Partnering with Patients and Families for Quality Improvement Collaborative
Alberta Health Services (Glenrose Rehabilitation Hospital), Edmonton, Alberta
  • Executive Sponsor: Val Guiltner (Director, Pediatric Rehabilitation)
  • Project Lead: Catherine Jones (Manager, Social Work)
  • Evaluation and Performance Measurement Co-Leads: Lesley Wiart (Site Lead, Clinical Outcomes), Cyndie Koning & Laura Mumme (Knowledge Mobilization Specialist)
  • Patient/ Family Advisors: Charlene Prochnau (Co-chair, Glenrose Family Advisory Network (GFAN)), Scott Wilson (Co-chair, GFAN)

Enhancing Support for the Transition to Adulthood for Youth with Complex Conditions
There are few resources available to support youth with complex conditions and their families as they transition into adulthood. Families often have difficulty navigating existing resources in a complex system and have expressed a need for information and resources to support their children through the transition. Glenrose Rehabilitation Hospital is partnering with youth and families to 1) co-design a web portal that will serve as a timely transition resource for families and 2) implement a common team approach to supporting transition based on the principles of self-management and family centred care. 

BC Cancer Agency and BC Children’s Hospital, Vancouver, British Columbia
  • Executive Co-Sponsors: Fiona Walks (Vice President, Safety, Quality and Supportive Care, BC Cancer Agency) and Patti Byron (Senior Director, Patient Care Services, Specialized Pediatrics, Inpatient & Ambulatory Care), BC Children's Hospital
  • Project Lead: Devon Poznanski (Program Leader, Survivorship & Primary Care Program)
  • Evaluation and Performance Measurement Co-Leads: Mary McBride (Distinguished Scientist, Cancer Control Research, BC Cancer Agency), Karen Blain (Provincial Director, Survivorship & Primary Care Program, BC Cancer Agency)
  • Patient/Family Advisor: Emilia Petrichenko
  • Transition lead: Marion Nelson (Transition Nurse Clinician, BC Children's Hospital)

Gaining Consensus for the Redesign of the Medical Summary for Transition of Adult Childhood Cancer Survivors
Starting at the age of 17 and five years post-treatment, childhood cancer survivors are transitioned from BC Children’s Hospital to primary care and adult services. This improvement project is developing consensus on the content of the medical summary given to patients at discharge, as part of a larger initiative in BC aimed at improving care for adulthood childhood cancer survivors. Adult childhood cancer survivors and their families are determining what elements they would like to see in a medical summary and what other resources they require to be fully informed and able to advocate for their health.

Bridgepoint Active Healthcare, Toronto, Ontario
  • Executive Sponsor: Jane Merkley (Vice President, Programs, Services and Professional Affairs, CNE)
  • Project Lead: Helen Lampi (Project Director)
  • Project Co-lead: Jackie Eli (Clinical Director, Rehabilitation & Clinical Integration)
  • Evaluation and Performance Measurement Lead: Michael Gekas (Lead Metrics, Director Corporate Performance)
  • Patient/Family Advisor: Nancy Evans (Patient Advisor)

Engaging Patients and Families at Bridgepoint: Experience-based Co-design of the Admission Process
The orthopedic rehabilitation unit is where individuals recover from traumatic injury, joint surgery or progressive bone and joint disorders. A preliminary analysis of gaps between current and ideal care identified the admission process as a key area for redesign. The admission process was time consuming and stressful for patients, families and care providers.

Staff are partnering with patients and families to co-design the first 48 hours of their hospital stay. Various quality improvement techniques and experience-based design methodology are being used to capture and understand the patient and family experience.

