Getting Better – Runner Up
BC Children’s Hospital
Patients and their families or caregivers are often an untapped resource when it comes to identifying opportunities to improve quality of care and patient safety.
They have different perspectives than care providers, and can highlight adverse events that might otherwise go undetected, such as miscommunication, complications, and problems with medication or equipment.
At BC Children’s Hospital (BCCH), an innovative tool called Patient’s View is helping to solicit feedback about quality and safety from the unique perspective of patients and families.
Using a customized version of the BC Patient Safety & Learning System (BC PSLS) on a mobile device, volunteers meet with patients and families a day or two before their planned discharges. Their safety concerns are entered into the BC PSLS database and shared with leaders at BCCH in aggregate reports that can be used to inform quality and safety improvement initiatives.
The family reports gathered by Patient’s View are rich and impactful. A mother described how she felt devastated when a care provider discussed her child’s private medical history at the bedside in front of her extended family. A father shared his feelings of anxiety when two physicians – within five minutes of each other – told him conflicting plans for his acutely ill child. These stories and more have led to many large scale patient safety and quality improvements at BCCH, including:
- Revising and standardizing post-operative tonsillectomy pain control education, after a family received conflicting information from medical and nursing staff;
- Calling translation services quickly, after learning from patients of parents who do not speak English that translating concerns about their own diagnoses and treatment plans to their parents was stressful;
- Fixing digital thermometers quickly, after hearing from a family member who noticed that care providers from multiple shifts were each thinking a broken thermometer was an isolated event;
- Having family members present at handover to ensure information shared between staff members is correct, after family members reported that sometimes critical information was not provided during transitions in care even when they had communicated it to the staff.
The team behind Patient’s View believes in focusing on what can go right, so patients and families are also asked to describe anything they noticed staff or the hospital doing to help promote safe care. One mother of a newborn who had experienced an adverse event shortly after birth was admitted to the surgical ward for a complicated corrective procedure and was feeling quite anxious given the baby’s history. The family found great relief in a fairly new and innovative nursing role being trialed on the unit that demonstrated complex care to nurses at change of shift. Patient’s View data helped inform this new role, which was later implemented. Another mother was thankful for the opportunity to fill out the Patient’s View survey because she found it very therapeutic to talk about her concerns.
The program also had a positive effect on its volunteers, who often have hopes for future healthcare careers – a former volunteer launched Patient’s View on the pediatric ward at Victoria General Hospital when she was a second-year medical school student. In addition, families appreciate being asked about their experiences, while staff and leaders value being able to use this new information to inform safety and quality improvement initiatives. Now that Patient’s View is embedded in the culture of care at BCCH, clinical staff seek out its volunteers to engage patients’ families.
Patient’s View is currently engaging patients and families to provide real-time feedback on quality of care and safety issues while trialing a new clinical decision unit in BCCH’s emergency department. It will soon be implemented on the inpatient ward at the BCCH Sunny Hill Health Centre, as well as BC Women’s Hospital and BC Cancer Agency. Additional possibilities include expanding to adult care facilities and ambulatory care settings.
Like most innovative undertakings, Patient’s View has required determination, patience and collaboration from a wide range of participants. Support from operational leaders and the department of Volunteer Services at BC Children’s Hospital and the PHSA Quality and Safety group, along with BC PSLS Central Office, has been critical to the success of Patient’s View.
At a Glance
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