As part of this year’s Canadian Patient Safety Week (CPSW), our annual campaign to inspire improvements in healthcare safety and quality across Canada, HEC’s President and CEO Jennifer Zelmer hosted an exclusive fireside chat for CPSW registrants. The virtual event brought together a panel of experts who shared their experiences, knowledge and strategies to reinvigorate patient safety.
Our panelists included:
- Professor Jason Leitch CBE, National Clinical Director for Scotland
- Dr. Robin McGee, Registered Clinical Psychologist, author and member of Patients for Patient Safety Canada
- Dr. James Makokis, a Nehiyô two-spirit Family Physician, Saddle Lake Cree Nation, Alberta
How can we improve and reinspire efforts for patient safety?
From hospital harm, shortages in the health workforce to systemic issues like racism, we still have work to do to create safer care for all. But progress is possible when we see the cumulative effects of our actions. Here are some key takeaways from our panelists on how to improve and reinspire efforts for patient safety.
Find early supporters
Referencing the father of quality improvement, Joseph Juran, Professor Jason Leitch said, “All improvements are local; all improvements happen project by project.… it’s usually individual people who come together.”
Using an example in clinical care, a key strategy that enabled Professor Leitch and his colleagues to “fix intensive care safety,” and which ultimately led to the Scottish Patient Safety Programme, was working with early supporters. When they achieved promising results (eradicating infections) with their first five units, it made it easy to recruit other units, which led to a wider rollout. Finding and working with early supporters is one strategy then that can enable safety improvements across the system.
Find your community
“There’s a world of difference between being the one person on a committee [as] the patient voice to having two people,” recalled Dr. Robin McGee. “Yet, I hadn’t really had any real traction on patient advocacy until I joined Patients for Patient Safety Canada and had access to supportive assistance.”
Professor Leitch echoed the sentiment, "You need tools, pals and courage. [...] You need the tools with which to do the change, you need a group of people around you to help you do it and then you need the courage with which to do it."
The bottom line: there’s strength in numbers. When you have a community advocating and working alongside you, the load gets lighter. Plus, the support is invaluable in cultivating the courage to keep pushing for improvements.
Acknowledge and address systemic issues
Health inequalities continue to exist in Canada. Whether due to social or economic inequality or other forms of systemic oppression, these issues lead to patient harm. Dr. James Makokis pointed to Indigenous health outcomes as an example where these communities continue to have the poorest outcomes in the country. The root causes? Colonialism, racism and dehumanization.
Dr. Makokis described many of his patients delaying treatment or seeking treatment far from home where they “know [they] might be treated well” versus places close to home where they’ll be treated poorly simply because they are Indigenous. These forms of harm are often not recognized as patient safety issues.
Safer care means rethinking patient safety to include cultural safety. It’s about having an anti-oppression lens on processes like the complaint system. How do we capture data? Who is looking at the data? Are people from groups who are racialized or discriminated against included? Dr. Makokis encouraged listeners to be self-reflective and look more critically to address these issues.
Humanize the process
“What has happened historically is when there’s a case of harm and the patient or family is trying to seek answers on how this preventable error occurred in the first place, they’re often met with defensive [or] even a refusal to speak to the patient,” said Dr. McGee. “[This] actually increases the degree of harm that arises from the incident.”
To reinvigorate patient safety, Dr. McGee emphasized the need to make the process more human for those receiving care and those delivering care. One way to do this is through supporting healing after harm approaches (such as the Mutual Healing program at Covenant Health) where healthcare providers and patients engage in mutual healing through open discussions. Dr. Makokis also expanded on the need to humanize care more broadly, bringing us back to the intent of the original treaties as symbolized by the Two Row Wampum belt of mutual respect and partnership.
Advocate: Everyone can contribute to safer care
“I have no choice but to bravely advocate,” explained Dr. Makokis. “I’ve been extremely discriminated against and physically assaulted even as [someone] who has inherent power by being a physician. But what about […] Indigenous patients, trans patients and People of Colour who have zero power within these systems?”
Patient advocacy is exhausting work. The responsibility to advocate doesn’t fall only on patients but on everyone within the system. When we all advocate for safer care, we can make care safer in every way for everyone.
What’s next?
Our health systems are complex, but they can evolve. When we work together to reinspire patient safety, we can also be ‘Rethinking Patient Safety’ to implement new approaches that address systemic challenges to make care safer for everyone.
Looking for additional resources?
- Sign up for our upcoming Patient Safety Action Series, a four-month virtual learning initiative designed to broaden your understanding of safety.
- Start conversations around patient safety with our Rethinking Patient Safety discussion guide.
- Explore cultural safety through A Journey We Walk Together: Strengthening Indigenous Cultural Competency in Health Organizations report, the College of Physicians & Surgeons of Alberta’s Talking Circles: a step towards cultural safety article or Joyce’s Principle.
- Get involved with a patient-led group such as Patients for Patient Safety Canada, Imagine Citizens, and the Patient Advisors Network.
