Proud to offer the finest health care to one of Canada s most diverse communities. PATIENT AND FAMILY ADVISORS YEAR IN REVIEW 2012/2013
HISTORY OF PATIENT- AND FAMILY-CENTRED CARE AT NORTH YORK GENERAL In the fall of 2012, North York General (NYGH) embarked on an exciting new journey to further improve the quality of care and experience we provide our patients and families. This is our Patient- and Family-Centred Care journey. North York General s mission is to provide exceptional health care to our diverse communities. Our vision is to lead the pursuit of excellence through learning, innovation and partnerships. One way to achieve our mission is by pursuing excellence in integrated Patient- and Family-Centred Care. NYGH has demonstrated its commitment to develop a culture of quality and safety by making culture a priority in our 2012-2015 Strategic Plan. The Culture Initiative is focused on continually evolving our philosophy and practices around quality, safety and Patient- and Family-Centred Care. The Culture Strategic Initiative builds upon our existing work as we become an innovative leader in providing patientand family-centred care. With the commitment that our patients come first in everything we do, our staff, physicians and volunteers interweave patient and family perspectives throughout the fabric of our organization. PATIENT- AND FAMILY-CENTRED CARE The Institute for Patient- and Family-Centered Care (IPFCC) defines Patient- and Family-Centred Care as an approach to the planning, delivery and evaluation of health care that is grounded in mutually beneficial partnerships among patients, families and health care. The core concepts or pillars of Patient- and Family- Centred Care identified by IPFCC are: Respect & Dignity: We listen to and honour patient and family perspectives and choices. Their knowledge, values, beliefs and cultural backgrounds are respected and incorporated into everything we do. Information Sharing: We share complete, unbiased information with patients and families to help them participate in their care. Participation: Patients and families are encouraged and supported to participate in their care and decisionmaking. Collaboration: Patients and families collaborate with health care leaders in policy and program development, implementation, and evaluation; in health care facility design; in professional education, as well as in the delivery of care. At NYGH, we are creating a culture of Patient- and Family-Centred Care through three streams of focus: Patient and Family Advisors, engagement of Staff, Physicians and Volunteers, and initiatives at the point of care. NYGH has a rich history of working with Patient and Family Advisors on our Mental Health Participants Council, Palliative Care Steering Committee and the Neonatal Intensive Care Unit (NICU) Family Advisory Committee. As we continue to build upon our culture of Quality, Safety and Patient- and Family-Centred Care, we are truly making a world of difference in each and every life at NYGH. PATIENT- AND FAMILY-CENTRED CARE Year in Review 2012-2013 2
PATIENT AND FAMILY ADVISORS Patient and Family Advisors are patients and family members of patients who have received care at North York General within the past two years. Patient and Family Advisors participate in ways that best match their interests, experience, skills and availability. By sharing their unique thoughts and perspectives, Advisors ensure the voices of patients and families are heard, considered and included in North York General s programs and plans for the future. Councils and committees across the hospital include Patient and Family Advisors in their decision-making processes. In September 2012, a call for expression of interest was put out by the hospital seeking patients or family members to become Patient and Family Advisors. Patients, family members or care providers who had an experience at NYGH within the previous two years were invited to apply. Recruitment and selection took place in October and 15 Patient and Family Advisors were selected. The nine-member Patient and Family Advisory Council, including two co-chairs, were selected from this initial recruitment. On November 27, 2012, the first formal Education Day was held with a focus on the orientation of Patient and Family Advisors. Over 60 staff and physicians, and 18 Advisors were joined by the hospital s Senior Leadership Team to mark the launch of Patient and Family Advisors at NYGH. PARTNERING WITH PATIENT AND FAMILY ADVISORS Patient and Family Advisors have proven to be value added partners on many committees, working groups and projects over the past year. The following four pillars of Patient- and Family-Centred Care highlight some of this great work: Information Sharing Transition of Care at the Bedside Clinical Pilot Project The team working on the pilot developed guidelines and provided education and training for their co-workers over four months. Nurses finishing a shift partnered with nurses starting their shift, the patient and their family to give a high-level report at the bedside and perform an equipment safety check before