Initiatives and Practices that advance Patient Safety through Patient Engagement
Advancing patient safety in partnership with patients is supported by implementing initiatives and/or practices that others have implemented with success. The examples below demonstrate the impact through patient engagement, in a variety of organizations.
McGill University Health Centre - transforming care at bedside initiative. Outcomes include: a 50 per cent decrease in medication interruptions, 60 per cent decrease in medication errors, eight per cent increase in registered nurse direct time in care, increased patient satisfaction, cost savings in equipment, decreased infection rates (25 per cent for Clostridium difficile and 26 per cent for VRE), improved team effectiveness, statistically significant reduction in nurse voluntary turnover and overtime.
Kingston General Hospital –organizational design and service improvement in partnership with advisors. Outcomes include: improved hand hygiene compliance (from 34 to 98 per cent), decreased hospital-acquired infections.
Montreal Children's Hospital – McGill University Health Centre - "We should talk" campaign encourages speaking up when there is a safety concern and to develop a collaborative approach when concerns are raised. Outcomes include: more effective communication to improve patient safety and foster frontline improvement in partnership.
Canadian Foundation for Healthcare Improvement (now Healthcare Excellence Canada) – Better Together campaign (Family Presence). Family presence policies allow patients to designate family members and loved ones who can stay by their side 24-hours a day, seven days a week. Research shows that family presence policies lead to safer care due to: better care coordination, fewer medication incidents and falls, and 30-day readmissions to hospital after discharge.
Huron Perth Healthcare Alliance – Bedside Shift Report (Transfer of Accountability). Results: no significant changes in quantitative data, but improvement in qualitative data.
University Health Network, Toronto Rehab's Lyndhurst Spinal Cord Rehabilitation Team - Patient-Oriented Discharge Summary (PODS). PODS ensure patients have the information and resources to support their transition, including a short-term care plan, medications that need to be taken, signs, symptoms and how to manage pain, outpatient referrals, follow-up appointments, and a telephone contact list. Results from the pilot program showed that PODS participants' confidence around being discharged doubled, in comparison to those who were discharged before the study began.
Mackenzie Health. Standardizing medication reconciliation at discharge. Patient satisfaction scores have improved since the new process was implemented. During post-discharge phone calls, when patients were asked about their medication plans and the effectiveness of counseling on what they needed to take at home, all patients reported positive comments. Other results included a greater number of medication discrepancies were identified and resolved, and more patients were receiving education about home medication.
North York General Hospital. Creating a specialist role (PES) to combine patient relations and patient safety. The program has been in operation for almost two years and management evaluation results show that 81 per cent of management feels that the PES has made a positive difference to the work they do and to patients and families. In addition, 100 per cent of management report that the PES has helped in the disclosure process. The patient experience specialist team has also received direct feedback from patients and families that has been overwhelmingly positive.
Mount Sinai Hospital (MSH). Engaging patients as advisors (PA) for inpatient psychiatry. Overall, the qualitative feedback from patients indicates that the work of the PAs provides them with hope and optimism for their recovery. Staff members are appreciative of the PA's perspective, as it enhances their ability to provide individualized patient care. MSH is aiming to elicit more quantitative feedback by adding questions to its patient satisfaction surveys to assess the impact of the advisors on care delivery.
William Osler Health System. Designing patient feedback systems to capture real-time information. The hospital has been deploying its surveys and phone calls since August 2011. Compliments have increased 100 per cent, while complaints remain steady, despite patient volume being up by 8.2 per cent. Staff reported that patients phone or write to say how much they appreciated the post discharge call; and managers also reported the calls allowed them to handle escalating situations before these became complaints. The team is able to complete approximately 2,000 surveys per month, whereas the NRC Picker Canada survey completion rate is approximately 34 per month.
Gateway Community Health Centre. The System Navigator. The patients being followed demonstrated an 87 per cent reduction in emergency department visits, an 85 per cent reduction in hospital admissions, a 71 per cent reduction in length of stay and 100 per cent implementation of a medicine reconciliation post-care plan.
Follow the links below to find more examples:
- Health Standards Organization: Leading practices database
- Agency for Healthcare Research and Quality: Impact Case Studies database
- Health Quality Ontario, 2016. Engaging with Patients: Stories and Successes from the 2015/2016 Quality Improvement Plans (including Engaging Under Represented Populations)
- Longwoods, 2017: Creating "Engagement-Capable Environments" in Healthcare
- Ontario Hospital Association, 2013: Achieving Patient Experience Excellence in Ontario: An Idea Book
- Patients for Patient Safety Canada: What our members do
