Patient partnering: A blossoming movement
A Conversation with patient advisor Diane McKenzie and Chief of Communications and Patient Partnering, Jennifer Schipper
Diane McKenzie: Patient partnering means building deeper, long-term relationships with health care professionals that lead to improved health care quality. This work is about challenges that need to be overcome. By working through those challenges – together – patients and organizations can make dramatic changes. It’s not easy. But together we are better when we are done.
Jennifer Schipper: When I first started at Health Quality Ontario more than four years ago, I was keen to “engage” patients and find out how we could work together.
One of my first meetings was with the founding president of Patient’s Canada, Sholom Glouberman, who told me: “Jennifer, patients don’t want to be engaged when it comes to health care improvement, they want to be married.”
Sholom’s phrase and sentiment has stayed with me ever since and has helped guide how Health Quality Ontario is working to help patients, health care professionals and organizations truly partner to effectively improve the quality of health care.
The speed at which this is occurring and the associated changes in language about this trend can be overwhelming to those who are not directly involved. For example, the concept of ‘patient engagement’ which was so dominant so recently, has largely been replaced by the more proactive concept of partnership.
DM: As a patient partner, I feel like the right language has just arrived. Everywhere. Organizations seem ready for this, even if some of their staff need time to get their heads around what partnering with patients means.
JS: In fact, patients do not seem afraid to call out instances of tokenism or lip-service when involving them in health care improvement. Instead, they are calling for meaningful partnerships with them to improve health care quality because it can only strengthen the quality of decisions made due to the insights and unique perspectives they bring to the table.
At Health Quality Ontario too, we have not been afraid to state that partnering with patients is essential in developing a quality health system.
DM: Patient partnering work can be both terrific and challenging as we all learn to do the right thing together. By speaking in an open and transparent way, we can work through our most difficult challenges.
JS: A recent commentary in CMAJ, former President and CEO Dr. Joshua Tepper and the VP of Evidence Development and Standards Dr. Irfan Dhalla stated that involving patients at the system level in decisions about what services should be offered is in its infancy in Canada but that “involving patients, and the public, increases the legitimacy of decision-making and will improve the quality of the decisions made.”
DM: In fact, leadership support within organizations for this kind of work is critical because it allows patient partners to have comfort/ confidence when tensions and resistance are high, knowing that some of their ideas will move forward, even if it takes time.
JS: Similarly, in his final blog post as CEO of Health Quality Ontario last month, Dr. Tepper wrote that “partnering with patients has to be part of the improvement process in health care.”
This is not necessarily easy work. While partnering with patients is an easy concept to endorse, it is not always easy to put into effect – especially with a need to involve patients with diverse levels of knowledge and capabilities and to ensure those from disadvantaged groups are properly represented.
DM: The journey toward a fully person-centred care organization is long and there are challenges. However, patients believe we can successfully work on these challenges with health care professionals together, through open and transparent dialogue, a laser focus on person-centred care, unwavering support from the organization and an openness to new ideas. I truly believe this type of partnership in care will ultimately lead to better outcomes for all.
JS: Health Quality Ontario has acknowledged the challenges of patient partnering and has curated and designed a number of tools and resources to empower patients and health care providers to build their capacity to effectively partner to improve care.
We and patient advisors like yourself are certainly not alone in acknowledging the importance of partnering with patients in Ontario. Indeed, the topic formed a significant part of the first Facebook Live chat recently between University Health Network President Dr. Kevin Smith and Professor Adalsteinn Brown, Dean of the Dalla Lana School of Public Health at the University of Toronto.
In that chat, Dr. Smith talked about the importance of improving the patient experience and Professor Brown said it was important to talk more with patients and their caregivers to improve how patients transition through the health care system. Professor Brown also said it was important to find a way to listen more effectively to what patients are saying so the quality of the system can be improved.
DM: Imagine the actions that could happen when health care providers truly listen to patients’ insights and piece together a solution based on their partnership in care?
JS: Imagine indeed. Ontario is building a strong, shared culture of patient, caregiver and public partnership where patients, health care providers and policy-makers understand how partnership leads to high quality care.
Once upon a time, not too long ago, health care professionals did things “to” patients and health care planners did things “for” patients.
DM: The result was a system that stood still in time, disconnected from the people it served and a system in which quality/outcomes declined.
JS: Now we are truly part of an era where both health care providers and planners are working “with” patients. And the system can’t help but improve as a result.
DM: With patients-as-partners, we are turning it around. Quickly.
* Please note, ‘patients’ refer to people being cared for in hospitals, through community programs, in their homes (including long-term care homes), as well as families and other public caregivers.
Diane McKenzie is a patient advisor for Health Quality Ontario and other organizations in Ontario and Jennifer Schipper is Chief of Communications and Patient Partnering at Health Quality Ontario