leaving for the day. Patient Safety Education Brochures The launch of the hospital s new corporate brand (April 2013) provided an opportunity to review the hospital s informational brochures and pamphlets. Patient and Family Advisors took a lead role in working with hospital staff to update and develop patient safety education materials. Participation Family Integrated Care Team in the NICU A new model of care was developed to be used in the Neonatal Intensive Care Unit (NICU). Parents partnered with the health care team to provide care for their infant. The objective of this pilot study is to explore the feasibility, safety, and potential outcomes of implementing this model of care in other Canadian NICUs. Recruitment Search Committees Patient and Family Advisors assisted in the recruitment of serveral senior level positions, including: the Medical Director and Chief of Surgery, and the Medical Director of Ambulatory and Cancer Care. PATIENT-AND FAMILY-CENTRED CARE Year in Review 2012-2013 3
Collaboration Integrated Care Collaboratives (ICC) This initiative is a multi-year plan to improve health outcomes of selected patient populations by improving the coordination of services across the care continuum with a patient- and family-centred care approach. Quality-Based Procedure (QBP) Working Groups Patient and Family Advisors were invited to participate as team members based on their knowledge, expertise and enthusiasm. These working groups assist in process improvement initiatives focused on implementing Quality-Based Procedures at North York General. Respect and Dignity Perioperative Services Patient- and Family-Centred Care Clinical Pilot Project This project aims to increase family presence in all areas of Perioperative Services by including patients and families to be champions of their care and to actively participate in their surgical experience. PATIENT AND FAMILY ADVISORY COUNCIL The Patient and Family Advisory Council works in partnership with North York General to ensure that the needs and priorities for Patient- and Family-Centred Care are considered and incorporated into matters that impact patients and their families. The Council meets monthly and is comprised of nine Patient and Family Advisors with two of those council members sitting as co-chairs. The Council also includes the Vice President, People Services & Organizational Development and Chief Human Resources Officer, the Director of Patient Experience & Quality and the Patient- and Family-Centred Care Coordinator. PARTNERING WITH THE PATIENT AND FAMILY ADVISORY COUNCIL After establishing the Patient and Family Advisory Council, the council immediately began to help establish some of the foundational components of Patient- and Family-Centred Care at NYGH. Identification Badge Review With the launch of the new NYGH corporate brand, identification (ID) badges were refreshed to reflect our new corporate visual identity. Patient and Family Advisors provided suggestions and feedback ensuring patients, families, and visitors are able to easily identify names and titles on ID badges. PATIENT-AND FAMILY-CENTRED CARE Year in Review 2012-2013 4
Understanding Patient- and Family-Centred Care at NYGH Taking the definition of Patient- and Family-Centred Care provided by the Institute of Patient- and Family- Centered Care (IPFCC) as a reference, staff and council members worked together to personalize a definition for our organization. The following definition and poster assist our patients, families, staff, physicians and volunteers in understanding what Patient- and Family-Centred Care means at NYGH: At North York General, we partner with our patients and families; working WITH them instead of doing things TO or FOR them. We are learning to see through the eyes of our patients and families so we can make their experience the best it can be. Visual Identity for Patient- and Family-Centred Care Working in partnership with Corporate Communications and Public Affairs (CCPA), council members were instrumental in the creation of a unique Patient- and Family-Centred Care cultural identity that is consistent with NYGH s visual identity/ brand. Patient Advisory Council Partnership stamp Patient- and Family-Centred Care approved stamp Patient- and Family-Centred Care wordmark Patient- and Family-Centred Care definition poster PATIENT-AND FAMILY-CENTRED CARE Year in Review 2012-2013 5
