At the end of this 90 minute session patient/ family/ advisors/ champions as well as health providers/ leaders/ authorities will leave with at least one practical idea to apply to patient advisor training as a result of their increased understanding of: Current training programs and models in use across Canada Training needs of patient advisors at different system levels Gaps in training needs and ideas on how to fill them Available supporting resources and leading practices

1. Patient Advisor Training:
Now and Next
August 25, 2016

2. Welcome
Canadian Patient Safety Institute
Ioana Popescu,
Patient Safety Improvement Lead

3. Participants

4. Bernie Weinstein
Moderator
KT Working Group Member, Patients for Patient Safety Canada
Patient Advisor Jewish General Hospital

5. Objective
Leave with at least one practical idea to apply to
patient advisor training as a result of increased
understanding of:
- Current training programs and models
- Training needs of patient advisors at different system
levels
- Gaps in training needs and ideas on how to fill them
- Available supporting resources and leading practices

6. Agenda
Patients for Patient Safety Canada Sharon
BC – Patient Voices Network Carol
AB – Alberta Health Services Ioana
Q&A
SK – PFCC Guiding Coalition Tamara, Laura
ON – Erie St. Clair Community Care Access Centre Kelley
Q&A
QC – Universite de Montreal Nicolas
Atlantic – Horizon Health Julia
Q&A

7. Your Questions
From Advisors and Staff via registration form:
- How can we improve safety and reduce risks (through
patients advisors as partners)?
- To become a more effective Advisor (thereby benefitting
my province; my community – Renal patients).
- What is the state of advisors training and who provides it?
- Is training geared to sector (e.g. primary care, public
health, long-term care, mental health), organization, type
of involvement, and/or type of advisors? If yes, how?
- What type of information do advisors need and how to
tailor it to the role or system level?

8. Sharon Nettleton
Co-Chair, Patients for Patient Safety Canada

9. PFPSC
• About Patients for Patient Safety Canada (PFPSC)
• Patient-led program of the Canadian Patient Safety
Institute
• Canadian arm of the World Health Organization
Patients for Patient Safety Network
• Since 2006
• Examples of collaborations
• Orientation of our Patient Champions
• By PFPSC for PFPSC
• Peer to peer
• Ongoing, on demand, tailored

10. Carol Stathers
Engagement Leader, BC Patient Safety & Quality Council
Patient and Public Engagement Team

11. Patient Voices Network
Patient Volunteer Orientation
Carol Stathers
Engagement Leader
Patient and Public Engagement
BC Patient Safety & Quality Council
cstathers@bcpsqc.ca

12. Patient Voices Network
Community of BC Patients,
families, caregivers, and friends
collaborating
with Health Care Partners to
improve
health system

13. PVN Orientation– It’s ongoing!
Pre-
Orientation
Orientation
Support
Education

14. Intake Process:
• Overview of Network
• Volunteers Experience
• Questions…
Pre-
Orientation

15. Format:
• Small Groups
• Webinar
Orientation

16. Orientation
Overview and History:
 Patient Voices Network
 BC Health Care System Overview
 Role of the Health Care Partner
 Resources

17. Orientation
Public Participation:
 Principles
 Spectrum of Engagement
 Examples

18. Orientation
PVN 5 Step Process:

19. Orientation
Volunteer Roles and Responsibilities:
 Volunteer Agreement
 Partnering for Quality Principles
 Privacy/Confidentiality
 Introducing yourself and PVN

20. • Sharing
• NetworkingSupport

21. • Newsletters, Website, Blogs
• Skill Building Webinars
Education

22. Questions & Thank You!
cstathers@bcpsqc.ca
778.516.3308

23. Alberta Health Services:
Engagement & Patient Experience Department
Jennifer Reese Deanna Picklyk

24. Overview:
• Our department supports 2 provincial groups of Patient & Family
Advisors
• Provincial Patient and Family Advisory Group - 30 + Patient & Family
Advisors
• Provincial Strategic Clinical Networks – 85+ Patient & Family Advisors
Orientation for Patient and Family Advisors
with these 2 Groups :
• Currently hold orientations twice per year (or more as needed)
• Approximately 6-8 hours in length
• Typically Co-Led orientations (Engagement Staff members and a more
experienced Patient Advisor)
• These advisors are also onboarded as a volunteer and given a general
orientation by volunteer services

