N.B. hospitals hope to learn from Kingston turnaround
Kingston General Hospital changed dramatically when it started putting the focus on patients
Hospital decision-makers in New Brunswick are looking to a Kingston, Ont., hospital for help in improving hospital care in the province.
Leslee Thompson, the president and chief executive officer of the Kingston General Hospital, is meeting with hospital managers from Horizon Health Network on Thursday to tell them of the Kingston experience.
In the span of a few years, Thompson's hospital went from having one of the worst reputations to having one of the best.
Thompson said she and her staff began listening to patients — the same sort of patient-focused care that Horizon Health would like to foster in its hospitals.
When Thompson arrived at the Kingston General Hospital in 2009, it had one of the worst infection rates, high staff absenteeism and a deficit of $24 million. The community let her know they weren't pleased with the hospital.
"A woman said to me, `Leslee, I'm afraid to go to your hospital,'" said Thompson. "And she said that in a very public forum. And that was very difficult to hear."
There were accounts of immobile patients being left with full bedpans, infections transferred by health staff who didn't wash their hands when they moved from room to room, and long waiting times.
Instead of simply taking complaints, Thompson said the hospital decided to recruit the complainers for input on how to improve. The patients went from being `complainers' to being `patient experience advisers.'
What has surprised me the most is that we've gone centuries without ever doing this.- Daryl Bell, Patient and Family-Centered Care
Angela Morin started keeping a binder to track her observations in the hospital because she was appalled at the medical morass of appointment times, charts and schedules that her sick friend was expected to negotiate. Morin's friend didn't beat her cancer, but the type of binder Morin went on to help create is now available to all cancer patients at the Kingston hospital.
"When I first started this I said, 'I can't hold everybody's hand, I've held Bonnie's hand through this, I can't do that for everyone,'' said Morin.
"This is my way of doing that. So when I see that, it's like holding a hand, right?"
Some of the changes suggested by volunteer advisers are small, like having name tags reprinted with bold lettering and two-sided, so patients know who is serving them. Hand-washing compliance reminders are now posted in each unit and have caused a dramatic improvement in infection rates. Patient experience advisers sit on hiring boards for staff that impact on patient care.
Daryl Bell leads the hospital's Patient and Family-Centered Care department. "What has surprised me the most is that we've gone centuries without ever doing this," he said.
He says initially it was a hard sell to get hospital committees to take advisers, but that changed.
"I was having to push it," he said. "Within a year people were coming to me saying, 'We've got to have an adviser on this.'"
Advisers now sit on more than 200 committees at the Kingston hospital.
Exporting the Kingston model
Word is growing about the hospital's successes, as demonstrated by Thompson's appearance before the board of New Brunswick's largest health authority.
"At the heart of the change is really shifting from the 'doing for', and 'doing to' mentality, to a 'doing with,'" said Thompson. "And once you start looking at how you work and what you do, through that lens, everything changes.
Horizon Health Network President John McGarry has been meeting with Thompson since May. McGarry said Thompson's presentation to the Horizon board on Thursday went well and the board wants to "get going" on making changes.
But McGarry said that doesn't necessarily mean wholesale adoption of the Kingston model.
"Every organization is different and you have to go at it at your own speed and with your own intensity," said McGarry. "We'll have to go slowly. We need to listen before we come out with ideas."
"If we are going to be patient-focused we need to talk to some of these people some more before we come up with some solutions that we think might work."