Pass it on! Innovative approaches to making a difference in healthcare 

Consulting the experts: How Vancouver Island Health Authority engaged communities in strategic planning

by admin admin | Nov 01, 2009
Based on feedback from a process of community consultation, VIHA went back to the drawing board and re-drafted its strategic plan after Board members realized that – even more important than seeking community involvement – the organization needed to build credibility by acting upon what it heard from residents.

Key Messages

In 2005, the Vancouver Island Health Authority launched a community consultation process. Over a six-month period, it held open houses in 14 communities across the Island, and consulted with the public, staff, physicians, aboriginal organizations, community groups and service partners.

After the consultation, the Board rewrote the organization’s strategic plan, indicating where community comments had led to changes in thinking and where concrete actions were taken.

VIHA continues to build upon the benefits realized from community engagement by continuing to incorporate its principles and processes throughout its planning, including the establishment of a Patient Advisory Council.

The Vancouver Island Health Authority was just four years old when it realized the power of citizen engagement.

It was October 2005, and VIHA was one of five health authorities the province had created by amalgamating smaller regions. As a result, its board members were still learning about the communities they served, and getting to know staff members who had suddenly found themselves thrust into a new, larger organization of 17,000 employees.

“Our senior leadership needed to connect with all of our staff who were new, and not necessarily willing, (recruits) to the new organization.” says Grant Hollett, the Authority’s director of planning and community engagement. Perhaps even more significantly, the Authority needed to assure the 750,000 people it served that it was actively listening and would respond to their concerns.

A primary order of business for the newly-amalgamated board was to develop a strategic plan for the organization. Once the plan was drafted, the Authority wanted to know whether it reflected the priorities and concerns of the people it served, so over the next six months a comprehensive community engagement process was rolled out. The process involved e-mail and letter exchanges, a dedicated web page, and open houses in 14 communities across the Island, along with extensive consultations with VIHA staff.

Hearing directly from patients afforded a fresh perspective for many of the Authority’s managers, like Sia Zabaras, assistant director of planning and community engagement. In Parksville, B.C., one woman who suffered from kidney failure had recently moved to be nearer dialysis services. Beyond the information provided by her family doctor, however, the woman had no idea how to access further information about services that could help her. “We’re not very supportive in communicating out there,” realized Zabaras.

 

Planning has become a part of everything that everybody does, not just the planning department.

 

Based on feedback from the consultation process, the Board went back to the drawing board and drove the process of re-drafting the strategic plan. They quickly realized that even more important than seeking the communities’ involvement was the need for the Authority to build credibility by acting upon what it heard, says Hollett. To that end, the new version of the strategic plan, released in April 2006, included a table showing residents and staff where and how their suggestions had been incorporated.

Jac Kreut, Board Chair of the Vancouver Island Health Authority, says that the community engagement approach provided a valuable base of knowledge that allowed the organization’s strategic thinking to align with the needs of the communities.“It helped us start the process of building long-term relationships,” he adds. The process precipitated changes at the internal level, too; more staff members have become engaged, so that planning “has become a part of everything that everybody does, not just the planning department,” says Zabaras.

The success of the VIHA’s process was so significant that the province subsequently instructed all five of its health authorities to adopt a similar community engagement strategy.

Distributing funding where it’s needed

The community consultation has also influenced the way the organization allocates dollars, now that it is more aware of the variable levels of services that existed, says Hollett.

In the Mount Waddington area, for example, a rural northern community with high rates of poverty, homelessness and addiction, the Authority worked with B.C. Housing and the Salvation Army to create the Light House Resource Centre. The centre provides mental health and addictions services and a drop-in space for homeless people, as well as some supported housing. To address concerns about the need for more primary care, the Authority developed integrated health networks, where teams of healthcare providers serve the communities. The Authority also increased its homecare and home support budget by 74 percent. Funding is being allocated to support smaller-scale projects, too – like providing family doctors with information about services that people like the dialysis patient in Parksville could access.

Patients as strategic advisers

Continuing with efforts to improve citizen engagement, a Patient Advisory Council was created in 2008. The Council, which is focused on patient safety, consists of eight former patients or people whose family members were patients, along with four staff members.

The Authority established the Council based on evidence that patients need to partner in their own care. Its members provide practical advice, such as assessing the functionality of patient rooms at a new acute-care centre that will open as part of Victoria’s Royal Jubilee Hospital in 2011. In addition, Council members have canvassed pharmacists in their communities, as part of a project to improve medication safety. “We’re working to develop a standardized medication information card that patients could take to their pharmacists to have their pharmacists complete for them,” says Lesley Moss, the Authority’s executive director of quality, research and safety.

The Council is also helping the Authority develop a public education campaign, modelled on Manitoba’s It’s Safe to Ask program. They want to encourage people to take increased responsibility for their own health by asking their healthcare professionals more questions about their care, explains Moss.

Initially, the Authority had to convince members of the Council that it would value and adopt their advice, says Evelyn Pearce, manager of quality assurance/process improvement. “There was concern in the beginning. One member described it as ‘window dressing’,” Pearce says. But after more than a year of work, Council members now know the organization takes its advice seriously and does its best to incorporate it into the planning process.

Although the Vancouver Island Health Authority has not yet been able to formally measure the longer-term impact of its community engagement process, there has been a tangible shift in culture within the organization, at all levels, says Moss. “At almost every meeting someone besides me will say – ‘Have we got a patient lens on this?’ I feel like all of us are embracing this communication with patients and getting their input in a more robust way.”

Disclaimer:

Pass it on! is a publication of the Canadian Health Services Research Foundation (CHSRF). Funded through an agreement with the Government of Canada, CHSRF is an independent, not-for-profit corporation with a mandate to promote the use of evidence to strengthen the delivery of services that improve the health of Canadians. The views expressed herein do not necessarily represent the views of the Government of Canada. © CHSRF 2009