25. Essential Elements of our Orientation:
• Overview of AHS and provincial lens
• Roles of an advisor
• Review of available Resources
• Discussion about decision making, making contributions
• Policies, Expenses, Code of conduct , confidentiality pieces
• Role of the staff liaison
• Storytelling workshop – how to tell your story with impact
• Reviewing the difference between “advisory role” and “advocacy role”

26. Where are we hoping to go from here?
• Fall 2016 will be starting to develop an broader orientation
curriculum for all patient and family advisors in the organization
(500+ and growing)
• Will be a sequential orientation program, tailored to different
levels of involvement (i.e. ad hoc, more formal advisory roles)
• Anticipate that this will be a combination of online and in-person
training
• Looking at obtaining access for advisors into AHS educational
opportunities where it makes sense for all to have that training
education.

27. If there are questions around this information
please connect with:
Jennifer Rees, Lead Engagement and Patient
Experience 780-735-0332 or at jennifer.rees@ahs.ca

28. Discussion

29. Saskatchewan – PFCC Guiding Coalition
Tamara Quine
PFCC Specialist, Regina Qu'Appelle
Regional Health Authority
Laura Marshall
PFCC Co-lead; Prince Albert
Parkland Health Region

30. Provincial PFA Orientation Presentation
 Participant Introductions
 4 Pillars of PFCC
 PFCC Best Practices
 Who is a Patient & Family
Advisor (PFA)?
 What is a PFAC?
 Opportunities for PFAs
 Skills & Tips for success
 Honoraria
 Next steps…

31. Supporting Resources
Onboarding Checklist PFA Handbook

32. Facilitator’s Guideline
Orientation
Evaluation

33. Feedback & Next Steps…
Tamara Quine
Regina Qu’Appelle
Health Region
Ph: (306) 766-0792
tamara.quine@rqhealth.c
a
Laura Marshall
Prince Albert Parkland
Health Region
Ph: (306)765-6628
lmarshall@paphr.sk.ca

34. Kelly Robertson
Senior Director, Patient & Family Centred Care and Chief of Professional
Practice; Erie St. Clair Community Care Access Centre

35. Patient Advisors:
Onboarding to Empower!
Kelley Robertson
Senior Director, Patient & Family Centred Care
and Chief of Professional Practice

36. About CCACs
• There are 14 Community Care Access
Centres (CCACs) across the province.
• Each is funded and legislated by the
Ontario Ministry of Health and Long
Term Care through the Local Health
Integration Network.
• Erie St. Clair CCAC covers Windsor-Essex,
Chatham-Kent and Sarnia-Lambton,
providing services to over 38,000
patients annually.
• Anyone can make a referral or call for
information about CCAC services.

37. What is the selection criteria for
our Patient Advisors (PAs)?
• A patient or family member of our CCAC within the last 5 years
• We look for diversity of culture, religion, socio-economics, age
and family structure
• Ability to work with a group and accept all ideas
• A willingness to share their personal story in an effort to
improve the healthcare services for others

38. How do we onboard our
volunteers?
1. Application (on-line or on paper) * verbal interviews completed if accommodation is required
2. Face to face interview
3. Reference checks (x2)
4. Criminal reference check
5. Orientation customized to the Patient Advisor, and identification is issued
Legislated components of
orientation:
• Confidentiality
• Accessibility for Ontarians with Disabilities
Act (AODA)
• Respect in the Workplace (Bill 168), and
code of conduct within our organization
• Health and Safety
Non-legislated components of orientation:
• CCAC 101, mission, vision and values
• Strategic plan
• Responsibilities and expectations of a PA
• Tips for being an engaged advisor
• Training on how to tell your patient story
* originally created by Delnor-Community Hospital, Geneva, Illinois
• Working with advisors to improve the
quality and safety of healthcare
• Better Together pledge *Institute for Patient and
Family Centered Care

39. We ensure the voice of the patient
is present in all departments!
Human Resources
• PAs complete a telephone pre-screening for all new applicants @ our CCAC
• PAs attend the face-to-face interviews
• PAs present assist with the orientation of all new staff, regardless of the department
Corporate Services
• PAs are members of our monthly ‘All Service Provider Meetings’ and various working
groups/committees that focus on the utilization of our resources e.g. supplies, auditing, site
visits, etc.
Technology/IT
• PAs are members of all project groups when we are introducing new technology that will
affect patients
Other examples:
• Professional Practice Council, Chronic Disease Management Council, Accessibility for
Ontarians with Disabilities Act (AODA) Working Group, French Language Services Committee,
and various quality project groups related to our Quality Improvement Plans
• We review our incident reports with our PAs each month to assist in solutions to further
improve the quality of the care we provide.