Advisor Recruitment As news about the impact of working with Patient and Family Advisors began to spread throughout the organization, council members collaborated with Corporate Communications and Public Affairs, Human Resources, Volunteer Services, and Information Services to establish standardized processes for the recruitment and orientation of new Patient and Family Advisors. Web pages were created on the NYGH intranet (eric) and on the external site (nygh.on.ca/ PatientFamilyAdvisors) to provide information on the role and the application process for anyone interested in becoming a Patient and Family Advisor. Number of Patient and Family Advisors: 28 Monthly Gemba Walks Each month prior to the Patient and Family Advisory Council meetings, the Patient and Family Advisors are invited to participate in Gemba Walks. Gemba Walks involve going to where the work is being done seeing the actual process, understanding the work, asking questions, and learning. Gemba Walks have been conducted in the following areas: Proposed inpatient units on the 7th/8th floors Labour & Delivery and Maternal Newborn Environmental Services (Inpatient Room Cleaning) Emergency Department Inpatient Mental Health Units Building Services Foodservices Department Perioperative Services Central Processing Department Central Processing Department Gemba Walk Patient and Family Advisor recruitment poster PATIENT-AND FAMILY-CENTRED CARE Year in Review 2012-2013 6
ENGAGEMENT OF STAFF, PHYSICIANS AND VOLUNTEERS To succeed in the evolution of our culture, staff, physicians and volunteers must be engaged, supported and committed to the Patient- and Family-Centred Care journey. To further support engagement, the hospital developed a Champion Passport which staff, physicians, and volunteers can complete to become certified Champions of Patientand Family-Centred Care. Patient- and Family-Centred Care Passport to Champion Certification The Champion Passport helps develop our culture by encouraging staff, physicians and volunteers to put into practice the philosophy and principles of Patient- and Family-Centred Care in every interaction they have with patients and families. Champions work across our hospital at the General Site and the Branson Ambulatory Care Centre. Number of Passport Certified Champions of Patientand Family-Centred Care: 40 Champion Check-Ins Champion Check-Ins are 30 minute meetings occurring twice a month during which Champions share success stories and identify opportunities for advancing Patient- and Family-Centred Care at NYGH. By linking stories to the four pillars of Patientand Family-Centred Care (Respect and Dignity, Information Sharing, Participation and Collaboration), Champions also demonstrate how to practice these values and provide ideas that can be put into place in other areas of the hospital. All members of the NYGH community are welcome to attend these relaxed and informative sessions. Patient- and Family-Centred Care Passport to Champion Certification Patient- and Family-Centred Care Physician Advisory Council In November 2013, a Physician Advisory Council was established with a mandate to engage NYGH physicians in the implementation of Patient- and Family-Centred Care. The work of this council is in support of the strategic direction of pursuing excellence in integrated Patient- and Family-Centred Care. PATIENT-AND FAMILY-CENTRED CARE Year in Review 2012-2013 7
MEASURING SUCCESS Annual Corporate Self-Assessment Audit Each year NYGH undertakes a corporate assessment of how well the hospital is performing from a Patient- and Family-Centred Care perspective. This standardized measure uses the Patient- and Family-Centred Care Organizational Assessment tool prepared by the Institute for Healthcare Improvement (IHI). During the fall 2013 assessment, NYGH was provided with the first corporate measure since establishing a baseline a year ago. The results of the first two years of this annual assessment are as follows: 2012 38% patient- and family-centred 2013 46% patient- and family-centred This twenty per cent change from the previous year is reflective of the impacts made during the first year of our Patient- and Family-Centred Care journey. Total Patient and Family Advisor Time Contributed: Over 800 hours! In this amount of time you could have: 1. Taken 20 trips around the world 2. Watched the movie Titanic 247 times 3. Undergone 533 knee joint replacement surgeries Patient and Family Advisory Council Satisfaction Score: 86% of Council member respondents rated the overall satisfaction of council meetings as excellent. These achievements demonstrate the great strides made to develop a culture of quality, safety and patient- and family-centred care. Recognizing that this is a journey, we are committed to pursing excellence in integrated patient- and family-centred care for the years to come. Patient and Family Advisors, thank you for sharing your time and experiences with NYGH. Council Member Feedback I believe the Council, with the help of staff, made remarkable progress developing a framework for the future of Patient- and Family-Centred Care. It is reassuring to receive positive feedback from staff regarding our activities. I am most impressed by the openness displayed by staff at every level, in every meeting I attend. This is a wonderful group of people to work with to foster Patient-and Family-Centred Care throughout NYGH. All members are totally committed and it is a joy to be part of this group. Staff Feedback Working with Patient and Family Advisors has broadened my thinking and perceptions of what being patient- and family-centred truly is. It s interesting the changes Patient and Family Advisors are asking for are not that big or arduous, it just takes patience, openness, and a willingness to try. The impact on myself, as a provider, has been to pause and