e9 helga avila - patient voices and process improvement at viha

Patient Voices

and Process

Improvement

at VIHA

Quality Forum

Presentation By

Helga Avila

Manager Process

Improvement

February 28, 2013

Mental Health & Addictions Process Improvement

• Patient experience session facilitated by Impact BC.

• 4 patients plus their caregivers at event

• Recruited by program

Maternity Clinic

Process and Facility Design

• Focus groups (4) & surveys (online & paper)

– Socially at risk focus group (9)

– Aboriginal urban (9) & rural (4) focus groups

– Medically at risk focus group (6)

– Not at risk surveys (364 responses)

• Socially at Risk - Recruited by Community Health Nursing – Saanich Neighbourhood House

• Aboriginal – Recruited by Public Health Nurses & Victoria Native Friendship Centre

• Medically at Risk - Recruited by Acute Perinatal program

• Not At Risk - Surveys and survey links distributed at Health Unit Prenatal education classes

Maternity Clinic

Process and Facility Design

Oceanside Process Design

• Patient journey mapping

• 2 patients and 2 caregivers

• Recruited through the Alzheimer’s Society

Mt Waddington

2 First Nations Sessions

A Spectrum of Engagement

Inform Input Make

Decisions

Share Accountability

Co-Lead

Where should we be?

A Spectrum of Engagement

Inform Input Make

Decisions

Share Accountability

Co-Lead

Transparency

Expectations

Risk

Ownership

Trust

Risk/Issues including Patients in Lean Projects

– When and how to engage the patient varies between projects, consultation and sensitivity is required when making these decisions.

– Need to be very clear on the patient’s role as a partner, type of engagement and the commitment required.

All patients have a rich history beyond their illness, respecting any professional perspective patients bring to events is important.

Benefits including Patients in Lean Projects

• Need to manage patients’ expectations regarding the speed of change and the need to prioritize implementation of ideas. Some things take longer to change than someone from outside the system might anticipate.

It takes time to prepare for patient sessions; include and follow-up immediately post event with patients, especially if ongoing follow-up is required to provide progress updates or collect additional perspectives.

Communication

Continuous Engagement

It’s important to circle back to the patient while developing solutions to service gaps and when mapping the future state. Making assumptions that we know the answers will render and or

magnify process flaws.

Using the Tools

Process mapping is a technical tool

that includes listing and grouping

issues, the risk is that the essence of

what the patient is trying to convey

might be diluted by the technical

process.

– Risk of overusing the patient voice to the extent that stakeholders become numb to the experience.

– Not incorporating the patient’s perspective when it has been collected.

– Risk that the patient’s expressed experience is not respected.

Thank-you! Helga Avila, Manager Process Improvement

Vancouver Island Health Authority