Bruyère Continuing Care, Ottawa, Ontario
  • Project Sponsor: Debbie Gravelle (Senior Vice President Clinical Programs and Chief Nursing Executive and Allied Health)
  • Project Lead: Sandra Schmidt (Project Lead, Transforming the Patient Care Experience)
  • Measurement Lead: Dr. Beverley Shea (Research Scientist, Bruyère Research Institute)
  • Patient/Family Advisors: Dr. John Robinson and Jacqueline Tetroe
  • Project Advisor: Dr. Peter Walker (Chief Executive Officer and Scientific Director BRI and VP Research and Academic Affairs)

Partnering with Patients and Families for Healthcare Improvement at Transitions 
Through active partnering with patients and families and using Lean methods and tools, this improvement project will increase engagement, positive patient outcomes and satisfaction with patient experience at transitions. This project focuses on transition points, such as admission, discharge and transfers and includes multiple quality improvement projects. By integrating the principles of co-design and in active partnering with patients and families the project includes the development of a Patient and Family Advisory Committee, a Volunteer Ambassador Program, the adoption of “Always Practices” for Nursing and the development of Individualized Discharge Plans including education and resources for patients and families to complement Bruyère's Saint Vincent Hospital “Path to Home Resource Lounge”.

Centre hospitalier de l’Université de Montréal, Montréal, Québec

  • Executive sponsor: Christiane Arbour (Director, Professional Services and Access Mechanisms Branch)
  • Project Co-Leads: Valerie Lahaie (Consultant, Health Promotion and Therapeutic Education, Professional Services and Access Mechanisms Branch), Audrey-Maude Mercier (Consultant, Health Promotion, Professional Services and Access Mechanisms Branch), François Laplante (Occupational Therapist, Coordinator, Clinical Teaching, Occupational Therapy Department)
  • Evaluation and Measurement Co-Leads: Marie-Pascale Pomey (Associate Professor, researcher, Institut de recherche en santé publique, University of Montreal (IRSPUM))), Johanne Higgins (Assistant Professor and researcher, University of Montreal)
  • Patient/family advisor: Olivier Fortin (Patient-mentor)

Patient Advisors: Key Players in Improving Care for Patients Who Have Experienced the Traumatic Amputation of an Upper Limb
Annually, the CEVARMU (the CHUM’s centre of expertise in surgical attachment of severed limbs) sees more than 150 patients aged 14 years and older who have experienced the amputation and attachment of an upper limb.  

This improvement project aims to reduce the perception of disability in patients admitted to the CEVARMU by formalising an innovative model of care partnership, together with patient advisors. Three patient advisors have been trained to become full-fledged members of the healthcare team. They meet patients on a voluntary basis to share their personal experience of injury and rehabilitation and provide their point of view, in addition to the health care team’s perspective.   

Child Development Centre, Whitehorse, Yukon

  • Executive Sponsor: Alayne Squair (Executive Director)
  • Project Lead: Amy Riske (Program Coordinator)
  • Evaluation and Performance Measurement Lead: Brooke McKenzie (Diagnostic Coordinator)
  • Patient/Family Advisor: Christine Pottie

Establishing a Family Partnership Council in Community-Based Pediatric Early Intervention: Partnering for Success
This project has resulted in the development of a Family Partnership Council as a formal channel for collaborative decision-making at the Child Development Centre. The council includes family representatives, clinical representatives and management representatives working together to make decisions on organizational level projects. Currently the Family Partnership Council is working to enhance the quality of the current process of entry into services, including referral, intake and initiation of service delivery.

Children’s Hospital of Eastern Ontario, Ottawa, Ontario

  • Executive Sponsor: Susan Richardson (Vice President, Patient Care and Provincial Programs)
  • Project Co-Leads: Mireille Brosseau (Project Manager, Patient Engagement), Christine Kouri (Manager for Patient Experience; Acting Chief Privacy Officer)
  • Evaluation and Performance Measurement Lead: Kristina Rohde (Program Evaluator, Clinical Research Unit) and Jennifer Ellis (Director, Quality and Safety)
  • Patient/Family Advisor: Linda Jones (Member, Family Forum; Member, CHEOworks Steering Committee)

Experience Based Co-Design with Oncology Inpatient and Outpatient Services
Using an Experience Based Co-Design (EBCD) approach, this project builds on an initial phase where interviews and feedback events helped to deepen mutual understanding and collaborationbetween oncology staff, patients and families. Participants are now co-designing solutions to improve the oncology orientation process and supporting materials thereby ensuring that oncology patients, families and staff have the knowledge and resources to become good partners in care.

