Centre hospitalier de l'Université de Montréal (QC)

  • Sandra D'Auteuil, Infirmière chef, Programme Psychiatrie, santé mentale et toxicomanie, Centre hospitalier de l'Université de Montréal, Montreal, Quebec (Head Nurse, Psychiatry, Mental Health and Addictions Program)
  • Laurentiu Fulicea, Psychiatre, Centre hospitalier de l'Université de Montréal, Montreal, Quebec (Psychiatrist)
  • David Gaulin, Cogestionnaire, Clinico-administratif programme psychiatrie et santé mentale, Centre hospitalier de l'Université de Montréal, Montreal, Quebec (Clinical and Administrative Co-Manager, Psychiatry and Mental Health Program)

Partenariat de soins en santé mentale

Mental Health Care Partnership

Therapeutic relationships evolve over the years according to people’s customs, needs and requirements. They range from conventional paternalistic approaches to patient-centered health care models and, today, a more collaborative approach. In psychiatry, as in many specialties treating vulnerable, complex segments of the urban population living with chronic diseases, the therapeutic relationship is a fundamental treatment tool. The Centre hospitalier de l’Université de Montreal (CHUM) recently took advantage of this opportunity and placed the patient’s experience at the heart of its strategic plan.

With a view to continuous improvement of service quality, at the CHUM’s psychiatry and mental health program, we followed suit by creating and implementing a two-tiered health care partnership (governance and treatment). We added measurement tools (satisfaction surveys and scales) as well as an integrated client-tracking model. The pilot project carried out by an outpatient clinical team and based on evidence from medical literature can serve as a guide for other teams wishing to make use of it. Given the magnitude of the project, we quickly seized the opportunity of building alliances with partners of the University of Montreal such as the Bureau facultaire de l’expertise patient partenaire (BFEPP) and the Centre de pédagogie appliquée aux sciences de la santé (CPASS) which provided us with essential information, as well as logistical and academic support. In addition, as the main objective is collaboration with patients, the project constantly relied on the support of patient advisors, without whom a collaborative approach would have been meaningless.

The restructuring of the outpatient continuous quality improvement committee became a crucial step of the project as it lead to the integration of two patient advisors. Guided by the structured approach of CPASS and inspired by the vision of the patients in question, the Committee was mandated with creating a client satisfaction survey, tools aiming at integrating patients within the treatment team and an integrated follow-up model. Following numerous training and awareness sessions on the Health Care Partnership, the clinical team of the pilot project did some pre-testing using questionnaires and tools on randomly selected patients with a view to their validation. Prior to implementation, we took the time to go over the experience with the clinical team in a focus group. We also held a number of private interviews with the different stakeholders (patient advisors, CPASS and BFEPP). The results were better than expected: our project not only promoted interdisciplinary collaboration but widened the boundaries of conventional health care treatments. The Health Care Partnership was therefore seen as a success story by patients at both targeted levels: governance and treatment. Both professionals and patients were unanimous in stating that the Patient as a Partner approach brings together stakeholders and that patients therefore felt more listened to, more involved and more secure. Furthermore, by taking part in the CHUM steering committee on the monitoring of patient experiences and the CPASS Collaborating Health Care Leaders project (LCE), we managed to not only considerably increase the visibility of the project within the organization, but to also ensure its sustainability and transferability.

The evidence-based approach of the EXTRA program has made our project possible, credible and successful. Greatly inspired by this creative adventure, we hope to continue to improve the healthy management of our organization within a cycle of knowledge transfer: we learn, we adapt, we innovate and we pass this on to others.