I was fortunate to have the opportunity to travel to British Columbia, Canada in February 2018 for a Study Trip as part of the Scottish Quality & Safety Fellowship. The aim of the Study Trip is to gain insights from other areas and consider how these can be applied to your own area of practice. I elected to visit the British Columbia Patient Safety and Quality Council as I was impressed by the ethos of the Organisation. The Council believes a patient-centred, innovative, and inclusive approach from the province’s health care system is essential to improving quality of care. Along with two colleagues, I made the journey to Vancouver (which turned out to have less snow than Scotland, in the grip of Storm Emma, which we missed the brunt of)!
We received fantastic hospitality during our trip with numerous experiences demonstrating how The Council are supporting Patient Safety and Quality Improvement. You can see from the map that British Columbia (outlined in blue) is huge geographically. In the interests of not making my Blog too huge, I wanted to share a selection of my learning experiences!
Health Design Lab – Emily Carr University
This is a research and design lab where faculty and students work collaboratively on projects with industry and community partners to address complex challenges in health and healthcare. Emphasis is placed on participatory design research and the involvement of patients, caregivers and healthcare staff throughout the design process. A range of methods are utilized in order to co-create outcomes and proposed solutions with the ultimate aim of ensuring that those whose health needs are being addressed have a voice in the process.
We were involved in an interactive co-design workshop with members of the Patient Voices Network (who are a community of patients, families and caregivers working with health care partners to improve the health care system). We participated in various activities in order to create a series of ideas and recommendations to inform future designs of the new St Paul’s Hospital entry and visitor experience. ‘Personas’ (which are a description of typical and atypical service users, with specific thoughts and needs) were also used in order to broaden the range of experience in the room.
Projects that the Health Design Lab have also been involved in include a digital therapeutic device for delirium and dementia and lighting for residential care. Further information can be found:
We were impressed by the energy and creativity brought to the projects by the students from the Health Design Lab. There is great value in working in partnership with others who can bring a strong design skill set to the process.
Residential Care Units
I had the opportunity to visit several Residential Care Units, which were focusing on Staff training, environment and improved care for individuals with behavioural and psychological symptoms of dementia. One of the sites we visited at Youville (Providence Health Care) had been involved in co-design work with the Health Design Lab whilst undergoing a process of “Megamorphosis”. This is an innovation and improvement project to understand the residential care experience for residents, family and staff. Building on the insights gathered, the next phase is to rapidly test ideas from residents, family and staff. Ideas being tested included lighting, resident doorways and work around finding out how residents want to spend their day (residents were provided with cameras in order to take photos of what is meaningful to them). The work is approached with these 3 themes:
- Emotional connections matter most
- Residents direct each moment
- Home is not a place, it is a feeling
Further information can be found:
I was impressed by the level of buy in to the Quality Improvement work and the willingness to try new ideas. There was a real emphasis on ensuring that residents and families are partners in the process.
We spent a morning with a GP (originally from Scotland) in Downtown Eastside, which is notorious for its levels of drug use, poverty, mental health, homelessness, and crime. It is also known for its strong community resilience and history of social activism. We heard about the work being carried out in primary care around Peer Advisors. These are people with lived experience of Downtown Eastside who have used Services. One peer advisor described the role as being like “interpreters in a foreign land”.
We were struck by the ability of the peer advisors to reach the people who needed support and the value that their experience and understanding can bring to Services. This can be transferred across settings and consolidates the belief that people are the real experts in their care.
I hope you have found this selection of learning experiences interesting and am happy to be contacted for any further information. I would hope to share additional experiences in a future Blog, including time with the Patient Voices Network and learning from the BC Quality Council around culture change. I would like to thank everyone involved in the Study Trip for such great hospitality and willingness to share. Vancouver is a beautiful, friendly city and I hope to return.
Alison McKean, AHP Post Diagnostic Lead, Alzheimer Scotland