Engaging Patient Partners to Enhance Collaborative Competencies

1. 2019 Perspectives Symposium
January 31, 2019
#TSINPerspectives2019

2. Sylvia Langlois
University Of Toronto
Engaging Patient Partners to
Enhance Collaborative
Competencies

4. In health care professionalism is situated in a
relational context

5. Relationship-Centred Care Framework
Dimensions
Clinician
Patient
PractitionerCommunity
Self

6. Competencies
A competency is defined as the knowledge, skill, ability and judgment
required for safe and ethical … practice.
(College of Nurses of Ontario, 2014)

7. Interprofessional Collaborative Practice
• Interprofessional collaboration is the process of developing and
maintaining effective interprofessional working relationships with
learners, practitioners, patients/clients/ families and communities to
enable optimal health outcomes. Elements of collaboration include
respect, trust, shared decision making, and partnerships.

8. Canadian Interprofessional Health
Collaborative
Interprofessional
Conflict Resolution
Collaborative
Leadership
Role Clarification
Team
Functioning
Patient/Client/Family-
Centred Care
Interprofessional
Communication

9. Professionalism
Accountability
Patient Sensitivity
Ethics
Excellence
Respect
Altruism
Interprofessionalism
Role clarification
Conflict resolution
Team functioning
Collaborative leadership
Interprofessional communication
Patient-centred care

11. Examples of Patient Engagement
• Hospitals
• Policy
• Research
• Education

12. Hospitals
• Kingston General Hospital
• Sunnybrook Health Sciences Centre
• Become a Patient and Family Partner
• Help improve the meal experience
• Help train medical students
• Participate in a large-scale mass casualty tabletop exercise

13. Policy
• New Accreditation Canada standards require patient engagement in
governance, leadership, and service delivery
• Patient Safety (e.g. Canadian Patient Safety Institute, Health Quality
Ontario)
• Safety
• Patient/Family-Centred Care
• Coordination of care
• Equity
• Health outcomes
• Effectiveness and appropriateness
• Efficiency

14. Research
• Canadian Institutes for Health Research
• Strategy for Patient-Oriented Research
• Patient experts
• Increased quality
• Accountable and transparent investments
• New and relevant research themes

15. Education
• Uni-professional education
• Sharing of stories and impact of condition(s)
• Simulation (assessment)
• Co-teaching
• Curriculum committee input
• Interprofessional education
• Advising and developing curriculum
• Co-creation of curriculum
• Teaching and facilitation
• Advancing notion of partnerships with health care providers and teams

16. Education: What We Have Learned about
Patient Engagement
• Health Mentor Program
• Ethics and Professionalism
• Selecting client autonomy as a crucial consideration in the provision of optimal client
care
• Recognizing and appreciating ethical complexity as an inevitable reality of the clinical
practice setting
• Identifying qualities of remarkable clinicians to inform personal ideals for future practice

17. • Health Mentor Program
• Patient Safety
• Patient partnerships as critical to optimal care
• Consideration of a variety of safety issues
• Importance of advocacy in promoting safety
• Improvement of future practice enabled through patient perspectives on clinical error
• Embracing interprofessional communication and collaboration

18. Student Response
“…as soon as I met my mentor and started to hear her story, I was
hooked. The program gave me the opportunity to learn more about
health professionals and our impacts on clients than any other area
of my education so far.”
Student Participant

19. Understanding Patient Partnerships in a Team
Context
• Developing insights through patient perspective
• acknowledging uniqueness of patient
• recognizing expertise of the patient
• understanding the impact of poor collaboration
• Promoting partnerships with patients
• acknowledging complexity of partnerships between healthcare team
members and patients
• recognizing strategies to promote communication
• encouraging shared decision-making.

20. • Advocating for the patient to be a team member
• enabling the patient for an empowered response
• collaborative advocacy
• Recognizing attitudes that promote therapeutic relationships
• recognition of one’s own limits
• curbing desensitization to suffering

21. Other Areas of Patient Engagement
Teaching: Patients as teachers
Assessment: Real patients as standardized patients
Classroom assessment
Program Evaluation

22. Conceptualization of Patient Engagement
• Democratic and Emancipatory
“Nothing about me without me”
Arnstein’s Ladder of Citizen
Participation

23. Relationship-Centred Care
Interprofessionalism
Patient Engagement
Examples: Hospitals
Patient Engagement:
Policy and Research
Patient
Engagement:
Education
Potential Patient
Engagement: Input
on Professionalism
(Collaborative
Competencies)

25. Potential in Considering Patient Engagement in
Issues of Collaborative Competency Development
• What can we learn from patients when addressing areas of
collaborative competencies as they relate to professionalism?

26. Potential in Considering Patient Engagement in
Issues of Collaborative Competency Development
• Are patients able to identify areas/behaviours related to collaborative
competencies?
• Are patients able to consider methods of addressing development or
remediation of such behaviours?
• What are the benefits of the clinician interacting with patients (non-
clinical scenario) to consider the impact of the behaviours?
• What aspects of behaviours demonstrated (if any) are best mitigated
by patients?

27. • Can the patient perspective play a role in fostering reflective practice
of clinicians?
• Can patients be involved in measuring the remediation process?
• Can patients be involved in providing feedback during the
remediation process?
• How would the general public respond to the engagement of patients
in the remediation of this aspect of professionalism?

28. Additional Questions
• What can we learn from best practices in other areas to advance
patient engagement in professional issues?
• What patient characteristics would be most beneficial to this
process?
• How do issues of representation affect the process of measuring and
remediating professionalism?
• What would the recruitment process look like?
• What training process will best support engagement in issues of
professionalism?

30. Resources
Centre for Interprofessional Education (University Health Network and
University of Toronto)
• Educating Health Professionals for Collaborative Practice (ehpic)
• Collaborative Change Leadership
• BOOST! (Building Optimal Outcomes from Successful Teamwork)
• Customized consultations