40. Supporting PAs:
Results:
• Better care plans – information sharing, better workflow, improved job satisfaction
• Higher patient satisfaction scores- ESC CCAC has the highest patient satisfaction scores
across the province, and we have improved our performance by 2% since the introduction
of PFCC at the ESC CCAC
• Increased involvement of patients/families in operations as our staff are engaged in
problem solving discussions with our Patient Advisors
• Reduced patient risk as we advance the quality and safety of our care through partnership
A change in our attitude and approach!
 The agenda and meeting notes for the are provided to the PA one week in advance
 If it is their first meeting with the group, a copy of the previous meeting notes are
provided
 PAs are always assigned to committee work in pairs. We want to ensure the PA does not
feel like they are the lone voice at the table
 We train our employees about the role of the PA, and to respect each PA’s unique
perspective on the care they (or their loved one) received
 We have frequent engagement with the PAs to ensure they are well supported in their
volunteer activities

41. Contact Us
We will engage with our community to learn
from the patient experience and deliver patient
& family centered care
*Erie St. Clair CCAC Strategic Plan, 2014-2017
We are pleased to share any of our material we have developed, so you
don’t have to re-invent the wheel!
Kelley.Robertson@esc.ccac-ont.ca
1-888-447-4468 ext. 7247

42. Discussion

43. Nicolas Fernandez
Assistant Professor; Center for Applied Pedagogy in the Health
Sciences, Faculty of Medicine, Université de Montréal

44. Engaging Patients in Health
Research
Nicolas Fernandez, PhD

45. Response to a question received at
registration
• Looking for resources to help develop a
patient partners in research curriculum to
train patients to be able to make
knowledgeable and meaningful contributions
to research design.

46. Partners in Care

47. Evolving Patient Engagement in Health
Research
Participant
Collaborator
Co-
researcher
• Clinical trial
• Focus group/ interview
• Patient recruitment
• Focus group/ interview
facilitator
• Study coordinator
• Protocol design
• Data analysis
• Knowledge translation

48. Patient engagement in Research
Domecq, J. P., et al. (2014). "Patient engagement in research: a systematic review." BMC Health Services Research 14(89): 1-9.

49. Emerging Patient Researcher Role
Marlett, et al. (2015).
Building new roles and
relationships in research: a
model of patient
engagement research
Quality of Life Research, 24:
1057-1067.

50. Partnership
Tacit knowledge about living
with the disease
Scientific knowledge about the
disease

51. The Cornerstone
Experience of living with an illness can
lead to meaningful learning that can be
used to understand the disease better
Dewey, J. (1938). Experience and Education
Patients’
Experiential
Knowledge

52. Patients’ Experiential Knowledge
• Patients are keen observers of the illness they
live with
• Patients use a unique language to translate
their knowledge
• Experiential knowledge is non-linear and
subjective
• Experiential knowledge resonates with other
patients

53. LEVEL OF
INVOLVEMENT
LEVEL OF ARTICULATION OF EXPERIENTIAL KNOWLEDGE Acceptance
Reflexivity
Working together
Ressource Patient
Patient Trainer
Patient Researcher
Leveraging Experiential Learning
Pp
PpPatient Partner

54. Learning to work together
Knowledge is hidden Knowledge is created
Knowledge is hoarded Knowledge is shared
Tuckman’s small-group development model, 1965

55. Main Findings
• Involve Early to leverage data on what it’s like to live with the illness
• Involve Deeply: Incorporate patient perceptions into decision-making
and issue resolution
• Have patients provide feedback on project progress
• Include patients in dissemination; good at judging relevance and tone of
message
• Patient stories provide powerful inspiration – remind research why they
do what they do.