CIUSSS de la Mauricie-Centre-du-Québec, Shawinigan, Quebec

  • Executive Sponsor: Karine Lampron (Assistant Director - Primary Healthcare Services and Chronic Disease Management)
  • Project Lead: Catherine Neault (Executive Advisor, Multidisciplinary Services)
  • Evaluation and Measurement Co-Leads: Nicole St-Pierre (Department Head, Program and Practice Evaluation, CIUSSS MCQ) and Marie-Pascale Pomey (Full Professor, Director of the Masters Degree in Health Administration with focus on the quality and safety of care (Queops-i), Department of Health Administration, University of Montreal)
  • Other members: Véronique Biron (Executive Advisor, Nursing) and Nancy Gilbert (Coordinator, Multidisciplinary Services)
  • Mentors: Sophie Baillargeon (Assistant to the Director of Nursing, McGill University Health Center) and André Néron (Associate Director, Collaboration and Partnership Branch, University of Montreal)

The Patient’s Voice: A Wealth of Sharing Experiential Knowledge
This ongoing improvement project fosters and supports the involvement of patient advisors at every level of governance within the organization. A partnership culture in care service and delivery has been emerging within CIUSSS de la Mauricie-et-du-Centre-du-Québec over the last two years. Through this collaborative, the organization is ensuring the sustainability of its partnership approach by standardizing the recruitment and training process of patient and family advisors who are active partners at every level of governance.  

CIUSSS du Centre-Est-de-l'île-de-Montréal, Montréal, Québec

  • Executive Sponsorr: Suzanne Lanctôt (Assistant Executive Director, Planning, Quality and Academic Mission)
  • Project Lead: Nathalie Trastour (Manager)
  • Renée-Paule Guertin (Head, Program Administration)
  • Evaluation and Measurement Co-Leads: Marie-Pascale Pomey (Full Professor), Luigi Flora (Educational Consultant and Researcher, Collaboration and Patient Partnership Branch, Faculty of Medicine, University of Montreal and Post-Doctoral Fellow, Faculty of Public Health), Djahanchah P. (SACHA) Ghadiri (Assistant Professor)
  • Patient/Family Advisor: Nicole Thériault (retired physician and diabetic)

Co-Designing as a Way of Improving Services that Promote Lifestyle Changes in Patients Newly Diagnosed with Type 2 Diabetes or Hypertension
This improvement project aims to implement a co-design process with patients, family members, healthcare teams and partners in order to identify strategies that could improve the Lifestyle Change Program. 

It aims to achieve a partnership with patients in order to: 

  • Empower and involve patients in the program’s improvement efforts,
  • Co-develop an improvement model, together with patients, that could be used throughout the institution,
  • Maintain or even improve clinical outcomes for patients who complete the Lifestyle Change Program. 
Grey Bruce Health Services, Owen Sound, Ontario

  • Executive Sponsor: Julia Scott (Vice President, Clinical Services and Chief Nursing Executive)
  • Project Lead: Diana Ryman (Director, Patient Relations and Patient Safety)
  • Evaluation and Performance Measurement Lead: Mary Jane Dandeno (Manager, Utilization Management)
  • Patient/Family Advisors: Bob McDowell, Nancy Weese

Implementation of a Patient Advisor Role to assist with Oncology Unit Design and Process Improvement
This improvement project is designing an approach to formally incorporate patient and family experience throughout the cancer journey, in order to improve oncology patient experiences and satisfaction. A patient advisor role is being designed and implemented within the oncology program. The patient/family advisory council and oncology clinical services team is partnering to review and design the oncology patient journey through diagnosis to treatment and recovery. 

Huron Perth Healthcare Alliance, Ontario

  • Executive Sponsor: Anne Campbell (Vice-President Partnerships and Patient Experience)
  • Project Lead: Dianne Gaffney (Corporate Lead Professional Practice)
  • Evaluation and Performance Measurement Lead: Iris Malig (Director of Decision Support)
  • Patient/Family Advisor: Cathy Bachner (Intermediate Teacher AMDSB)

Partnering with Patients and Families to Implement Bedside Transfer of Accountability
The transfer of responsibility for a patient from one nurse to another at change of shift is an important opportunity to exchange essential patient care information to ensure a smooth transition for the patient, as well as to enhance the safety and quality of patient care. This improvement project is improving the quality and safety of patient care and the patient experience by engaging patients and families in the bedside exchange of information at change of shift.  

Island Health, Victoria, British Columbia

  • Executive Sponsor: Marguerite Rowe (Executive Director)
  • Project Lead: Colleen Butcher (Manager Seniors and Spiritual Health)
  • Patient/Family Advisor: Bernie Lafrance

Optimizing Care for Patients Diagnosed with Dementia and Their Caregiver in Acute Care
Feedback from patients and families at Nanaimo General Hospital identified an opportunity for improvement to patient- and family-centred dementia care. This improvement project is developing partnerships with patients diagnosed with dementia and their caregivers, to increase involvement in decisions about the plan of care. It will also implement sustainable changes to the acute care environment to support evidence-informed dementia care needs such as activity aprons, painting elevator doors and quiet units. 

McGill University Health Centre, Montreal, Quebec

  • Executive Sponsor: Patricia Lefebvre (Quality, Patient Safety, and Performance, McGill University Health Centre)
  • Project Co-Lead: Alain Biron (Quality, Patient Safety, and Performance, McGill University Health Centre)
  • Project Co-Lead and Patient/Family Advisor: Emmanuelle Simony
  • Patient Partnership Program Coordinator: Karine Vigneault (Quality, Patient Safety, and Performance, McGill University Health Centre)
  • Evaluation and Performance Measurement Co-Leads: François Yale (Quality, Patient Safety, and Performance), Marie-Pascale Pomey (Associate Professor)

Patient Engagement in Quality Improvement:  Meeting the Challenges of Sustainability
Different patient engagement practices have been tested at the MUHC. Building on these experiences, there is a need to further develop, spread and sustain these practices across the organization.

This improvement project is introducing new methods to strengthen the spread and sustainability of specific patient engagement practices, including the highly successful Transforming Care at the Bedside program, a patient engagement project funded by CFHI in 2010. Specific objectives include; creating new quality improvement infrastructure to support sustainability of patient and family-centred care as a corporate priority; formalizing the recruitment of patient advisors and the training of patients, clinicians and staff on how to work in partnership; and ensure the benefits of partnering with patients in quality improvement initiatives is communicated to leaders in Quality Improvement within the MUHC.

Niagara Health System, St. Catharines, Ontario

  • Executive Sponsor: Brady Wood (Chief Communications Officer, Corporate Communications)
  • Project Lead: Cynthia Bryson (Dialysis Manager, Kidney Care Program)
  • Evaluation and Performance Measurement Lead: Elaina Orlando (Quality & Patient Safety Advisor, Quality Patient Safety & Risk)
  • Patient/Family Advisor: Kirsten Ernesaks (Online Community Patient Moderator)
  • Other Team Members: Anna Cobian (Web and New Media Coordinator), Nicole MacNiel (Registered Nurse)

Building Community for Dialysis Patients at Niagara Health System
At the St. Catharines site of the Niagara Health System, the kidney care program supports the treatment of up to 180 dialysis patients on a weekly basis. Many of these patients are visiting the site several times per week and will maintain such a routine for the duration of their life.

Although these patients visit the hospital regularly and often see the same fellow dialysis patients, they report feeling isolated and have expressed an interest in increasing connections with one another in order to improve their sense of community and feel more empowered in their decision-making. This improvement project aims to increase by 30% the proportion of dialysis patients reporting a strong sense of community among fellow dialysis patients by December 2015 through the development of an online community.

Nova Scotia Health Authority (NHSA)- Central Zone (formerly Capital Health), Halifax, Nova Scotia

  • Executive Sponsor: Lynn Edwards (Senior Director of Primary Health Care and Chronic Disease)
  • Project Co-Lead: Graeme Kohler (Manager, Primary Health Care)
  • Project Co-Lead and Evaluation/Performance Measurement Lead: Tara Sampalli (Assistant Director of Research, Primary Health Care, Manager Integrated Chronic Care Service)
  • Project Manager: Ashley Ryer (Project Lead, Primary Health Care, Mumford Professional Centre)
  • Patient/Family Advisor: Mary Brocklehurst, Judy Porter, and Les Wood

Patient and Family Engagement: Developing and Implementing a Resource Guide in Primary Health Care
This improvement project is improving patient and family engagement within primary health care and improving the care experience for patients and families. A resource guide for patient and family engagement is being developed and piloted within the Diabetes Management Centres, with the intent to spread to other programs and services within Primary Health Care.

Ontario Renal Network, Ontario

  • Executive Sponsor: Peter Blake (Provincial Medical Director, Ontario Renal Network)
  • Project Lead: Mary Ann Murray (Advance Practice Nurse, Home Dialysis Unit, The Ottawa Hospital)
  • Project Manager: Lisa Joya (Business Strategist, Clinical Programs, Ontario Renal Network)
  • Evaluation and Performance Measurement Lead: Janet Graham (Regional Director, Champlain LHIN, Ontario Renal Network)
  • Patient/Family Advisor: Randall Russell

Shared Development, Shared Decision-making: Co-Creating Chronic Kidney Disease Education to Support Patients and Families in Making Informed Care Decisions
Patients requiring renal replacement therapy often experience uncertainty when considering their options. Patients who experience decisional conflict are more likely not to adhere to their decision, blame providers for poor outcomes, fail a knowledge-test and delay decision-making. The Ontario Renal Network, in partnership with The Ottawa Hospital, is partnering with patients and their families to improve the ability of healthcare providers to engage in shared decision-making. A training video will be produced to enhance the decision-coaching skills healthcare providers in regional CKD programs across Ontario.

Owen Sound Family Health Team, Owen Sound, Ontario

  • Executive Sponsor: Caroline Rafferty (Executive Director)
  • Project Lead: Jennifer Kehoe (Planning and Programs Analyst)
  • Evaluation and Performance Measurement Lead: Debbie Kean (IT Support and Communications)
  • Patient/Family Advisor: Dorian Shortt (Certified Financial Planner)

Chronic Disease Self-Management in Diabetes 
The aim of this improvement project is to build the capacity of health care providers within the Owen Sound Family Health Team to engage patients in their care and to increase knowledge around the value of self-management. It is expected that improved patient engagement will lead to improved patient outcomes and patient experience.  

Prince Albert Parkland Health Region, Prince Albert, Saskatchewan

  • Executive Sponsor: Patricia Stuart (Vice President of Quality Management)
  • Project Lead: Malori Keller (Kaizen Specialist)
  • Evaluation and Performance Measurement Lead: Laura Jensen (Quality Improvement Consultant)
  • Patient/Family Advisor: Ken Wiest

Developing Standards for Partnering with Patients
There are over 320 active patient and family advisors in Saskatchewan. However, many reported a lack of understanding about their role and patient- and family-centred care. They feel supported at meetings but do not know what occurs following their recommendations and therefore doubt the value of their role. This improvement project is improving the experience of these patient and family advisors by enhancing integration into teams of healthcare employees and providers.

St. Joseph’s Healthcare, Hamilton, Ontario

  • Executive Sponsor: Winnie Doyle (Vice President Clinical Services)
  • Project Lead: Valentina Constantinescu (Patient Safety Specialist),
  • Project Member: Tarrah Long (Nurse Educator)
  • Evaluation and Performance Measurement Lead: Valentina Constantinescu (Patient Safety Specialist)
  • Patient/Family Advisor: Cindy Machida (Patient Advisor)

Learning With and From One Another; Patients and Providers on the Same Improvement Path
Patients in the adult rehabilitation unit are not as involved as they would like in the discharge process.

This improvement project is enhancing the patient, family and staff experience in preparation for discharge by using the teach-back method. Teach-back confirms understanding by asking the patient to explain in their own words what they need to know to safely manage their health. This intervention is expected to help patients develop the knowledge and skills to transition safely from hospital to the community and to feel more empowered to make future healthcare decisions. 

Stollery Children’s Hospital, Edmonton, Alberta

  • Executive Sponsors: Tracy MacDonald (Senior Operating Officer), Christine Kyriakides (Facility Medical Director)
  • Project Lead: Heather McCrady (Manager, Family Centred Care)
  • Evaluation and Performance Measurement Lead: Shelby Corley (Lead, Evaluation Specialist)
  • Patient/Family Advisor: Nicole Lyste (Member of  NICU Family Advisory Care Team & Family Centred Care Network)

Family Bedside Orientations
Family Bedside Orientations are provided by volunteer peer mentors who have personally experienced caring for a child admitted to hospital. Conversations between the peer mentors and caregiver(s) focus on hand hygiene practices, use of patient bedside whiteboards, familiarity with the child’s medications, participation in medical rounds, and family involvement in the child’s care.

The Family Bedside Orientations project was implemented in July 2014 at Stollery Children’s Hospital. Early findings suggest the initiative has become a well-known presence on the unit and has achieved support from both staff and families. Ongoing evaluation is examining if the initiative has helped reinforce hand hygiene, medication reconciliation practices and overall engagement with the patient’s care and care team.

Sunnybrook Health Sciences Centre, Toronto, Ontario

  • Executive Sponsor: Craig Duhamel (Vice President of Communications and Stakeholder Relations)
  • Project Leads: Tracey DasGupta (Director of Interprofessional Practice), A.J. Lopez (Professional Leader for Nursing, Manager of Clinical Informatics), Isabella Cheng (Professional and Educational Leader, Occupational Therapy)
  • Evaluation and Performance Measurement Leads: Brigette Hales (Manager of Quality and Patient Safety) and Guna Budrevics (Performance Improvement Specialist)
  • Patient and Family Partners: Barry Brown, Kevin DeGrace, Phyllis DeGrace, Jackie Dunkley, Allison Elliot, Paul Kocher, Jeremy Richardson, Don Ross, and Sky Zazlov

Seeking and Embedding the Voice of the Patient
This improvement project aims to create an environment where patients and their families feel that care is based on what is most important to them, and that they are respected as equal partners. 

Sunnybrook Health Sciences Centre is partnering with patients and families to  inspire and educate staff on the Person Centred Care approach, to influence practice change.  At Sunnybrook, Person-Centred Care is about consistently Seeking and Embedding the Voice of the Patient. Working together as partners in care, staff, patients, and families co-create an organizational culture of caring, connection, compassion and communication.

Co-created with patients and families, three educational videos were developed to bring Seeking and Embedding the Voice of the Patient to life. The videos are being implemented as part of an interprofessional education strategy, together with patients and families.

In order to recognize the success of the project, staff are measuring patient satisfaction, staff attitudes, and patient and family engagement in areas receiving the education.

Vancouver Coastal Health and Fraser Health, British Columbia

  • Executive Sponsor: Leanne Appleton (Director, Acute Services, Coastal COC LGH Site Lead)
  • Project Lead: Dolores Langford (Physiotherapy Practice Coordinator, Coastal Community of Care, Vancouver Coastal Health)
  • Evaluation and Performance Measurement Lead: Valerie MacDonald (Clinical Nurse Specialist Orthopaedics/Surgery)
  • Patient/Family Advisor: Judy Battista

Good to Go: A Safe and Smooth Transition Home after Hip Fracture
Over 4,000 people in BC have a hip fracture each year. Qualitative research shows patients feel overwhelmed, confused and distressed when they return home from the hospital after hip fracture repair.

“I thought I would be back to my normal state. So it’s frustrating that I don’t know what to expect, how long it will take”.  – Patient comment from baseline survey.

This improvement project is improving the patient experience during the transition from hospital to home, for patients who are over 65. Patients, families and health professionals are partnering to develop, test and refine tools and processes to help manage care at home and improve communication with community healthcare providers.