A few weeks ago we were lucky to have had the opportunity to meet with Health Minister Sarah Hoffman (now Deputy Premier). The meeting went well and we had a chance to provide information and suggestions based on our experiences since Greg’s premature death 3 ½ years ago. Minister Hoffman asked us what our top three priorities would be for the health system and we were happy to share our thoughts with her and we now want to share the priorities with you. We will post all three priorities on Health Arrows – this is the first. We believe these steps would make substantial improvements in the way health care is provided to patients and their families.
Fundamental culture reset with commitment to a clear cohesive vision.
In the last couple of years we’ve have seen headlines such as:
- Alberta Health Services searching for 7th CEO in 8 years – The $500K-a-year job no one seems to want
- Alberta Health Services ‘patient first strategy’ met with cynicism
- Alberta Health Services needs ‘organizational vision’ to boost flat employee morale, CEO says
It is not all bad though, we have witnessed good things happening at the individual caregiver and local level. These gems are the result of very committed individuals. The disturbing part is that these people also know from their own experience and by seeing what has happened to their peers, that they cannot afford to have a light shone on them (our family’s original goal for Health Arrows) because it would not help build momentum for improvement like it should, but instead would differentiate them from the rest of the system and being known to be innovative or leading has been a recipe for career limiting or ending action by senior management. It is for this reason, these good people have asked us to not reference them or the great work they are doing with patients. This must change.
The system needs a culture reset. A high performing system would be dramatically different from the long established top down, largely disconnected, siloed system that we currently see. A successful reset needs to guide absolutely everyone onto the path of a new collaborative and supportive culture.
We were pleased to hear Deputy Premier and Health Minister Hoffman note the need for teamwork. There are tremendous people involved in all levels of the system and these people need the freedom to actively partner with patients and to work with each other for better patient outcomes. It is our belief that the Minister, with the support of Premier Notley and the government, must start immediately to publicly commit to move toward team based care and team based, collaborative systems throughout all facets of health care in Alberta. Every decision, at every level, must be made with this fundamental goal in mind. From the floor of the ward to the floor of the legislature must contribute to this goal or it should not be made until an alternative is found that does. The vision for the system must incorporate the key characteristics of care that is team based, patient partnered, high performing and continuously improving. “Alberta leads in continuously improving, high performing, team-based, patient partnered health care” would be an example of a new Vision that we believe incorporates the characteristics that are necessary to generate the new direction required.
The vision must promote a culture that:
- Empowers and engages all members of the health care system to innovate, communicate and genuinely work together to accomplish the overall vision of the system.
- Partners with patients. Patients themselves have a very important role to play, both in their own care and decisions associated with that, but also from a unique perspective with respect to what they and their families encounter on their treatment journey.
- Drives continuous improvement. Trade “continuous improvement” as the go forward mantra instead of the current apparent priority of “system stability” and “change fatigue” political speak protecting the unacceptable status quo. Seek to be the high performing system, track progress and meaningful measurement and report on it publicly.
- Learns from, acknowledges and embraces failure.
If the dedicated people throughout the currently disconnected system are able to utilize their creativity, to work together, to innovate and to truly partner with patients in their care the Alberta health system has the potential to be so much more than it is today. It will be those team based connections which will make use stronger and drive us forward.
Greg died because of multiple gaps in care where different doctors and care providers did not communicate effectively or at all, with each other. No one chose to take continuous responsibility to work closely with Greg to ensure he got the care he needed. Instead, individual actions, individual “silos” only did what they judged they needed to for themselves. They fell tragically short. While each person can argue that it was not their responsibility, it is very clear that the lack of a system of team work and overall sense of responsibility was the problem then and remains the case today.
Working together, we can and must make it better.