56. 2015

57. The Foundational Curriculum for
Patient-Oriented Research
Three modules :
1. Patient Oriented Research
2. Fundamentals of Health Research in Canada
3. Building Partnerships and Consolidating Teams
• Workshop March 2015: patients, researchers,
clinicians, and other citizen and patient
engagement experts
• Train the trainer and roll-out week of
September 13th 2016

58. nicolas.fernandez@umontreal.ca

59. Julia Brooks
Manager, Volunteer Resources; Horizon Health, Saint John, NB

60. Patient and Family Centred Care

61. Horizon Health Network
• Largest Health Network in
Atlantic Canada
• Over 13,000 staff, 1000
physicians and 3000
volunteers
• Over 100 facilities, clinics &
offices providing medical
services ranging from acute
care to community based
health services.
• 20 Foundations and 19
Auxiliary and Alumnae

62. What is Patient Family Centred Care
Patient and Family Centred Care at Horizon
Health Network is healthcare based on a
partnership among practitioners, patients’ and
families (when appropriate). It is our goal to
ensure decisions respect patients’ needs,
values and preferences. Its outcome provides
patients with information, knowledge and
support to participate in their care as they
choose.

63. How did we begin?
• January 2014 Visit to Kingston General
Hospital
• Feb 2014 design of the recruitment
handbook and brochure
• March 2014 first recruitment notice to
public
• April 2014 first council meeting

64. Program development
• PFCC is under the umbrella of
Volunteer Resources and follows the
same process as HR and Volunteer
Resources for onboarding
• Application, References, Criminal
Check, Horizon Orientation, Patient
Experience Advisor training

65. First Pilot - Moncton
• 2 Patient Experience Advisors were
asked to support the way finding in the
new ambulatory clinic.
• They provided simple solutions to the
identified problems

66. Ideas and Solutions Forums
• The CEO, VP of Quality and RD of
Volunteer resources conducted public
engagement sessions in all the major
centres within Horizon. Members of the
public were invited to attend open
sessions and to address 5 questions
about healthcare in NB.

67. Staff engagement tool kit
• This document helps prepare
committees and teams on how to
welcome patients and family members
to be an equal partner/member.
• It also lays out the plan for how to
properly prepare the Patient Advisors
for their meetings and participation.

68. Advisors and Committees
• We currently have 54 Patient
Experience Advisors.
• There are 43 teams or committees who
have one or more PEAs embedded in
their programs.
• We have held 12 focus groups using
our PEAs

69. PFCC Advisory Council
Members

70. What has been accomplished
so far
• Dress Code/ ID Policy
• Family Presence Policy
• Patient Rights and Responsibility's
Document
• Smoke Free Policy
• Pet Visitation Policy

71. • Proactive Patient Rounding
• Patient communication white boards
• Patient Experience Advisor Evaluation
• Complimentary Therapy Policy
• Our first PEA education conference
• In November of 2016 we will host
Horizon’s First National Patient and
Family Centred Care Conference.

72. Where to from here?
• Our council is nearing the end of their
three year strategic plan.
• We will be preparing for our 2018
Accreditation and recruiting new PEAs
to serve on several other committees
and working teams throughout the
organization

73. Who to contact for more information
Elizabeth Cormier
Regional Director Volunteer Resources, Auxiliary, Alumnae
Relations and Liaison Patient and Family Centred Care
Saint John Regional Hospital
PO Box 2100,
Saint John, NB, E2L 4L2
506-648-6523

74. Discussion

75. Resources
- Patient safety 101: The​ basics. Dr. Ward Flemons
- http://www.gowebcasting.com/conferences/2015/10/28/canada-s-forum-on-patient-
safety-and-quality-improvement/day/2
- European Patient Ambassador Program
- http://www.europeanlung.org/en/projects-and-research/projects/european-patient-
ambassador-programme-(epap)/home
- Rare Diseases Europe
- http://www.eurordis.org/training-resources
- Coursera – free online courses:
- University of Florida: https://www.coursera.org/learn/fixing-healthcare
- The George Washington University: https://www.coursera.org/learn/quality-healthcare
- Canadian Patient Engagement Network
- Participate through LinkedIn and/or Facebook.
- HealthCareCAN - Patient-Centred Experience & Design Program
- http://www.healthcarecan.ca/learning/courses/patient-centred-experience-design-
program-paced/

76. Wrap up

77. Evaluation
Next steps

78. Thank You
patients@cpsi-icsp.ca
Mulţumesc
Dhanyaawaad
Asante
Shukria