanding patient needs before discharge

• Enhance self-efficacy

• Reduce anxiety prior to discharge

• Provide a written summary in patient’s words and

an individualized contact list for first month at home

49

What is SCI Rehab PODS?

1. An SCI-focused PODS document

• Medications

• Care Plan

• Signs, Symptoms and What to do’s

• Appointments

• Individualized Contact List

2. Teach-back style PODS meeting that

uses self-management best practices

led by a neutral clinician facilitator

50

In patient’s

own words

51

SCI Rehab PODS

Pilot Study Results(% that strongly agreed)

52

Question Pre-PODS (Feb patients)

PODS

Pilot

I understand the purpose of my medications

and when to take them

42% 83%

I understand how to manage my daily care 41% 67%

I understand what symptoms to look for and

what to do

33% 83%

I know my follow up appointments 42% 67%

I know who to call with questions 33% 83%

When I left hospital I felt confident about my

discharge

25% 50%

Results

PODS pilot participants were also asked about

the document and meeting in greater detail

Question % Agree or

Strongly Agree

The document itself has been

useful since you went home

84%

The PODS meeting helped me

understand what to do at home

60%

It was helpful to have a Patient

Advisor present for the meeting

80%

53

SCI Rehab PODS: Current State

• As of May 2015 → full implementation

• New SCI rehab standard of care!

• 7 trained neutral facilitators

• 2 PODS schedulers

• Resource neutral, no additional $

• Positive feedback from patients and staff

54

“I feel like I am ready

to go home now.”

“I was so surprised he

could articulate what he

needs to do at home!”

55

PODS Completion Rate

May 2015 – March 2016Total D/C

Patients

PODS

Eligible*

Total PODS

Completed

% PODS

Completion

253 247 239 97%

April 2016 – November 2016

219 207 204 99%

Take Away Messages

SCI Rehab PODS:

• enhances safe transitions between

rehabilitation and home

• consolidates learning through teach-back

and establishes an individualized plan for

community transition

• is patient-centred with a focus on safety,

self management and building confidence

56

Thank-you

Sandra.Mills@uhn.ca Heather.Flett@uhn.ca

www.uhnopenlab.ca

57

With special thanks to the SCI Rehab PODS team:

Melanie Alappat, Dionne Rockley, Josh Forbes,

Anthony Simas, Carol Scovil, Helen Morris,

Anellina Ventre, Cathleen Wu, Chris Alappat,

Filomena Mazzella, Ruth Tonon, Stacey Budden

Executive sponsors: Joanne Zee & Dr. Mark Bayley

Next Steps

Champion Awardshttp://www.patientsafetyinstitute.ca/en/Events/PatientChampionAwards/Pages/default.aspx

HealthCareCAN – Patient-Centred Experience Design Program

http://www.healthcarecan.ca/learning/courses/patient-centred-experience-design-program-paced/

Patient Engagement Resources

Canadian Patient Engagement Network

Accreditation Canada Leading Practices Database

Canadian Foundation for Healthcare Improvement Resource Hub

http://www.patientsafetyinstitute.ca/en/toolsResources/Patient-Engagement-Resources/Pages/default.aspx

Patients for Patient Safety Canada

www.patientsforpatientsafety.ca

For more information or to contact the speakers email patients@cpsi-icsp.ca

2017 Champion Awards

June 12-13, 2017

National Health Leadership Conference

Vancouver