reflect on the patient and family perspective. That is why we are all here. I have enjoyed building relationships with our Advisors and they have assisted us in program planning significantly. I trust their perspective. Their feedback is more helpful than a survey. Care environment designs have been better informed. Advisor input has resolved internal clinical practice conflicts, meaning when we have preexisting practices that do not appear to have any meaningful clinical basis Patient and Family Advisor input quickly identifies what practices are relevant to patient needs and what practices are relevant to staff or operational needs. These inputs help make better informed decisions that result in value added changes. PATIENT-AND FAMILY-CENTRED CARE Year in Review 2012-2013 8
EDUCATION Conferences: North York General Patient- and Family-Centred Care Education Day (November 2012): Eighty attendees including 18 Patient and Family Advisors IPFCC-Annapolis, Maryland (April 2013): Fifteen attendees including three Patient and Family Advisors NYGH Patient- and Family-Centred Care Learning Lab with Georgia Regents Medical Center (May 2013): One hundred twenty attendees including 13 Patient and Family Advisors Kingston General Hospital (KGH) Transforming the Patient Experience Knowledge Exchange (May 2013): Fifteen attendees including five Patient and Family Advisors Ontario Hospital Association (OHA) Health Achieve Conference (October 2013): Four Patient and Family Advisors attended Health Quality Ontario (HQO) Health Quality Transformation Conference (November 2013): Three Patient and Family Advisors attended Presentations and Abstract Submissions: Five posters presented at the KGH Knowledge Exchange (May 2013) Patient and Family Advisory Council co-chair presented at the Board Quality Committee (June 2013) Poster presentations at the Quality Worklife, Quality Healthcare Collaborative (QWQHC) summit (June 2013) Advisor co-presentation at the Family Medicine Residents Education Day (September 2013) Advisor story telling presentation during Patient Safety Week (October 2013) Advisor co-presented at the Emergency Department Administration Conference (November 2013) Two abstracts accepted for the Nurse Leadership of Ontario Network Conference (to take place in March 2014) Abstracts submitted to the 6th International Conference on Patient- and Family-Centered Care (to take place in August 2014) PATIENT-AND FAMILY-CENTRED CARE Year in Review 2012-2013 9
PATIENT AND FAMILY ADVISOR PARTICIPATION LIST Strategic Initiatives Access to Care Steering Committee Culture Steering Committee Integrated Care Collaborative: Breast Cancer Integrated Care Collaborative: Hip and Knee Joint Replacement Patient- and Family-Centred Care Steering Committee Corporate Committees ehealth Steering Committee Emergency Preparedness Committee Quality of Care Committee Additional Committees Bereavement Support Team Education Council Falls Prevention Steering Committee Pain Steering Committee Patient- and Family-Centred Care Physician Advisory Council Quality-Based Procedure (QBP) Working Groups Research Ethics Board Recruitment Clinical Team Manager 5 West and Nursing Resource Team Medical Director and Chief of Surgery Medical Director of Ambulatory and Cancer Care Patient- and Family-Centred Care Coordinator Patient Experience Specialist Programs/Departments Mental Health Participants Council NICU Family Advisory Committee Palliative Care Steering Committee Clinical Projects Family Integrated Care Team in the NICU Patient- and Family-Centred Care Clinical Pilot Working Group Perioperative Services Patient- and Family-Centred Care Clinical Pilot Working Group Critical Care Unit Transition of Care at the Bedside Clinical Pilot Project Physical Environment 7th/8th floor inpatient unit planning Emergency Department Renovation Project Medical/Surgical Clinic Redesign Committee PATIENT-AND FAMILY-CENTRED CARE Year in Review 2012-2013 10
PATIENT AND FAMILY ADVISOR PARTICIPATION LIST Working Groups/Ad Hoc Initiatives Building Services Script Project Discharge Management Project Hand Hygiene Signage Revision Health Links Process Development Event Communication/Media CBC Metro Morning Hospital News National Post North York Mirror Identification Badge Review Medical Imaging and Cardio-Respiratory Signage Review NYGH Parking Rates Communication Strategies NYGH Top Chef Patient Safety Education Brochures Patient Safety Week Participation Pre-Chemotherapy Program Revision Scotiabank Language Services Kiosk Smoking Cessation Initiative Surgery Registration Process Review Ultrasound Service Process Improvement: General Site Ultrasound Service Process Improvement: Branson Ambulatory Care Centre Way-finding Project PATIENT-AND FAMILY-CENTRED CARE Year in Review 2012-2013 11
GENERAL SITE 4001 Leslie Street Toronto, ON M2K 1E1 416.756.6000 BRANSON AMBULATORY CARE CENTRE 555 Finch Ave. West Toronto, ON M2R 1N5 416.633.9420 SENIORS HEALTH CENTRE 2 Buchan Court Toronto, ON M2J 5A3 Long-Term Care Home 416.756.0066 Specialized Geriatric Services 416.756.6050 ext. 8060 NYGH.ON.CA Funding support provided by: