Interview with Sandra Schmidt

CFHI Interview with Sandra Schmidt, Project Lead, Transforming the Patient Care Experience, Bruyère Continuing Care

March 2016

Bruyere Continuing Care

Bruyère Continuing Care staff listen to patients and families share their priorities when transitioning out of hospital. These ideas were combined with best practices to co-create the Path to Home Passport Discharge Program.

In an occasional feature, we interview leads of CFHI-supported projects. This month we profile Bruyere Continuing Care about their involvement in the Partnering with Patients and Families for Quality Improvement Collaborative.

Please describe your involvement in CFHI’s Partnering with Patients and Families for Quality Improvement Collaborative?

Bruyère’s patient population has changed with much shorter lengths and increased complexity over the last five years. We have had the opportunity to develop an excellent partnership with our Bruyère Research Institute and our newly developed Patient and Family Advisory Committee to transform our patient experience.

Through this collaborative, we have held Kaizen events with patients, family members and stakeholders to assist in developing ideas and in planning various transformation initiatives. Patient and family stories were captured and analysed for themes. Listening to what was most important to our patients and families informed our co-design process to develop evidence-based initiatives to fill the identified gaps. All of our initiatives have been co-designed with patients and families, taking evidence based practices and combining what patients and families tell us is most important to them.

What improvement project(s) is your team undertaking as part of the collaborative?

We are involved with patients and families in co-design and focusing on what was most important to them. These have included a Volunteer Ambassador Program, Customized Care Boards, Patient and Family Advisory Committee, a Path to Home Passport, Nursing Always Practices and so forth.

What key challenge will your innovation solve?

Challenges that our innovation addresses include:

Decreasing anxiety in patients and caregivers through being proactive instead of reactive. Examples include:

  • Developing our Admission Ambassador Program and welcoming new patients to our hospital, answering non-clinical questions, taking them on a tour of essential areas on their unit and within the hospital.
  • Providing evidence-based, patient-centered care where patients are engaged in their own care.
  • Patients and caregivers will now be prepared with written information and skills they need for a successful discharge process – identifying and answering their most pressing questions before going home.
  • Engagement and co-design with the patient and family advisors in the processes and policies of the hospital (satisfaction survey questions, complaint processes, always practices) so we invite the perspective of our patients and families to guide us.

How does your innovation improve care for patients, families and caregivers?

We have had patient and family involvement and engagement every step of the way from the conception phase, through the development of the initiative and evaluation. Our initiatives are driven by ideas from our patients, families and their caregivers focusing on their priorities for the best outcomes. Initiatives have encouraged teamwork within Bruyère, focusing corporate services on the initiatives and how we can work together to make them happen.

Are there any cost savings that can be realized from your innovation? If yes, please describe.

Our initiatives are being evaluated. However, the initial results show our initiatives have created the following cost savings:

  • Savings in staff time, which increases time at the bedside.
  • Decreased complaints, which has led to increased savings of managers’ time investigating and following up on concerns and incident reports.
  • Increased patient safety with bedside handover and bedside safety checks reducing preventable harm.
  • Improved patient satisfaction surveys, which has reduced time spent investigating and resolving issues.
  • Decreased severity of patient and family complaints.
  • Increased compliments.
  • More donations to the Bruyère Foundation and Angel Program

What has your experience been like working with CFHI?

Membership in the CFHI collaborative has helped accelerate the change process for us. We now have initiatives to fully partner with patients and families to focus on what is important to them and to use quality improvement tools to identify that positive changes have been made.

We have also received excellent support, education and coaching from CFHI. This has included initial conference in Montreal, webinars, assigned coaches Mary Lynne McMaster and Heather Thiessen, access to improvement coach Patti O’Connor, quarterly collaborative storybook webinars to share our work and learn from others in the collaborative, and financial support.

We have also had an opportunity to share our journey at conferences such as Health Achieve and Accreditation Canada, McGill University Health Center, Institute for Strategic Analysis and Innovation, SPOR, and St. Michael’s Transition Symposium.

A very high functioning team has been formed with the close partnership of Bruyère with inspiration from Dr. John Robinson and Jacqueline Tetroe (our patient and family advisors) and with leadership and expertise from Dr. Beverly Shea a research scientist from the Bruyère Research Institute.

What kind of support did CFHI provide to you and your team during the collaborative?

CFHI provided coaching, advice, skill development on using Lean Methods to demonstrate improvement. We also received timelines to move forward with our initiatives and provide progress reports, and we got $50,000 of funding.

What challenges did you encounter during the collaborative? How were these challenges overcome?

One of the biggest challenges came in the form of competing priorities for time and funds. We listened to patients and families stories, held Kaizen events around transitions, aligned our initiatives with our strategic plan, and with the patients’ first priorities. We also focused on themes from our patient and family stories to fill gaps and put into place initiatives that would be low cost with high value.

What feedback have you received concerning the Partnering with Patients and Families for Quality Improvement Collaborative so far?

Bruyère is very thankful to have been part of this collaborative. It has really accelerated our adoption of very powerful and meaningful initiatives. The funding provided was the only way we could have moved this forward as quickly as we have. It has been a great opportunity to share our initiatives with other organizations and to learn from their experience.

Do you have any results from your improvement project that you can share?

Results so far have included:

  • The Volunteer Ambassador Program has found that 100 percent of patients admitted now feel welcomed to our hospital.
  • We are now spreading the program to the Palliative Care Unit at a second hospital site in March 2016.
  • We have a fully operational Patient and Family Advisory Council that is designing and implementing new initiatives such as a formal complaint process, satisfaction survey, etc.
  • Customized Care Boards have been designed with information that patients and families wanted and needed to improve communication between them and us.
  • Nursing Always Practices – Patients and their significant others are engaged in bedside handovers and will be completed in the first quarter of 2016.
  • Other outcomes to be measured include reduced hospital readmissions; increase adherence with discharge instructions and medications; attending follow-up appointments and tests; improved patient and caregiver experience with the discharge information provided.