It’s Time to Put the Patient in Queen’s Park

By: Zal Press and Dawn Richards

September 28, 2014

As dedicated patient experts we welcome Ontario Premier Wynne’s Mandate Letter to Health Minister Eric Hoskins. We are encouraged that in an interview with the Globe and Mail (Kelly Grant, July 11, 2014) Minister Hoskins committed himself to “improving the patient experience” and the Mandate letter leads with a priority to “Putting Patients at the Centre”.

HeadshotIn our many patient roles, we’ve heard the platitudes of “patient-centred care” and “patient experience” bandied about like badminton birdies that can fall to the ground with nary a concern and then replayed with the same casual whimsy.

Will this time be different? We’d like to give Minister Hoskins the benefit of the doubt and support his intent with a vision that embraces the opportunity that a focus on patient experience provides.

We start by providing a common understanding of the “patient experience.” The Beryl Institute, a global community of practice and premier thought leaders on improving the patient experience in healthcare, defines patient experience as:

the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care.“

This definition tells us that patient experience is more than just satisfied patients. Satisfaction is the result of a single interaction that can evaporate, while experience is the full narrative arc that leaves a lasting impact. The challenge to our healthcare leaders in policy, administration, professional practice etc, is to undertake methodologies for engaging patient and family voices that ensure the best service, safety and quality outcomes.

How do our institutions currently stack up to the challenge of patient experience? The Change Foundation studied the emergence of Patient and Family Advisory Councils (PFAC) in Ontario since the enactment in 2010 of The Excellent Care for All Act (ECFAA), which mandated that hospitals “establish a patient relations process to address and improve the patient experience.” The Change Foundation study, “Patient/Family Advisory Councils in Ontario Hospitals: AT WORK, IN PLAY (Parts 1-3)” (April 2014), found that almost half of councils interviewed were in infancy. Furthermore, while the report identifies 7 categories in which the PFACs are accountable, there is no dedicated position representing patient experience. For many institutions PFACs are simply the first tactical step to engage with patients, and by no means the only patient engagement strategy available.

It is our view that a commitment to prioritize patient experience must come from executive leadership, to instil patient centricity as a core principle of the institution and its culture, demonstrated through a strategic partnership with patients.

We call on Minister Hoskins to act BOLDLY in his capacity as the province’s healthcare leader and to role model the expectation mandated by the Premier by “putting patients at the Centre.” How? By bringing the patient voice to the Ministry with the creation of:

 The Minister’s Patient and Family Advisory Council.

 We view this Patient Council as a professional advisory panel composed of dedicated patient experts with the appropriate professional patient experience and the personal experience of chronic illness informing their perspective. There are numerous qualified patient experts who fit this criteria – people who:

  • Are engaged in the global conversation around and are familiar with patient-centred care and patient engagement initiatives
  • Understand the need to redevelop the language of partnership in the discourse between patients and healthcare professionals
  • Have a demonstrated understanding and experience with patient and family advisory councils
  • Have demonstrated a capacity for building, supporting and advocating with a patient voice.

As The Change Foundation report emphasizes, patient experience is an evolving trend that demands that this Council must perform at the highest level. Consequently we do not view it as a volunteer position, as is common in hospitals. Rather, its members must be properly compensated on equal terms as other expert advisors and consultants. They need to be accountable and perform according to a specific scope of work in order to have maximum impact.

The Minister’s Council will advise on ministry strategies with the exclusive objective to improve patient experience. By applying patient experience across the breadth of the ministry, Minister Hoskins would be faithfully demonstrating the fundamental principles of collaboration and transparency that form the core of the Mandate letter from the Premier.

Ultimately, if Minister Hoskins wants to deliver on his promise to improve the patient experience, he’s going to have to walk the talk, and that means making patient influence felt system-wide. It’s time to elevate the recognition of patient experience as the key driver of system transformation if we are to build a compassionate and sustainable system that serves the health needs of the entire population.

It’s no longer good enough for healthcare services to be delivered without the patient voice having a reserved seat at the government table. We believe that a dedicated role for patient experience, provided by a patient’s voice, has the highest potential to develop meaningful patient centred strategy, the most effective tactical operations and the best health outcomes for patients and families. It’s time to integrate patient experience into everything the Ministry does, rather than function as a solitary initiative.

It’s time to put the patient in Queen’s Park.

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Zal Press is Executive Director of Patient Commando Productions, a producer of authentic patient experience programming for health care professionals, and Co-Chair of the Beryl Institute Global Patient and Family Advisory Council.

Dawn Richards is a science and patient consultant. She is Vice President of the Canadian Arthritis Patient Alliance, the first patient advisor of the Canadian Medical Association’s Wait Time Alliance, a member of the Institute Advisory Board and Ethics Committee of the Institute of Musculoskeletal Health and Arthritis (CIHR), and a Patient Panel Reviewer of the BMJ.