Healthcare Management Forum

Healthcare organizations face growing pressures to increase patient-centred care and to involve patients more in organizational decisions. Yet many providers worry that such involvement requires additional time and resources and do not see patients as capable of contributing meaningfully to decisions. This article discusses three efforts in four organizations to engage patients in quality improvement efforts. McGill University Health Centre, Saskatoon Health Region, and Vancouver Coastal and Fraser Health Regions all engaged patients in quality improvement and system redesign initiatives that were successful in improving care processes, outcomes, and patient experience measures. Patient involvement in redesigning care may provide a way to demonstrate the value of patients’ experiences and inputs into problem-solving, building support for their involvement in other areas. Further study of these cases and a broader survey of organizational experiences with patient involvement may help elucidate the factors that support greater patient engagement.

This article intends to frame the broader concept of experience design and the engagement of patient and family voice, reinforcing how truly aligned healthcare professionals are not only on the value of this work but also in understanding the benefits of it. When addressing the idea of design, it is important to look at the broadest possible construct and consider the engagement of patient and family voices in healthcare operational efforts, not as passive advisors but as active participants in data gathering, providing input, and with actual decision-making. The article offers engagement is not just part of process, facility, or experience design but must be part of the decisions made in how organizations in healthcare today are built, led, and sustained, fundamentally reinforcing our opportunity in healthcare is to focus on overall experience with purpose and intention. This commitment is what will lead to the outcomes all ultimately hope to achieve.

Radiation therapy service quality is not only defined by the technical aspects of care—the patient’s involvement and satisfaction also contribute largely to determining the quality of care received. Although there have been recent increases in support for the development of patient engagement activities throughout Canada, the lack of guidance and knowledge of patient engagement techniques within the radiotherapy context limits implementation. Without processes to obtain first-hand insight from patients, the need for these programs is overlooked. With a commitment to improving quality and consistency of care, the Canadian Partnership for Quality Radiotherapy recognized the need for a set of national guidelines on patient engagement in radiation therapy service delivery. Making use of the perspectives and first-hand experience of patient representatives, this initiative aims to develop a pan-Canadian guidance document that radiation therapy centres can adopt for successful integration of patient engagement through core activities of service delivery.

For non-profit organizations in the disability sector, engaging stakeholders with disabilities on matters of strategic planning is both a responsibility and an expectation. As part of our current strategic plan, which calls for organizational and systemic transformation, the Canadian National Institute for the Blind (CNIB) has engaged blind and partially sighted stakeholders alongside other interest groups to build and advocate for a more holistic model of vision healthcare and rehabilitation. This article describes the CNIB’s multi-year process, including early-stage consultations, collaborative strategy development, and political advocacy and shares our organization’s key success factors and learnings in creating meaningful, mutually beneficial engagement.

This article outlines the experience of the Arnprior Region & Ottawa West (AROW) Health Link using a multi-dimensional engagement framework in the co-development of systems change with client representatives. The article outlines patient, organizational, and societal factors influencing client engagement. The key learning that has allowed the joint Client Engagement Committee to evolve has been the core of client leadership. Client-led tables and workgroups have fueled client-to-client engagement, which has shifted clients from being a part of the change to driving the change.

For the past several years, Interior Health (IH) has worked collaboratively with Aboriginal leaders to build strong relationships and develop an environment of reciprocal accountability and knowledge exchange. All partners are committed to working together to change the healthcare system so that it responds appropriately and effectively to the needs of a population of people with the poorest health outcomes. The development of the IH Aboriginal Health and Wellness Strategy is an example of meaningful engagement with First Nations communities in the IH region at the system level. The strategy was built by IH, led by First Nations, and developed in collaboration with First Nations, Urban, and Métis partners. It aims to address the shared long-term goal of improving the overall health and wellness of Aboriginal people and enable a cultural transformation to overcome the barriers that are stopping Aboriginal people from seeking care from a shared healthcare system.

De-adoption refers to the discontinuance of a medical practice or health service found to be ineffective or harmful following a previous period of adoption. As growing healthcare budgets threaten to cripple the societies that fund them, facilitating de-adoption may be integral to sustainable healthcare systems that provide high-quality care. This article explores ethical issues pertinent to de-adoption including the underpinnings of beneficence, non-maleficence, justice, and autonomy.

La désadoption désigne l’abandon d’une pratique médicale ou d’un service de santé inefficace ou nuisible après une période d’adoption. Tandis que les dépenses croissantes en matière de santé menacent de paralyser les sociétés qui les financent, le fait de faciliter la désadoption peut faire partie intégrante de systèmes de santé durables qui prodiguent des soins de qualité. Le présent article explore des enjeux éthiques qui se rapportent à la désadoption, y compris les principes sous-jacents de bénéficience, de non-maléficience, de justice et d’autonomie.